Latest / Radically Genuine / 131. Manufacturing Bipolar Disorder
Transcript
- Welcome to the Radically Genuine podcast. I'm Dr. Roger McFillin. Sean, I feel like today is a public service announcement. Maybe a prolonged public service announcement, but a public service announcement nonetheless. The more you know. Shooting star. I'm really, really concerned about the mislabeling of reactions to adverse events and emotion dysregulation as bipolar disorder. I need to be more outspoken about this because I think we are creating indelible harm with way too many people as this is haphazardly being handed out quickly in outpatient offices, short-term psychiatric hospitals, and by some of our, unfortunately, our most unethical and limited physicians. You know, these very serious diagnoses are being widely applied to a large group of people. Unfortunately, I think it's more primarily female. Some people who are just interpersonally sensitive, artistic, and creative. So today is also a history lesson, just to provide some very critical information on how the prevalence of this diagnosis has dramatically increased in the post drug era. and how marketing propaganda from the pharmaceutical company has essentially created a market for drugs that are repackaged as mood stabilizing. But I want to ask you first, as a lay person who hasn't really worked in this field nor really examined the data to any great extent other than a previous podcast we did on it, when you hear the word bipolar just from popular culture exposure, what comes to mind? I would say in extreme, um, personality shift that maybe might not be appropriate for the moment or, you know, thinking of, uh, maybe if I were to go to bed at night, I'd fall asleep and then I'd hear noises downstairs and maybe my wife would be awake and she's downstairs focused on something, uh, at two o'clock, three o'clock in the morning that she can't go to sleep because she needs to get something done, like cleaning the kitchen. Sean (02:26.714) So like mania. Yeah, like I'm a manic episode. Yeah. Yep. And how's it portrayed from your opinion in like movies television popular culture? that it's almost like extreme and uncontrollable and If someone were to approach that person and have a conversation about you know, trying to settle down it usually is You know flies back in your face of you don't understand. I need to get this done that type of stuff Yeah, so like traditional as we'd see a manic episode would be a female generally female, you see that's a trait of popular culture. Men may be portrayed as more aggressive, but maybe assign a different label to it. So this hyperactive, decreased need for sleep, potentially even becoming a psychotic episode, poor judgment, very talkative, maybe making rash decisions. So that is kind of traditionally how we would view a manic episode. I wanna walk you down a little bit of a history lesson here. And you get some of this... information and data from journalists who are willing to kind of go back into hospital records and research and different errors. One of the, I think, most seminal books in this area is The Anatomy of Epidemic by Robert Whitaker. It's an outstanding book because of how thorough the research is. And just like Dr. Leland Stillman said on our podcast, we tend to kind of forget history. You know, we have to kind of re-remember things that we used to know. And I'm afraid that due to industrial misrepresentation of conditions and disorders to fit their bottom line, we forget how rare many of these mental health conditions are. So basically if you increase the prevalence rate of any condition, you're going to increase the amount of customers that you have for your drugs. So prior to 1955. bipolar disorder, which was known as manic depressive illness, which is I think when people think bipolar disorder, that's what they imagine, mania, depression, those extreme swings in mood. It was a rare disorder. How rare was it? Well, there were only 12,750 people hospitalized for that disorder in 1955. And there was a disability rate of only one in every 13,000 people. Sean (04:51.53) In addition, there were only about 2,400 first admissions for bipolar illness yearly in the country's mental hospitals. Outcomes were relatively strong as well. 75% or so of first-admission patients would recover within 12 months. Over the long-term, only 15% of all first-admission patients would become chronic Leo, and 70 to 80, 5% of patients would have good social outcomes, meaning they returned to their jobs, they lived independently, they got married. It really was an episodic condition that did not indicate a chronic course. In the pre-drug era, bipolar patients or manic depressive patients were usually asymptomatic between episodes. So you would have an episode. And then between those episodes, stability. 85% returned to their occupations. They showed no signs of long-term cognitive decline. So you just look at before 1970, for example, 1970, it's when lithium was approved for manic depressive illness. It just wasn't that prevalent of a condition. It happened, it needed to be managed. and it could cause real significant impairment, just no one knows why. No one knew why it would occur. We still don't really know why someone will become manic. We have ideas. There's certainly a good body of research that suggests that we're learning more and more about what could induce mania, but no one really knows why and why those people would present with those symptoms. So there's a label assigned to it, manic depressive illness, later bipolar one. disorder. Right now, there's an estimated 4.4% of US adults experience bipolar disorder at some time in their lives. Right? What does that mean? That translates to roughly 11 million adults, or one out of every 22. Oh, so we're finally getting the people the help that they need because in the previous years, they were just not getting diagnosed properly. Yeah, they were just running around on the streets, apparently. Sean (07:18.526) We've removed the stigma. Now they feel comfortable getting the help that they need. I mean, that's what you would hear. That's what you hear on the news. Yeah, I mean, that would that be