Thanks for posting the article. I have been a software engineer for 15 years who has been struggling with issues due to being bipolar (and undiagnosed until a year ago).

I've had a hard time accepting my diagnosis but have taken steps as of late to start moving forward with treatment.

The few people who have found out that I am bipolar (and who don't know me well) claim that I am making up my illness as I seem fine on the surface. I think certain people believe that I am not bipolar because I am a skilled engineer (obviously anyone with the ability to reason knows this makes no sense).

Certain family members have cut me off after the diagnosis as well.

The poor reactions I've had are forcing me to keep silent about my issues, so I'm glad to see other people coming out with theirs.

In the same way that ADHD is very much agreed to be over diagnosed, do you believe bipolar might also be over diagnosed? I have seen family members conditions worsen after treatment(which may just be a coincidence), or maybe the inadequacy and/or causation of treatment.

In my case, I feel as though my condition was under-diagnosed until I couldn't ignore it anymore. In retrospect I had episodes my entire adult life, but I was able to get through them and never really saw them as abnormal. Now I am to recognize them as part of the illness.

Probably like ADHD, lots of docs would suggest that bipolar is both over- and under-diagnosed. With the rise of the atypical antipsychotics, it became sort of a 'flavor of the month' diagnosis for folks with anxious depression, or treatment-resistant depression, or irritable depression, or depression with substance use disorders. On the other hand - it's still underdiagnosed as well, with one (older) survey suggesting ~1/3 of folks waited a decade or more for a correct diagnosis [0], and no reason to believe this has improved all that much.

[0] https://www.ncbi.nlm.nih.gov/pubmed/12633125

I think "borderline" is what is now the sweeping diagnosis for everything that can't be boxed properly to any of the available shelves, and that one might be overused more. When you know some true BPDs in real-life, it's not fun at all - cut wrists, irreversible body modifications, constant threats of suicide, used as a back-up when important plans fail, use of other people for validation, inability to hold consistent mental state etc. Bipolar comparing to that seems pretty benign even if it's terrible enough.

BPD is a really specific personality disorder with fairly clear characteristics. While personality orders in general are somewhat controversial, and notoriously difficult to treat, I’d be interested in seeing evidence of overdiagnosis.

Depression on its own can be crippling and lethal, so complicating it with an addictive, potentially reckless or even psychotic second state is a nightmare. Mania is often misunderstood as just elevated mood and high energy, but the reality is more often of the “running up crushing debt, promiscuous and dangerous sexual activity” flavor than “spent all week coding a masterpiece.”

In extremes mania leads to a psychotic break to the point of being difficult to distinguish (even in a clinical setting) from schizophrenia. I knew a lovely guy who worked on motorcycles for Harley, and he was always troubled, classically bipolar, but refused to get help because he loved the highs. Then one day I got a call from his wife that he had spent three days “talking to Jesus and the devil” and pleading the case for his soul. He had to be committed for observation, which turned into weeks and then months of inpatient care. Bipolar disorder really is no joke, and the tendency for people with the disorder to struggle with substance abuse doesn’t help. “Dual diagnosis” is a phrase that portends a world of trouble, especially if you’re not wealthy enough to avoid various aspects of the system.

The last point is that BPD typically improves with age, while bipolar disorder typically becomes worse.

> In extremes mania leads to a psychotic break to the point of being difficult to distinguish (even in a clinical setting) from schizophrenia.

If you read some of my other posts on this page this is exactly my frustration with the current diagnosis. People who should be diagnosed with borderline Schizophrenia(hallucinations and/or voices) are being bundled with those that simply are getting angry.

I agree with everything you said except honestly believe the medications are what are causing the issues in many cases. My concern is that kids are being diagnosed with a chronic condition, and then being treated like ADHD. My favorite fun fact is that people treated with placebo in a NIMH study were less likely to be rehospitalized then those treated with actual medication[1]. Many of the most popular medications(Zyprexa & Sequel) cause insomnia and in extreme situations psychosis. The NIMH completely threw out the study deciding that recommending placebo was completely illogical.

[1]: http://psychrights.org/research/digest/chronicity/Neurolepti...

I think Daniel would know more about this - I'll see if he has a comment.

Agreed to be over-diagnosed by who? (genuinely curious)

Many top psychologists have come out suggested ADHD is overdiagnosised. The are numerous articles about the explosion of diagnosis[1].

[1]: http://www.psychologytoday.com/us/blog/saving-normal/201605/...

According to the experts at Stanford at least 25% of people diagnosed with ADHD/ADD are actually misdiagnosed Narcoleptics. Anyone diagnosed with ADHD/ADD could easily rule this out with a simple sleep study. https://www.psychologytoday.com/us/blog/sleep-newzzz/201305/...

But that's because psychology is generally anti-diagnosis, and because psychology rejects diagnosis.

bipolar is under diagnosed 70% of people with bipolar disorder get never diagnosed or misdiagnosed as depressive.

It is both over and under diagnosed just like ADHD.

Hi, I have a few questions I would like to ask off-thread. My email listed.

I will send you an email