Goodbye ADD, Hello Bipolar Disorder

Canada often lags behind the U.S. in some social trends, and it seems that we are just getting in on the latest fad of diagnosing children with bipolar disorder. I predict it will become our next ADHD. Many people suggest that this is because the drug companies have just released a new psychotropic drug to treat bipolar diagnoses, so suddenly the incidence rate will sky rocket. This happened with Ritalin and ADD/ADHD too.

Bipolar is a diagnosis on the DSM-V, which stands for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is a big resource book that is put out by the American Psychiatric Association and it contains a description of all the known psychological symptoms. The symptoms are grouped into syndromes and each is referred to as a “mental disorder.”

Most of my Adlerian colleagues would agree that the symptoms described are accurate, but grouping them together and calling them “mental disorders” is wrong. Instead, the Adlerian model takes a more holistic view and sees the expression of symptoms as being congruent with a person’s lifestyle, and the expression of symptoms something that reveals or reflects their beliefs or “private logic.”

Adler wrote that behaviors serve the person by some way moving the individual from their own subjective feeling of being in a “felt negative” position to a perceived “felt positive” state. Their symptoms are “helpful or useful” in some way to them, and so therapists work to help people discover the errors in their private logic that are creating life difficulties for them. That means therapy instead of pharmacology, or in some cases, a combination of the two.

Let me use the example of blushing to make my point. If someone is in a situation where they interpret the events through the lens of their belief system to be “embarrassing,” they blush. That means their cognitions trigger the release of body chemicals that cause vasodilation, and hence the blood vessels open and we see a “blush” appear on the cheeks. Body and mind work as a complex system that are interdependent. Our thoughts affect our biochemistry, and vice versa.

I believe it is too simplistic a solution (not to mention too toxic on the tissues of the body) to prescribe a vaso-constricting medication to eliminate blushing, when a more fruitful conversation could be had about why the person judged the situation to be embarrassing in the first place. Does this illustrate my point? Albeit with a silly, unrealistic example. (If someone you know is taking drugs for blushing, we need an intervention!)

Too often we diagnose a child as having a “mental disorder” and do nothing other than drug their brains. People assume a “mental disorder” means there is nothing that you can do yourself to help yourself or other members of your family. For parents, it may even come as a welcome idea that their child is “disordered” and therefore it wasn’t their faulty parenting. We owe our children more than this. We do live in an era that is very strongly oriented towards the medical model and psychopharmacological approach, but it is not the ONLY approach. Family therapists (Adlerian as well as other counseling models) want the public to know this.  The American Counselling Association and other national organizations were so upset with the changes to the latest edition of the DMS that they are abandoning it as a source and looking to the World Health Organizations diagnostic criteria instead.

If you have a child who is in the process of being diagnosed, please take the time to read Dr. William Glasser’s book Warning: Psychiatry Can Be Hazardous To Your Mental Health for a fuller discussion of this topic before you initiate a treatment plan.

 

Please note this post was originally published in 2007 and was recently updated to ensure accuracy.