I have been listening to a most interesting book called “Sway: the Irresistible Pull of Irrational Behavior.”
While talking about the many reasons why people make these kind of decisions he talks about the diagnosing of children with Bipolar Disorder. There was a tremendous rise in the diagnosis from 1993 to 2003. In 1993 there were 20,000 diagnosed with the problem and in 2003 there were 800,000. What happened?
To diagnose it before 1980 most doctors were expected to see someone admitted to the hospital with a manic episode . The DMS III guide updated in 1980 added less severe symptoms for a diagnosis of bipolar disorder. The new criteria includes feeling sad, tearful, fatigued, having insomnia, indecision, more talkative, distratibility, and inflated self esteem. Symptoms that are not uncommon in teens.
At the same time pharmaceutical companies were developing medications they wanted to sell that could be used for this diagnosis.
(He talks about the other reasons we might have seen a rise such as more people seeing a psychologist or psychiatrist and several other reasons that he is able to discard.)
His conclusion for the rise comes under the idea of diagnosis bias. First off the symptoms could be found in most teens and secondly the pharma companies were pushing for drug use.
Whether Ori and Rom Brafman (the authors) are right or not it is an interesting idea. It does make you wonder how many individuals were and are receiving diagnoses because of diagnosis bias. I am not as familiar with the idea in mental health care but I have certainly seen it work with physical symptoms.
There is no easy way to know if a mental illness diagnosis is correct. We certainly understand that once the person is labeled it would be difficult to erase it. As I have said before my physician was hesitant to use the diagnosis of anxiety for me due to the stigma attached. We want no stigma attached to a mental health diagnosis. Doctors also need to be careful about coming up with the right diagnosis.
We all need to rid ourselves of our own bias regarding labeling of any kind and work to reduce labeling due to mental health issues.
Here are some reasons why irrational decisions are made. Not just regarding bipolar disorder but any decision.
I am enjoying this book which goes into many different ways that irrational decisions are made in a wide spectrum of places. A good read.
2 thoughts on “Why that decision?”
Great post! One of the biggest fallacies I think there is surrounds the issue of treating mental conditions with medications. You will often hear doctors, psychologists, and psychiatrists say that the person has a chemical imbalance and therefore prescribe some medication. Yet, to my knowledge, no one has ever documented what is out of balance chemically – which brain chemicals, which neurotransmitters? What are the normal circulating brain volumes of these chemicals? Without that information, how can one claim there is an imbalance that requires treatment. Great emphasis has been placed on serotonin re-uptake inhibitors, yet no one can tell me what a normal brain concentration of serotonin is, and not so surprising LSD is an SSRI too. Big Pharma is definitely a drug pusher, and they pay docs to push their drugs.
Absolutely true. And I love the term “diagnosis bias.” This is a great book!
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