Conventional And Alternative Treatment of Bipolar Disease
Nicholas Corrin, L.Ac.
In 2001, 30,000 Americans diagnosed with bipolar disease committed suicide. Clearly, the system failed them, and continues to do so to this day, as no fundamental progress has been made in conventional psychiatry. But is the system failing patients and their families even more radically than this one startling statistic already shows? A more vital question would be, in what actual form does bipolar syndrome really exist? Is it partially a contrived syndrome that is projected on to patients, a figment of imagination in the minds of a psychiatric profession for whom drugs are the answer to everything? And to the extent that it is an objective (as opposed to a subjectively constructed) phenomenon, how can we best treat it and heal patient suffering?
If bipolar disorder does indeed exist as a distinct category of mental illness, the best way to examine it may be in the form of internal biochemical imbalances. The good news is that when the micro-nutritional particularities of bipolar disorder are analyzed, and when we directly address the metabolic, neuro-chemical and energetic dysfunctions that occur beneath the language-constructs that conventional psychiatry references in its ineffective, drug-driven methodologies… patients get better.
In 2008, a study by researchers at Rhode Island Hospital and Brown University made the following astonishing determination: they found that less than 50% of patients previously diagnosed with bipolar disorder received an actual diagnosis of bipolar disorder after using a comprehensive, psychiatric diagnostic interview tool. This diagnostic tool is called the Structured Clinical Interview for DSM-IV (SCID). In their follow-up study, the researchers determined the actual psychiatric diagnoses of those patients. The July 28, 2009 online edition of The Journal of Clinical Psychiatry has published a report of the researchers’ conclusions.
Simply put in bluntest terms, the report’s conclusions are that bipolar is being heavily over diagnosed by the psychiatric profession. That is, in approximately 50% of cases, the SCID did not confirm previous diagnosis of bipolar disease. Instead, it most frequently re-organized previously diagnosed bipolar patients into two diagnostic categories of borderline personality disorder and impulse control disorder. Now, you might well ask, what exactly is borderline personality disorder, not to mention impulse control disorder? Or, from another angle, what would constitute — and who exactly has the knowledge and authority to determine — personality “order”, non-borderline personality, or a prime example of impulse control “order”? Who are the arbiters of these norms and ab-norms upon which these diagnostic categories of the psychiatric profession rely so heavily?
You can see where we are leading to here. What sort of central authority assumed by the psychiatric profession gives it the authority to judge what constitutes an “orderly” personality and what constitutes a “disorderly” one? Looking around at the world, can we honestly say that in politics, law, economics, fashion, sport and last but not least, medicine, we see mostly examples of “orderly” personalities free of “impulse disorders”, calmly going about their business and, in the process, contributing beneficially to humankind? I think not, and I suspect you would agree with me based on the above evidence that so many psychiatrists have, rather irrationally one might say, been having clear impulse control issues with the over-diagnosis of bipolar disorder..
Aside from these two diagnostic categories, many other patients previously over-diagnosed with bipolar disorder were, according to the same report, frequently re-diagnosed with major depressive disorder, antisocial personality disorder, post-traumatic stress disorder and eating and impulse disorders.
If this sounds a little too much like a free-for-all to you, or inspired guesswork, or perhaps some new version of psychiatric color by numbers diagnostics, I might have to concur. But the most important point is this: lead author of the study, Mark Zimmerman, MD says:
We hypothesize that in patients with mood instability, physicians are inclined to diagnose a potentially medication-responsive disorder such as bipolar disorder rather than a disorder such as borderline personality disorder that is less medication-responsive.
What does this mean? In simple English, Zimmerman is saying that psychiatrists have been effectively giving a diagnosis to fit a drug rather than vice-versa. Instead of trying to observe, understand and treat the phenomenon in front of them, they are “torquing” the case towards prescription of a pharmaceutical drug with known deleterious side effects. At this point, you may well be thinking, “Is it any wonder that 20% of people diagnosed with bipolar disease end up committing suicide?” It is a perfectly valid question. More than that, it is a question that needs to be addressed to the psychiatry profession as a whole along with questions regarding accountability. If persons are committing suicide in such numbers after receiving medications based on frank misdiagnoses (according to psychiatry’s own specialized diagnostic tools), then what on earth (or hell) is actually going on?
