Thanks for an interesting and impassioned comment. Your rudeness serves only to undermine your position. The behavior known as bipolar does indeed exist. But as I’ve stated in the above post, it is more accurately conceptualized as rudeness and irresponsibility than as a medical illness. Your comment would seem to support my position. If you’d like to have some serious dialogue, please come back, but without the vituperation and invective.

First, my apologies for the delay in approving your comment. It’s been a long week!

Thanks for your very interesting comment. Because I do not know you personally, it would not be appropriate for me to comment directly on your situation. What I can do, however, is provide some general comments which you can mull over and decide if they have any relevance.

The decision to take or not take drugs is a personal one, on which I take no stand other than encouraging people to explore – in depth – the negative side effects. If you feel you need to take drugs to keep yourself on the straight and narrow, and that the side effects are worth it, then it is no part of my business to suggest otherwise.

It is clear from your comment that something went awry in your life last year, and that this resulted in your being committed to a mental hospital. In the mental hospital you were told that you had had a “manic episode” and that you needed to take pills, probably for life. You were probably told that the “manic episode” was caused by something going wrong in your brain, and was not triggered by anything going on in your life at that time. I would guess that no attempt was made to explore this aspect of the matter. In fact, I would guess that little attention was paid to your history in general.

Now it is clear from your comment that you have accepted the psychiatric formulation. What this means is that when you look back on and recount the incidents of last year, you are inevitably seeing them through the lens of pharmaceutical psychiatry. Now I’m not suggesting for a moment that you are fabricating or deliberately distorting this material. Your account of these matters rings very true. But when we are seeing things (especially past events) through a certain perspective, it is easy for that perspective to shape the images that we see.

If I were still a practicing psychologist and someone had come to me with the kind of presentation you describe, here are some of the issues I would have explored.

Firstly, I would try to establish a sequence of events. Did these unusual behaviors start up overnight, so to speak, or was there a period of gradual building-up? Secondly, I would ask about precipitating events. What keeps people on an even keel from day to day and from year to year is reinforcement. We do things and we get a pay-off. This applies to everything from getting up in the morning to going to bed at night. We do the things that pay off, and we stop doing the things that don’t. So I would explore what kind of pay-offs the individual was receiving prior to the episode in question, and in particular I would explore if there had been any significant losses of pay-offs in recent weeks/months. I would also try to determine what, if any, pay-offs were associated with the episode of dysfunctional behavior. Although dysfunctional behavior often involves negative consequences, there are often positive pay-offs as well. Attention is the obvious pay-off, but release from responsibilities, sympathy and solicitousness of others, diminished expectations, etc., are all potential candidates.

My general principle here, which is based on a wealth of research, is that when a person’s behavior changes in significant ways, it is usually because significant changes in reinforcement (pay-off) have occurred. This principle is very basic to an understanding of behavior, and I would look very carefully before abandoning this perspective and pursuing alternative hypotheses.

Your position, I believe, is that something went wrong in your brain. And, of course, this could be true. Brain injuries and malfunctions can have a serous effect on behavior. However, nobody, to the best of my knowledge, has specified what sort of malfunction would result in this kind of behavioral change. Also, when brains malfunction, the usual result, in my experience, is more chaotic and fragmented than your self-description. Admittedly, words like “chaotic” and “fragmented” have a subjective ring, but your description of your manic episode – indeed the descriptions I hear of all manic episodes – sound to me more like someone who, for some reason or another, has lost his anchors and is desperately casting around for new ones.

So we can agree to differ. If you would like to tell your story in more detail, click on the Tell Your Story tab at the top of this page.

Once again, thanks for coming in. If there are any points here that you would like to pick up and pursue further, please come back.

Best wishes.

However, toward the later stages I started to begin believing that I was chosen in some way, that I was perhaps the second coming of satan, or buddha, or what have you. And I’m an atheist, so why would I begin to develop grandiose thoughts like this? Because I wasn’t raised right?

Being in a “manic episode” was, for me, like being on a strong, internally-generated drug, and the high lasted for weeks. This wasn’t a “problem of living” or questionable parenting – from my perspective, looking back, I’m pretty sure there was something funky going on at a chemical level with my brain.

After being arrested (long story) and forcibly hospitalized for 72 hours, and taking their meds, all of my religious delusions began to evaporate. Which again, as an atheist, I ended up viewing as a good thing.

Bottom line – I don’t care how it’s labeled, but what happened to me was extremely powerful, strange, and disruptive. Do I like being known as a person with bipolar? No. Do I enjoy taking medication? Not really. But I can’t really afford to go through what I went through last year again. So if bowing down to the psych profession is part of the deal, then I’d rather make a deal with the devil than live under the mistaken impression that I’m him.

Thoughts?

Thanks for your interesting comment. Actually, I spent almost all of my career working in prisons, addiction units, and community mental health centers. Indeed, it is my first-hand knowledge of what the mainstream mental health system has done, and continues to do, to the people in its care that motivates me to keep writing. The history of psychiatry is a history of client abuse, and the current disease and drug-pushing model – despite its façade of apparent concern and helpfulness – is the most damaging and destructive chapter to date in psychiatry’s biography of shame.