an argument that one side would now it's absolutely ridiculous because people because people would be hospitalized. Yeah, yeah. Because it's a serious mental illness. Families would be seeking out the help and would it would be in the hospital, we'd have hospital records to support it, right? So let's just put that off the table. It's like comical. An estimated 82.9% of people with bipolar disorder experience serious impairment. A 2022 long-term prospective study found that about half of patients with type 1 or 2 bipolar disorder, and I'll talk a lot about type 2 bipolar disorder, suffer from persistent work disability that leads to disability pension. Today bipolar patients are much more symptomatic than they were in the past. Only one third returned to their usual occupations. And they become cognitively impaired over the long term. So they continue to worsen on multiple accounts. Which didn't happen in the past. Did not happen in the past, no evidence. The number of US people aged under 20 who received the diagnosis of bipolar disorder increased 40 fold from 1994 to 2003, 40 fold. Wow. Yep. That is from 25 in every 100,000 people in the population to a thousand and three per 100,000 and it doubled in adults over 20 years old. So do you think, um, that there are people were just spreading bipolar disease and you know, we didn't wear our masks and it became an epidemic? No, clearly not. we increased the prevalence, we diagnosed it more during this drug era. So I just wanna say these very important statistics again. Only 12,750 people hospitalized in 1955. One in every 13,000 people severely disabled due to that condition. Fast forward to the modern era. Sean (09:41.57) And we're talking about one out of every 22 people, 4.4% or 11 million adults experiencing bipolar symptoms, quote unquote. That is a dramatic and unrealistic statistical abnormality. Yep, it's not real, it's not true. And I'll make my case for it today. And I think people will understand how easy it is to achieve the diagnosis of bipolar disorder today. Is that 4.4%? Is that bipolar one and bipolar two combined? Symptoms. Okay, gotcha. Okay. And what's interesting is though, although historically bipolar disorder, manic depressive disorder wasn't considered chronic, right? Most people just have one episode. We don't know why they recover. You go to any popular websites, right? Like those WebMD types. And you try to do some. investigation on the chronicity of this disorder, how long it's going to last, what are the outcomes and I'll read this quote. At this time, there isn't a cure for bipolar disorder and it's considered a lifelong condition, but thankfully treatments are available to manage it. Those treatments I will talk about today. So what was once a rare condition is now widely applied. to any mood dysregulation. Let's talk about the factors that influence that. Well, you can't have this discussion without talking about the DSM. The DSM, obviously, as we've talked about pretty extensively on this podcast, creates what's called categorical diagnoses, okay? Symptom checklists. You either have it or you don't, which is not very... reliable or valid, especially given the spectrum of experiences that all humans will face and what is actually normal in response to reactions to stress or adverse events. So when you make something categorical, meaning you only have to meet this amount of symptoms to achieve the diagnosis, what's gonna happen is there are gonna be diagnostic inflation, okay? Sean (12:00.702) Many of these diagnoses overlap each other as well, meaning the symptoms of one condition are widely applied to many. This is invalid and unreliable. The inter-rater reliability is extremely poor, meaning the same behavioral presentation does not lead to the same diagnosis. You can go to five separate psychiatrists, get five separate diagnoses, and you start seeing these things lumped together. ADHD and bipolar too, you know, is the one that kind of explodes, that they just love to hand out for. any sense of mood dysregulation. It really is a crap shoot based on the biases of the person sitting in front of you. So the false confidence in these fabricated diagnoses, they're constructed diagnoses that certainly have financial influence. And these doctors communicated as if they're discreet and they're real to their patients. And this would be comical again, if not so tragic. The number of diagnoses has ballooned with each subsequent revision. And so it's just become nothing more than a manual for drug dealers. How do we know about the financial conflicts of interest? Well, this recently reported in the British medical journal, Lisa Cosgrove and her colleagues reported that 60% of the panel and task force members of the DSM-5-TR, the one that they're putting together now, received payments from the pharmaceutical industry. Collectively, 55 members had tied to the industry and received $14.2 million. It's a nice paycheck. Yes, it is. And so obviously right there, you know, it's a revelation of the biases and the conflicts of interest, right? They're hired by the pharmaceutical companies. And that's just for, you know, that's for all different types of work. They're paid spokesmen, many of them, for these drugs. Not to mention the DSM itself makes about 5 million per year for the American Psychiatric Association. That's why you have to have so many revisions. It's not like we have these scientific updates. So if you revise this every five to 10 years, right, then you can start selling the new one and you can create the revenue for it, okay. So. Sean (14:04.702) Number one, it's easy to obtain the diagnosis because of loosening criteria and lowering thresholds to achieve the diagnosis. And I wanna start with bipolar one disorder. Okay. So bipolar one disorder is the diagnosis that is most comparable to the traditional manic depressive illness. And I don't want to deny that condition doesn't exist. What I will say is we're not really good at understanding its cause and we're horrible at treating it. Right? So as I like to say with many psychiatric diagnoses, it's not like you develop mania because you have bipolar disorder. You develop mania because