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The recent Hull University report, which suggested that antidepressant drugs were no more effective than placebos for mild depression, was greeted as a welcome antidote to the age of pills. Yet missing from the media debate was an awareness of a new and fundamental shift in our understanding of mood disorders. Many of those who wrote articles lamenting their experiences on Prozac and Seroxat are, in fact, still taking psychiatric pills—but mood stabilisers rather than antidepressants. They have simply traded in one diagnosis for another. Formerly depressed, they are now officially bipolar.
If trends in the original Prozac nation, the US, are anything to go by, bipolar disorder will be the next big mood disorder to hit Britain. All across the US, the chronically gloomy have been re-diagnosed as moody. If Woody Allen was neurotic in the 1970s, he would have been declared depressed in the 1980s and bipolar today (maybe he is). Even depression guru Andrew Solomon, who dissected gloom in his bestselling The Noonday Demon: An Atlas of Depression, revealed not long ago that he is bipolar.
First used in the 1960s and 1970s as a new name for classic manic depression, bipolar disorder has subsequently been broadened as a category to include a number of softer symptoms. The Diagnostic and Statistical Manual of Mental Disorders (DSM), the American “bible” of mood disorders, officially lists four kinds of bipolar disorder. Manic depression has been recast as bipolar I, for extreme swings between “episodes” of depression and exuberance that can careen into mania. The second kind listed in the DSM, bipolar II, is a harder-to-spot version in which patients seesaw between depression and milder ups or “hypomania,” meaning, literally, “beneath” mania. The third type of bipolar disorder, which is characterised by milder but equally disruptive ups and downs, is called “cyclothymia.” A fourth type, NOS (or “not otherwise specified”), covers conditions that don’t conform to any of these labels.
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