I have had a few patients who fit what is usually referred to as “bipolar disorder” – periods of mania followed by periods of depression – but very rarely. It is grossly over-diagnosed and in children? Rubbish! When the APA decided that there was a category called “autistic spectrum disorders” suddenly millions of children were so diagnosed making millions more patients. The DSM is not based on any real evidence but is useful for billing. After all, one won’t get paid without a billing code.