Update on Bipolar Disorder: Particle or Wave?
This essay is a brief update on an earlier Psychiatric Times article by Dr James Phelps. Several major studies have appeared since the publication of the original article, which shed further light on this issue.
In some circumstances, light is more easily understood as particle, a photon; in other settings, light behaves more like a wave. This dual nature of light has been understood as part of a broader “complementarity” of physical phenomena for decades.1
Psychiatry, on the other hand, continues to struggle with a similar duality: is bipolar disorder a thing, like a photon? Can we use a system of categories, like Linnean classifications, to characterize it and differentiate it from similar phenomena? Or is it more of a continuous phenomenon, akin to a wave version of light? Indeed, just as we have names for nodes on the continuous electromagnetic spectrum (red, green, blue), is bipolarity better understood as a spectrum of entities, with names for nodes on this continuum (eg, Bipolar I, Bipolar II, Bipolar NOS, agitated depression, recurrent unipolar depression)?
This essay is a brief update on the 2006 Psychiatric Times article,
Overdiagnosis?
Mark Zimmerman and colleagues published a series of papers based on the diagnoses offered patients by Brown University area clinicians (“Have you ever been told you have bipolar disorder?” the research team asked). All patients received a Structured Clinical Interview for DSM-IV criteria as the “gold standard” against which these prior diagnoses were compared.