something else is happening. Could it be related to metabolic illness? Could it be related to blood sugar? Insulin resistance? Exposure to toxins? some genetic vulnerability in response to a stressful event, sleep deprivation. Drugs or alcohol. Drugs or alcohol, right? The spectrum of human responses to various environmental toxins, even pharmaceuticals, drugs, so forth, or stress leads to various reactions in certain people. So yes, certain people may be vulnerable to that. We just don't do a very good job of identifying who that is, why that is, or effective treatments to do so. Thankfully, I think we're starting to open up our understandings of why someone might experience such severe mood dysregulation based on physiological reasons. Some of the people who are doing that work, obviously, we've spoken to Georgia Ede, which is a podcast that's going to be coming out. Yep. And Christopher Palmer, author of brain energy, and what I'll talk about a little bit later, some other very innovative research. Even the, we just released Julia Brits with OCD, all the common things that could contribute to OCD, which I thought was really interesting. Yeah, if you don't investigate the underlying medical conditions that may lead to it, then you can just label something bipolar, communicate to the person that they would require these drugs for life, and it is a chronic condition, even though historically it doesn't demonstrate this, where I think it's evil. Sean (16:30.534) is when you're applying this to young people. When I mentioned those large increases, the 40-fold increase in diagnosis of bipolar disorder for young people, that coincided with a gentleman by the name of Joseph Biederman, who was hired by the pharmaceutical companies to promote this childhood bipolar disorder. Even though in the DSM, there's no identification of childhood bipolar disorder, and the course, when it does exist, a manic depressive illness in adulthood, kids who are emotionally dysregulated don't seem to anyway follow that same course. So there is no such thing as childhood bipolar disorder. That is certainly my public service announcement. Number one, don't let any quack tell you there's the existence of childhood bipolar disorder. All they're saying is your kid is very moody and has behavioral problems. That's it. Check, check, check. We'll talk about your son a little bit later. Although I think it's an interesting story if you want to If you want to tell that story, what you just mentioned to me before we jumped on the podcast, it's a little bit represent, it represents how the body and how behavior is influenced by what we put into our body. Sure. I mean, first off, my son is three years old, three years old, three and a half, but they diagnosed three year olds with bipolar, which is insanity. And any parent of a three year old would say that's insanity also. But we've had so many conversations about nutrition in here. And a number of people said how bad sugar is. We're just coming out of Eastern Easter basket, still raised up high. So we can't get it and we'll allow them to have a piece of candy a day, which is a lot, which is a lot. And it's become too consistent and that we have noticed a change in his. Aggressiveness, irritability, almost. He wants it all the time, which any three year old would want candy. So We have noticed that he can get aggressive later in the day and even at soccer practice, you know a little more assertive maybe Going after another kid that type of stuff. So we're pulling back on the sugar and We've noticed on the days when he does not have any sugar He's the sweet loving kid that we've had for the previous three years It wasn't until we started allowing him to have a little bit of treats every now and then that we saw the change of personality So we're pulling back now bit of an incident on the soccer field. I heard Sean (18:55.066) Just a normal three and a half year old tantrum in the middle of the field that, you know, I had to pull him off and make him sit on his ball and until he calmed himself down. And you see those significant differences from the food he eats on his behavior. So imagine if you have a kid who's like eating Cocoa Puffs and drinking Capri Suns. Yeah, I'll tell you what, the one thing my wife has done an excellent job of is cooking real food and he eats what we eat. And I'm really grateful for that. And maybe it's why he's having such a huge swing in personality when he gets a little bit of sugar. Imagine how many kids are being diagnosed ADHD and they're being fed. Those foods is never discussed. It's never evaluated. It's never even known. And now you're putting in sugars and seed oils and chemicals, and then you're prescribing them up. Stimulant. Yeah. Right. Sad. That is the reality of our healthcare system, folks. Absolute reality. And some of them are ingesting like red dyes and other things actually banned in other countries for creating these exact symptoms, not in the U S right. You don't think that's purposeful folks, right? So be careful. Be careful when you, when you give them those skittles or you give them anything that's, you know, has those dyes in it. It's poison, right? And so then the behavioral manifestation mimics what psychiatrists and pediatricians are going to call, you know, mood dysregulation, you know, ADHD, so easy to give the label now they're going to start you on the course of psychiatric drugs. So how easy is it to meet criteria right now for bipolar disorder? Well, bipolar one disorder is supposed to be that traditional manic followed by depressive illness, right? That's what we saw. That's going to drive the hospitalizations to disability. It's that mania, a distinct period of abnormally and persistently elevated, expansive or irritable mood. that's abnormal and it can be really problematic. So yes. For how long? This is the new criteria. This is the DSM-5 criteria. It has to last a week. This is for bipolar one. So one week, okay? Now listen, if someone is sleeping two hours in the process of starting a business in an area they have no expertise, giving away money, leaving their family, really impulsive actions that don't represent Sean (21:16.318) anything