What is going on, again in plain English, is that patients summarily (and incorrectly) diagnosed with bipolar disease have been prescribed harsh pharmaceuticals which, if not triggering suicide, lead to harsh side effects to vital organs, including possible impact to renal, endocrine, hepatic, immunologic and metabolic functions. In brief, according to the authors of the Rhode Island study, the so-called mood stabilizers prescribed for bipolar by psychiatrists can be extremely harmful to the body via toxic side-effects, if they do not already kill it off indirectly through suicidal despair. Consider this: about 20% of bipolar cases are considered likely to commit suicide. For this reason, they are conventionally prescribed mood-stabilizing drugs which we will discuss in more detail later in this article. Now, if we consider that of those 20% of bipolar suicides, about a half (according to the Rhodes Island study) will have been misdiagnosed and, presumably, administered mood-stabilizers, we must draw one of three conclusions. Either 50% of the suicides (around 15,000 persons) who were not suffering from bipolar, were indirectly led to kill themselves by a combination of diagnostic medical error and incorrect drug prescription. Or, the ones who committed suicide were pretty much all genuine cases of bipolar, which would mean that the number of suicide cases amongst bipolar cases under psychiatric care rises to a staggering 40%. Or, thirdly, some combination of the former and the latter.
The author of the Rhodes study, Dr. Zimmermann, concludes by suggesting that certain types of (good, old fashioned) talk therapy (i.e. psychotherapy) are preferable to psychiatric intervention in patients with so-called borderline personality disorder. Zimmerman concludes, “Because evidence continues to emerge establishing the efficacy of certain forms of psychotherapy for borderline personality disorder, over-diagnosing bipolar disorder in patients with borderline personality disorder can result in the failure to recommend the most appropriate forms of treatment.”
Is psychotherapy itself — basically, a talk therapy — sufficient to treating serious mental illness? We suggest not. Fortunately, there are other ways to help resolve these forms of suffering. At Eclectic Healing Arts we see the most effective approaches as a combination of:
- Nutrient (Orthomolecular) Therapy: correcting neurotransmitter, hormonal and nutritional imbalances and deficiencies using natural, non-toxic, non-pharmaceutical supplements.
- Energetic Therapy: correcting pre-cursor programming coded as aberrant frequencies in body bio-electric channels and neural circuitry, using Acupuncture, Vibropuncture, EFT (Emotional Freedom Technique), Far Infra-Red frequencies, Vibrational Essences from Plants, and Bio-frequency generators to harmonize the body-mind interface.
- Holistic Psychotherapeutic Counseling to re-vision the role of the individual in a rapidly changing world, and re-empower the person with a sense of meaning, direction and self-esteem.
How is Bi-Polar Disease Diagnosed?
Essentially, bipolar disease is viewed as a swing system incorporating two antipodal variants: a manic (up) phase, and a depressed (down) phase. Bipolar is subdivided into various sub-types or geno-types, but there is little clarity or consensus as to their exact parameters. There are no clear genetic factors indicating a predisposition for bipolar disease, nor is there any irrefutable evidence from CAT-scans, MRI or PET associating brain tissue abnormalities that could be correlated with a bipolar diagnosis.
In brief, there is nothing solid to go on when a psychiatrist makes this diagnosis. According to the research findings of Dr. Zimmerman and his team, the tendency to diagnose affirmatively would appear to be one of convenience and expedience. Since what is called “borderline personality disorder” is refractive to psychiatric medication, why not diagnose in such a manner as to make the patient’s condition artificially conform to one in which medication will have demonstrable effects?
Bipolar Disease, Suicide Rates And Drug Profitability
There is, as always, hovering somewhere in the background, a dollar sign attached to this expedient question of drug choice: how can drug companies maximize profits?
It is shocking to see how, in recent times, preservation of human life has been seen as far less important to the psychiatric industry than the dollar sign. A brief glance over recent prescription history will obviate this fact for us. This is evident if we scrutinize the findings of a 2003 study led by Dr. Frederick Goodwin of the George Washington University Medical Center , published in the Sept 17 2003 edition of JAMA. Goodwin and his colleagues studied the records of 20,638 bipolar patients who were members of two HMOs, the Kaiser Permanente Medical Care Program in Oakland and the Group Health Cooperative in Seattle.
Dr Goodwin was one of the authors of this study to determine the relative influences of lithium and the newer drug, divalproex (Depakote) in arresting patient tendency towards committing suicide. Despite the fact that lithium has proven just as effective as the newer Depakote at preventing the wild mood swings associated with bipolar disease, patients who were taking the newer Depakote were 2.7 times as likely to commit suicide as those on lithium, according to the report. With annual bipolar suicide rates of 30,000, a 2.7 x greater margin represents an awful number of casualties that would have been avoided had the patients been prescribed the equally effective, but less lucrative drug lithium.
