Does Bipolar Really Exist?

In the weeks running up to Christmas there was a series which I recorded called "Bedlam". That is of course the old name for the asylum at the Maudsley back when we locked up and mocked the mad. I accidentally deleted the 1st episode but last night managed to sit down and watch the next part on crisis care in an inpatient unit. All familiar fare to me both personally and professionally.

Once again as so often happens when I watch such programmes I came away with more questions than answers. That is usually the way with me. Does mental illness exist? And more pertinent to that episode does bipolar exist?

A man they filmed in some depth called Dominic went in with a diagnosis of bipolar, and after his 3rd admission in a few weeks came out with a diagnosis of personality disorder. At the stroke of a pen a psychiatrist had changed his life. I doubt Dominic really understood the enormity of what had just happened. He will learn unless he is extremely lucky and gets a therapist who is good.

Yes, bipolar gets drugs, PD gets therapy. But what is the difference? The symptoms are almost exactly the same. The outcomes are poor for the latter, perhaps less so for the former. In reality if in doubt call it PD. I have met many students who come with both diagnoses. Yet I do not believe they can co-exist. So who is right? What is right? Do either actually exist? I do not know the answer to those questions.

What I do know having learned from bitter experience that it is far better to be called bipolar than PD. The world will take one seriously then. With PD one is pretty much fucked.

When I was in the System they kept telling me pills would not work and therapy was what I needed. Therapy never gave me anything. Risperidone saved my life. So all the high, mighty and powerful, be careful what you diagnose. The consequences if you are wrong do not need explaining. I do that in "A Pillar of Impotence". A number of people both professionals and services users alike firmly believe that all practitioners should read it. That will never happen as I'm just too unimportant to get that sort of exposure.

I Heard a Voice.