about their past. That's serious, right? And to me, you know, understanding mania in that context and in labeling them as having manic depressive illness or a bipolar condition because we have to stabilize that episode. That makes sense to me. That's grounded in some empirical and historical evidence. What I'm just saying is that it's rare. It's just historically rare. And the drugs that we're going to use to treat it, Really, they're about emergency medicine, about stabilizing that episode in the short term, not something that we have outcomes positively for long-term use of that. In fact, it's quite the opposite. And even in the short term, you don't know what the root cause is, which goes back to the things that we just spoke about. You're not targeting the root cause, you're just stabilizing an episode. Stabilizing temporarily, let's find out what caused this. Okay, now, here's my case for how easy it is to be diagnosed with mania. It's different than the past. It's different than manic depressive illness. You only need three or more of the symptoms, okay? Only three? Only three of these seven, okay, Sean? Three of these seven. Now remember, mania that creates psychosis certainly serious, okay? But you don't even need that to meet the criteria. So I'm gonna... I'm going to give you the seven symptoms and I'm going to choose three that I believe are going to be widely applied to anybody at different points in their life. Okay. So the first one is inflated self-esteem and grandiosity that I'm not saying is widely applied to everybody. That is something that can be representative of a manic episode, right? But inflated self-esteem and grandiosity be like, you know, listen, I'm I have godlike status. Okay. There's a difference between self-esteem. Right. And grandiosity. Right. Like... Was it and or? Or grandiosity? Yeah. And? Yep. I am going to become rich. You know, I'm going to start this company. I'm going to change the world. You have no background or evidence. Like things like that, they really stand out. And again, that would be indicative of a manic episode. Okay. However... Sean (23:36.898) just this idea of inflated self-esteem can get really misrepresented in a checklist and it can get misrepresented by the worst of clinicians because it's not really something that's constant. You know, we see this all the time. Sometimes people feel good for various things. Maybe they feel like they look good. Maybe they have higher energy because they're rested or eating good foods or exercising. So it's this inflated sense of like feeling good. That is normal. Some days we don't feel so great about ourselves. Other days we can feel better. Confidence isn't just some consistent presentation that exists, so that can get misrepresented. All right, number two is something that from a checklist standpoint now gets misrepresented as a reason for a past episode of mania. And that's decreased need for sleep, okay? It is quite normal for people to go through periods with a decreased need for sleep, right? Generally speaking, you might be excited about something, you might be working on a project that impassions you. Um, and maybe you only need six hours of sleep. Other times in your life, you need eight hours. Certainly not in itself evidence of a manic episode. However, somebody not sleeping much at all can induce a lot of problems. And yes, it's got to be understood in context. A lot of this stuff takes requires investigation. Okay. Number three, more talkative than usual or pressure to keep talking. Again, Everything's on a spectrum to what degree, to what extent, to what severity. So when you give someone a checklist, it's very easy for them to say, I'm more talkative than usual. Number four, flight of ideas or subjective experience that thoughts are racing. Flight of ideas is one thing a lot of people right now report thoughts are racing. Worryers have racing thoughts. You know, anxiety. Flight of ideas is different. That's like the bouncing of ideas, new things to new things. There's not always like a coherent way of following somebody. If you ever meet somebody who's manic, it's very obvious. Here's, this is ridiculous. Number five, why is it in the criteria, distractibility? What is it? Distract. Somebody jiggled their keys and I looked left. Yeah, everyone's distractible. Yes, right. It's a human condition, so forth. For them to put that in a... Sean (25:59.374) criteria, a symptom for mania is just absolutely absurd. Okay. Number six, increasing goal directed activity. Well, that could be a benefit. I'll go back to cleaning the kitchen. So let the person clean the kitchen and then tell them to go to sleep when they're done. That's where it can get misrepresented. Yeah, you know, sometimes people just get, you know, some energy to get things done. You know, Sunday, I did spring cleaning. I've there's been times where I've woken up in the morning. I'll use the kitchen as another one where I feel like it's just gotten to the point where it annoys me. So I'll pull everything out and I'll start scrubbing stuff and then you know, wife and kid will come down. I'll be like stay out of here. I'm in the I'm in the zone right now. Find something else to do for the next hour. Yeah, and I'll do that. Like, once I do it, once I get it started, I'll work all day just to get it done. Yeah, because I don't want to stop and have to go back to it another time because I don't like it. Yeah, right. So I like cleaned out my grill this weekend. Like about time. Yeah, I mean, everything out scrubbing everything and just cleaning off the cushions for all the furniture getting everything ready for the kind of spring summer that we do out there cleaning everything out. And you know, once you get started, you get on roll, you just get it done. Right? Yep. That can be interpreted through these checklists and through these horrible psychiatrists who are doing things in 15 minutes, increased in goal directed activity check, when really these things require investigation. They require context. Now, number seven, excessive involvement in activities that have high potential for painful consequences. All right, so this is like the