My position – which I’ve stated clearly throughout the blog – is:

1. Almost all of the problems categorized in DSM are simply problems of living, which the APA has medicalized to falsely legitimize drug-pushing.

2. All of the so-called “symptoms” in the DSM criteria lists are behaviors, and are best conceptualized in terms of the well-known and well-researched principles of behavior acquisition.

3. The so-called diagnoses have no explanatory value, but are constantly presented to clients and to the public as if they did.

4. Feelings such as depression, elation, anxiety, fear, etc., are not illnesses, despite the massive PR efforts of the psychiatric-pharma industry to convince us otherwise.

Your suggestions that perhaps I have simply misunderstood the DSM, and that I lack first-hand experience, are particularly interesting, in that they suggest a kind of elitism that I’m sure was not your intention, but which is very common in mental health circles. This kind of elitism is understandable and occurs to some extent in all professional groups, but is particularly perverse in the mental health industry, in that it promotes a self-congratulatory smugness that militates against critical self-appraisal.

Essentially, it doesn’t matter whether I have experience or not. What matters is: Are the issues that I have raised valid? Have I missed some important fact? Have I stated something that is simply false? And you haven’t addressed these kinds of questions.

Once again, thanks for your comment. I am a great believer in dialogue and discussion, and I hope you will come back in more detail. You clearly believe that my analysis of the situation is faulty or deficient in some respect. Please spell this out.

Best wishes.

Firstly, sudden onset problems are a common feature of human existence. A great many of the mass shootings that have occurred in recent years would fall under this rubric. Similarly, temper tantrums are often described as having arisen “out of the blue.” And at the group level, prison riots have been known to occur at times when the facilities had seemed particularly peaceful.

Implicit in your question is the notion that if the problem arose suddenly, then it can’t be the product of deficient socialization during childhood. I don’t think this position is tenable. Consider the analogy of earthquakes. All reputable scientists today are in agreement that earthquakes are caused by the very slow gradual movement of the Earth’s tectonic plates. Yet the actual earthquake is a sudden, virtually unpredictable, event. Human beings are a great deal more complicated than tectonic plates, and in my view it is not only possible, but indeed likely, not only that sudden onset problems occur, but also that they might be causally related to the gradual processes of earlier learning.

Consider, for example, the case of a small boy whose parents indulge his every whim. He is raised to think of himself as a “prince.” He is not required to do chores or make sacrifices. All the good things of life come his way just for the asking. Then he goes out into the real world and encounters resistance, hardship, adversity, etc.. Now whilst it is not possible to predict the outcome of this encounter in individual cases, it is certainly easy to imagine that sudden onset problems might develop. But it is also easy to see that the problems didn’t really arise “out of the blue,” but were the likely outcome of the child-rearing policies of the parents.

The general question of small gradual changes over time resulting in a sudden major change is addressed in a mathematical system called catastrophe theory. This was developed around 1970 by Rene Thom (1923-2002), and was applied to social/psychological systems by Erik Christopher Zeeman (1925–) during the 70s and beyond.

Your question raises another implicit issue. And that is the quality of information. The mental health system is notoriously poor at gathering information. Almost all client information that enters the system is by self-report. So when a client tells a psychiatrist or other mental health worker that a problem arose “out of the blue,” there is a very strong tendency to believe him and to enter this “fact” as “data” for both clinical and research purposes. The reality, of course, might be quite different. With specific reference to the problem known as Bipolar Disorder, the presence of “mood swings” is generally considered definitive. This is typically assessed by an intake worker simply asking “do you have mood swings?” If the answer is yes, then a “diagnosis” of Bipolar Disorder is almost inevitable, though there is seldom any attempt made to elucidate exactly what the client meant when he said “yes” to this question. I have often explored this matter with clients, and in my experience, what they almost always had in mind when they said “yes” was the presence of frequent temper tantrums. Now in my view, temper tantrums are innate. I have seen very young babies develop extreme temper tantrums when their needs were not being met, and one of the great challenges of parenting is inculcating more moderate ways of dealing with the experience of frustration and of feeling attacked. The fact that society works as well as it does is tribute to parental success. But the fact that tragic outbursts of rage still occur quite frequently suggests that parents (or at least some parents) need more help/coaching. Within the mental health system, however, the only “help” given is a drug for the “patient.”

In writing the Bipolar post I was trying to show how the various “symptoms” are in fact behavioral problems stemming usually from some deficit in the child-rearing area. This is a sensitive topic. Most parents take their parenting responsibilities very seriously, and are sometimes irritated and even angry at the suggestion that their performance in this area was anything less than stellar. I think there is a great need in our society to lift this taboo, and to create more opportunities for parents to acknowledge their difficulties and deficits and to receive real help/support/coaching, etc.. I don’t believe that our present mental health system, dominated as it is by pharmaceutical and APA interests, is capable of providing this kind of help.

So, once again, thanks for your comment. I hope I have addressed your question adequately. If not, don’t hesitate to get back to me.

“This facet of the manic presentation then is best conceptualized as a deficit in training and socialization, rather than a symptom of a medical condition.”

And I wondered how this might fit with suddon onset symptoms? If, prior to the onset of the “manic episode” there were no problems with the “skills normally learned in childhood” – what then accounts for symptoms?

Curious as to your thoughts, and looking forward to your response!