impulsive- Risk taking? Risk taking. Now, these are the things I would wanna see. Severe impairment from these activities that have a high potential for adverse consequences, significant decrease in sleep, right? High energy, functional impairment. I need to see those things. But when you go to only three symptoms and you can get them from distractibility, decreased need for sleep, and increase in goal-directed activity, you can understand how easily someone can be diagnosed with a manic episode. Here's the problem. The problem is that most people being diagnosed with bipolar disorder are not being diagnosed with bipolar disorder because they're in a manic episode. They're getting it done historically. Sean (28:25.834) Right? So they see someone is struggling, depressed, maybe what's called hypomanic, and I'll get to that in a minute. And the doctor, these doctors in psychiatry who have been so conditioned to fear this condition called bipolar disorder, like, oh my God, if someone has bipolar disorder, they have this underlying bipolar disorder, what if I prescribe an antidepressant? Now that's gonna induce a manic episode. because they have underlying bipolar disorder. And it's like one of the few things they're really quote unquote experts in the entire system is the management of this condition. So as you would expect, you know, they see it a lot more than what it actually is. So someone comes in and is just like low mood or depression. Well, they're gonna ask questions and try to determine if someone has a history of a manic episode. And so what I am seeing in clinical practice is What is not mania is being assigned as mania to a large degree of people, even young people, even teenagers, where this mood instability is normal. And not sleeping at night. Oh my god. It's just, I can't believe what's happening out there. Okay. Sean (29:45.806) So there's your, you meet that criteria for that one manic episode, right? And you combine it with hypo meat, any period of hypo mania. Does the manic episode have to be prolonged? One week. So it has to last for a week. Okay. So it won't just be like you on the weekend. No it's got to be, it's got to be a week combined with either what they call major depressive disorder or hypo mania. And this is to get bipolar one. Remember this is that serious. manic depressive illness. So we've already seen that's easier to get assigned that manic episode. And we've talked about how easy it is to meet the criteria for major depressive disorder. That's just a two week period of time. And you only have to meet five or nine of symptoms, right? And what I will argue is every human being can meet the criteria for major depressive disorder at some point in their life. Okay. So what is that? Five or nine symptoms in a two week period. Depressed mood, loss of interest or pleasure, change in weight or appetite, sleep problems, loss of energy or fatigue, worthlessness or guilt, impaired concentration or indecisiveness, thoughts of death or suicide, slowing down what's called psychomotor retardation or agitation. Thoughts of death or suicide. What if somebody keeps saying like, momento mori to you? Is that thoughts of death? Yeah, so most humans will think of death. And so when you put it, like there's reasons why it's framed this way. I don't think of suicide. I don't have suicidal ideation. But do I think of death? Yeah, but that's why it's framed that way. As a reason to live. That's why it's framed. Cause you asked more people, have you ever thought of dying? Or have you ever had the thought of suicide? Well, of course. course, you've had the thought of it doesn't mean you're wanted to your intentions was to do it. So that's what you do. This is diagnostic inflation. This is how you increase the prevalence rate of a diagnosis. So since everybody, if you set it to the right person, most people experience, I'm not gonna go tell doctor about this. This is just normal, right? They just accept that this is part of living, I'm going to get through it, right? But a large portion of people aren't going to do that. They're going to go to the doctors and Sean (32:09.822) Now they've meet that criteria for major depressive disorder. Now you can historically go back. You can easily dig up what's called a manic episode. Okay. Yeah. You also don't know what other people are thinking. So if you're thinking of death, which is normal, and then you go to a doctor and the doctor says it's not normal, then all of a sudden you start thinking there's something wrong with yourself. Exactly. Right. All right. Now we start getting into where this stuff is a bit of a running joke. Okay. Hypo mania. Hypomania is a running joke for many people who are critical of psychiatry's assault on normal. I've heard clinicians refer to this as bipolar light. Like hypomania is a core feature that has led to the astronomical rise in diagnoses of bipolar disorder, specifically with a new category called bipolar two disorder. Until 30 years ago, bipolar disorder, bipolar two was like this Pinocchio of psychiatric disorders. like long recognized and referred to as not a real disorder. But in 1994, this disorder was finally given recognition in the DSM and it's called bipolar two. And do you know who was the chair of DSM four? I do not. Was this first name Alan? You do know it. Okay. I just didn't know his last name. Yeah, gentleman's by the name of Dr. Alan Francis. Yes, there it is. He's kind of well known now because he's speaking out against the assault on normal from his field in psychiatry. But I hate, well, I loathe this guy. Cause I find- Well, I'm on a first name basis with him. I find him disingenuous, right? Because he really had the ability to curb this. He was in a position of leadership. In 2020, he tweeted this out. I greatly regret adding bipolar two to DSM four. We had good reason to reduce iatrogenic switches, rapid cycling, in spectrum patients due to antidepressants. So right there he's kind of acknowledging that antidepressants induce a mood dysregulation. So they shouldn't be over the counter as some people are now recommending. That's ridiculous, right? But it led to much. Sean (34:39.527) There's no such thing as bipolar two. It's a myth, right? You can achieve bipolar two by this, okay? One major depressive episode in your lifetime, okay? Which I've already said can be applied to anyone if you want to frame it that way. And then one... or more hypomanic episodes. So I said that hypomanic, hypomania is like bipolar light. So like, what does that mean? Like what is mania light, like hypomania? A little bit more irritable? a few days of feeling good. You said it had to be like a week, a manic episode, for more than a week for bipolar one, the uno, but for the deuce, it just needs to be- Four days. Four days is what they say? Okay. Yeah, four days. You know, it's ridiculous, right? Because anyone at any point can be identified as hypomanic. Any point, in fact, it's a very attractable quality, right? It's the times when you're feeling a little bit good, you have more energy, you're a little bit more talkative on the other end of it, maybe a little bit more irritable, slightly more distractible, a little bit difficulty sleeping. Right. This is such a harmful diagnosis that without a doubt is pushed by the pharmaceutical industry. I had a poor night of sleep not so long ago and I woke up very irritable. Aren't those things just connected? Yeah, they are. Yeah. None of this. makes any reasonable scientific or rational sense. So don't try to rationalize it. Okay. Now, this is the thing that I'm seeing in clinical practice and it's a dramatic rise and I can't get data on it. I have no idea what the prevalence rate is, but I have so many people who are coming in here for evaluations who are identifying themselves with bipolar two disorder and, or ADHD. Why don't you just go along and identify yourself as bipolar two with them? Sean (36:45.23) Because if we are all, we all go through these periods, can't you just say like me too? Well, instead I choose to provide education a little bit more thorough on how this can be represented. Like the first thing you wanna do is you wanna explore, validate and explore their history to see the presence of a manic episode because that's serious, right? We've had doctors on here who've said, yeah, listen, someone is, you know, stripping their clothes off, you know, howling at the moon. Yeah. And you know, those type things that necessitate psychiatric intervention, I'm not minimizing that. I'm talking about the widespread application of this condition to the range of normal. And this is what I'm seeing, unfortunately, almost a large degree of people who enter into the psychiatric hospital, regardless of context. So you're talking about teenagers too. You're talking about trauma victims, acute trauma victims. This is like the worst of it, like someone was a sexual assault victim. or went through something that was really tragic, like they saw somebody that they love die in front of them, a car accident. They're in some acute trauma form and they go through a crisis period and they go to the emergency room for some help because they're not sleeping, they're feeling horrible. How quickly they will get labeled as bipolar two disorder or even ADHD based on these symptom checklists, based on 15 minute meetings and you're put on multiple drugs. I'm gonna talk about what those drugs are and how problematic they are. I just want people to know how easy it is now to receive this diagnosis. When you're looking at the dramatic increases of this condition to now 4.4% of the population, when you think about 40 fold increase in people under 40, it's not because more people are getting bipolar disorder, it's because they change the criteria in order for it to fit more people. Okay. That's what is really damaging to our, our culture. The worst thing for me is like some of the prolonged abuse. You know, I'll see someone who was sexually abused for years when they were younger, went through some pretty significant trauma. Now they're in their early adulthood and they're kind of experienced some of the after-effects of that. And now they're assigning themselves as bipolar. The problem with this too, is the general public doesn't distinguish the difference between bipolar one or bipolar two. They just start saying, I'm bipolar disorder. I have bipolar disorder. And that gets stuck. That is labeled for life. Sean (39:03.098) Once you tell yourself or once someone else says you have bipolar disorder, the way that it's communicated in our popular culture, it's a chronic severe mental illness. So maybe they go with that label for life. And then I will argue that the drugs that are used to treat this supposed condition are going to create disability that far exceeds the initial condition in the first place. Based on those drugs. So let's say I... get labeled bipolar to because I meet the criteria and I go on to a medication. Could I then become bipolar one? Of course you can. How how often does that transition happen? Well, let's talk a little bit about the history. People want to know how do we treat bipolar disorder in the United States. And I'll tell you like, there's not going to be that much difference between how you're going to treat bipolar one and bipolar two disorder. So it would be the same. If you go to a psychiatrist and medication is the route. Yeah, it's going to be a range of various psychiatric drugs. It's not psychiatric drugs light. Have you actually? No, no, it's, it's quite serious. So everyone knows about lithium, right? Yeah. 1970 lithium was approved by the United States FDA for the treatment of bipolar disorder, which still remains at primary use lithium, lithium salts are now classified as mood stabilizers. Now these are marketing terms, antidepressant, anti-anxiety, mood stabilizing, right? That is to conjure up an image that this drug is going to stabilize mood. The mechanisms of action in lithium are still not known. We don't know why lithium would stabilize a manic episode. These lithium salts, have really been on the decline. So rarely do I see somebody on lithium anymore, right? When someone is truly in a manic episode, a lot of evidence suggests that might be the safest and most effective course to stabilize somebody, to be honest with you, but they're just not really utilized to the extent that they were. I tried to dig on that and the primary belief it's on the decline due to aggressive marketing of the alternative drugs. Sean (41:25.142) that are patentable and therefore more profitable. So, you know, the pushes from the pharmaceutical industry who want to create a market for their antipsychotics and anticonvulsants that are also being marketed as mood stabilizing. The problem though with lithium is that it has a reputation amongst psychiatrists as a drug that is potentially really toxic and it's difficult to use. So you have to monitor serum lithium levels. in order to optimize the treatment efficacy and prevent lithium toxicity. So this has to occur frequently in the beginning. This is an added risk. You have to trust that your patients are going to get the blood work and this is gonna be monitored. And so many patients are in and out of psychiatry. They're seeing so many. I think it's just an added risk. They also have a lot of common side effects that can be problematic, even if you don't get to a toxic level. So like... Acne like rash, appetite changes, diarrhea, dizziness, dry mouth, frequent urination, hair loss, hand tremors, headaches, increased thirst, nausea, vomiting, swelling. Major concern is also weight gain. And then there are some more serious, though those are more common. Then the serious ones are like fainting, blurry vision, chest tightness, shortness of breath, confusion, hallucinations, movements that are slow or jerky. ringing in the years, seizures, speech issues, uncontrollable shaking. And then if you become toxic, right? Like if that's not toxic, cause that sounds like it would be at toxic levels. Yeah. I mean, that's certainly a serious side effect. And then there's the higher risk of lithium toxicity, which is like kidney failure, psychosis, memory problems, cognitive impairment, potentially death. Okay. So you can see like there's nothing that's easy about taking lithium and it probably should be rarely prescribed. Just like any psychiatric drug should be really, really rarely prescribed. The use of lithium during pregnancy, it's associated with a two to three fold increased risk of spontaneous preterm birth and a larger for gestational age infant and cardiac malformation. So Sean (43:47.742) It's problematic if you're of a childbearing age, long-term use of lithium is associated with kidney damage, thyroid issues, and cognitive issues. So what the field has done is created or marketed new drugs to try to stabilize mood and behavior. The first one is anticonvulsants. remarketed as mood stabilizers, right? Sounds better, doesn't it? Oh, mood stabilizer. But it's really a drug that has been used for seizures, sometimes migraine headaches, and they've gotten FDA approval for bipolar disorder, drugs like Depakote, Tegretol, Lamictal, and then there's other anti-convulsants such as Topamax, Triliptol. they're sometimes prescribed off label. And I've also seen gabapentin. So originally for seizures, repackaged, you see this in the pharmaceutical industry, repackaged as mood stabilizers. The reason that these drugs are applied for bipolar disorder are certain theories that these anti-convulsant medications make nerve cells in the brain less excitable, thus leading to a lower likelihood of like a mania or a depressive episode. Another theory that's proposed is that they raise the levels of the neurotransmitter GABA, which we talked about, have talked about in previous podcast, which is- It's your brake pedal. Yep, calming the brain, right? They may also modulate glutamate. Glutamate is the excitatory neurotransmitter, meaning it causes other neurons to fire. The accelerator. So these are all theoretical. I'd like to look at it as like a sedentary quality on some people, right? Some people, right? But there's just concerning side effects with anticonvulsants as are common with most psychiatric drugs. These behavioral side effects include disturbing changes in mental states, depressed mood, psychosis, anxiety, suicidal thoughts, irritability, aggression, impulsivity and impaired judgment. Sean (46:12.982) I've seen people be placed on these drugs for migraine headaches, and that would be the result. And the problem in this field is that these side effects, what do they mimic, Sean? Sean (46:27.87) Bipolar disorder. The drug side effects mimic bipolar disorder. So now you are a compromised psychiatrist who just does what you're told and lacks critical thinking and you did your weak ass investigation of 15-20 minutes. Hey, you got bipolar disorder. Why? Because you know, you're sad now and I think three years ago based on your memory that you went through a hypomanic episode and then you prescribe the drug and they worsen, thus confirming that somebody has bipolar disorder. So those drugs are usually combined with anti-psychotic drugs, okay? Yes, they prescribe anti-psychotic drugs even if you're not psychotic people. So just because it says anti-psychotic doesn't mean you're getting a drug because you have psychosis. In fact, most of the time it's prescribed for mood stabilizing effects. So you're on mood stabilizers and then an anti-psychotic to overcome the side effects of the mood stabilizer. Well, it could be seen that way. Generally speaking, they're going to be prescribed in combination to provide a mood stabilizing effect. There's no clinical studies on those drugs in taken together, correct? No clinical trials that I'm aware of taking together. but there could be research evidence that psychiatrists will misrepresent as safe and effective that says, hey, combining this, you know, we'll improve this. Certainly you're gonna get that when you go to your conferences and the drug companies are gonna push their propaganda. So there's these newer, what's called atypical antipsychotics. They're just the new ones. And they are marketed as having mood stabilizing properties which can lead to, you know, a dramatic. increase in their use for any mood dysregulation. The truth of the matter is you find a lot of this stuff is like trying to induce some form of like sedation, right? Or, you know, almost like a psycho motor retardation of these kinds of behavioral effects. What are these drugs? What are we seeing most often? Abilify, Raylar, Clozapine, Latuda, Zyprexa, Seroquel, Respidel, Giodon, right? There's just a range of them. And... Sean (48:52.674) These drugs are going to be prescribed in combination with anti-convulsants. Yes, even if there's no evidence of psychosis or mania. So again, all those conditions that I mentioned earlier, like someone who is in acute stress, someone who has a trauma background, someone who is just like really sad going through a crisis event down in their life. It's just easy that you can walk out of a hospital or walk out of doctor's office on multiple drugs. And in my opinion, trying to examine all this research, it's junk science that's pushed by the pharmaceutical industry to people like bipolar disorder as a discreet illness that's chronic, that you need these drugs for life, is not anything that's scientifically grounded and it's certainly not historically grounded. The word mood stabilizing is powerful because even parents of kids are going to say, well, we've got around a mood stabilizer. What's a mood stabilizer? They have no idea. That's what the doctor told them. Here we have this drug that's going to stabilize their mood. So if you present it in that way and you don't talking about the cost of the drug, then you're going to view that as the necessary intervention. The problem with these drugs is they have horrible outcomes. And even worse side effects. I mean, it is absolutely horrible. It's a path to this polypharmacy. These drugs induce weight gain and metabolic illness. Sedation is commonly reported. We also can see these psychiatric drugs induce depressed mood, irritability, anger, violence, psychosis, mania, akathisia. It's rare for me to find someone who's taking these drugs in combination that doesn't feel like absolute shit. all of the people I meet who are polypharm drug, their health has significantly declined. It becomes this revolving door of new drugs, increased dose. They are literally throwing things at the wall to see what sticks. As the body is always adapting, you're always going to have to change this drug, add another drug. Now you've got weight gain, disrupted sleep, fatigue, and that's the best of it. Right? Sean (51:07.958) That's when you can say someone's stable. Sean (51:13.39) frustrating to work in this field right now. And you also see other doctors who are adding SSRIs and benzodiazepines. I think they're doing that for the side effects of the other drugs, like a series of like, uppers and downers. I'm observing young people on four to seven psychiatric drugs at a time. They're a shell of their formal self. They're experiencing weight gain, fatigue, sedation, low motivation, and various side effects. And now they are brainwashed. into believing they have a severe chronic illness by the name of bipolar disorder and their life is essentially ruined. There's no recovery rate from this. And even with these psychotic disorders, which may induce stabilization in the beginning for someone who's actually psychotic, new research is coming out, right? It doesn't necessarily prevent the next psychotic episode. So this is the field that I'm currently working in and this is what I see in clinical practice. And this is why I believe that entering into this industrial complex, the psychiatric industrial complex, you're more likely to worsen than recover because this is how they're going to view you. Now, like now, luckily, we're starting to see this burgeoning new scientific evidence that can help people with more safe and effective interventions from the beginning. Okay. First of all, a lot of people are presenting with mania. They're doing it because it's drug induced to begin with. Yeah. It could be something like just cannabis. or it could be a street drug or it could be a prescription drug. Or unknown. Right. We're also seeing that mania can be induced by... metabolic illness, hyperglycemia, hypoglycemia. And that's why I'm really interested in knowing the effects of these health interventions on stabilizing mood. So just like your son, sugar can have that dramatic increase, so can chemicals, toxins, a number of other things, and poor diet. So can sleep disruption, circadian rhythm disruption, shift work. There's all these various causes for someone might... Sean (53:20.138) themselves as severely dysregulated and not because they have that bipolar disorder, right? It's because of legitimate medical conditions. And that's why this is a public service announcement. So Sean, to wrap this up, this is what I advocate for, informed consent, right? Unfortunately, we can no longer accept the diagnoses of a psychiatrist when they're throwing out bipolar disorder and people deserve to be exposed to accurate information as well as alternative explanations. And so we have to be very careful about how this is being. articulated to people, especially young people where mood dysregulation is much more common. Right? Remember, go back to the DSM has a lot of these diagnoses have overlapping symptoms. Okay, so what one doctor sees as bipolar disorder, another person can see is just a this is just a reaction to traumatic event, we can help get you through this. And the outcomes based on how that is conceptualized are going to differ greatly, one's going to create mass harm. The other is going to support someone to kind of overcome that episode. And, uh, you know, I think I have to be more outspoken about this condition, this disorder, just because the prevalence rate is increasing so much. I've been so focused really on SSRIs because of how frequently they're prescribed in primary care settings. And, but let's face it, the effects of these anti-psychotic and anti-convulsant drugs and polypharmacies. much more debilitating than even one SSRI. So when you just see that these drugs are so irresponsibly prescribed and people aren't informed of the risks, and then you assume you have bipolar disorder for life when you have some, you met some criteria for this weak condition bipolar two disorder that shouldn't even be in the DSM, shouldn't even be recognized, well, then you can see how this can lead somebody down the path to health.