In 1994, lithium, still accounted for 80% of prescriptions for bipolar disorder. In 2001, divalproex accounted for more than 70%. In 2003, annual sales of lithium were about $43 million per year, while those of Depakote were more than $1 billion, said Dr. Goodwin in his report. That represented approximately a twenty-five fold increase in income . Today it would appear, lithium and divalproex are most often prescribed together in combination. Could the implicit logic here be to try to prevent patient suicides whilst retaining drug based profitability?
An Alternative View
So there is no success story with bipolar from conventional medicine. Is there another way? Resoundingly, yes. When less attention is paid to the artificial language based contrivances (i.e. diagnostic categories), and more attention is paid to the actual nutritional and neurochemical imbalances that correlate with the sufferings of seriously disturbed patients – whether these people have been labeled bipolar type 1 or 2, schizo-affective disorder, or unipolar depressive is not relevant, what matters is their internal condition of metabolic and micro-nutritional imbalance– the possibility of a genuine cure begins to shine through. Remarkable recoveries have been generated by physicians and other health professionals adopting an individualized nutritional approach to mental illness.
Dr William Walsh was formerly Director of the Pfeiffer Treatment Center in Chicago. In the following paragraphs, we summarize points from a 2003 lecture by Dr. Walsh, in which he distinguishes bipolar typology according to whether or not patients exhibit a methylation disorder, and whether those that do are over or under methylated. For Dr. Walsh, “bipolar disorder is not a single condition, but an umbrella term which includes a number of very different biochemical abnormalities. I’m bothered by any attempt to generalize over the bipolar phenotypes and to blindly recommend any formulation or therapy for all of them. The key is to determine a patient’s biochemical individuality, and to provide focused appropriate treatment.”
According to Dr. Walsh, the three primary biochemical classifications of bipolar disorder are the following:
- Undermethylation, characterized by low levels of serotonin, dopamine, and norepinephrine, high whole blood histamine and elevated absolute basophils. They usually respond well to methionine, SAMe, calcium, magnesium, omega-3 essential oils (DHA & EPA), B-6, inositol, and vitamins A, C, and E. They may appear outwardly calm, but suffer from extreme internal anxiety.
- Overmethylation: this is the biochemical opposite of undermethylation. It is characterized by elevated levels of serotonin, dopamine, and norepinephrine, low whole blood histamine, and low absolute basophils. This population is characterized by the following typical symptoms: Absence of seasonal, inhalent allergies, but a multitude of chemical or food sensitivities, high anxiety which is evident to all, low libido, obsessions but not compulsions, tendency for paranoia and auditory hallucinations, underachievement as a child, heavy body hair, hyperactivity, “nervous” legs, and grandiosity. They usually respond well to folic acid, B-12, niacinamide, DMAE, choline, manganese, zinc, omega-3 essential oils (DHA and EPA) and vitamins C and E, but should avoid supplements of methionine, SAMe, inositol, TMG and DMG.
- Pyrrole Disorder: This condition, also called pyroluria, is a genetic stress disorder associated with severe mood swings, high anxiety, and depression. The biochemical signature of this disorder includes elevated urine kryptopyrroles, a double deficiency of zinc and B-6, and low levels of arachidonic acid. Pyrolurics are devastated by stresses including physical injury, emotional trauma, illness, sleep deprivation, etc. Symptoms include sensitivity to light and loud noises, tendency to skip breakfast, dry skin, abnormal fat distribution, rage episodes, little or no dream recall, reading disorders, underachievement, histrionic behaviors, and severe anxiety. They usually respond quickly to supplements of zinc, B-6, Primrose Oil, and augmenting nutrients.
Therefore the key to treatment becomes a highly individualized one where, in particular, methylation and kryptopyrrole levels are assessed, and specific nutritional protocols constructed based on these parameters. For this customized therapy, we now refer our patients for nutritional consultation and assessment at Foster Health Inc. in Victoria, BC (www.biolifeprint.com). However, it is also true that recently, a non-individualized nutritional approach – basically a “shotgun” approach to treating mental illness nutritionally, has been devised by a Canadian company, (www.truehope.com). Their formulation has seen tremendous success across a wide spectrum of severe mental illnesses, and is now available through Eclectic Healing Arts as part of our alternative treatment protocol for bipolar disorder.
Other Keys To Healing Bipolar Disorder
If the answer to bipolar disorder is partially, but not exclusively, remedying internal biochemistry with appropriate nutritional protocols, part of the answer also may lie in correcting disturbances in the bio-electrical and neural systems that regulate absorption, combination and distribution of internal bio-chemistry. This is where such techniques as EFT (Emotional Freedom Technique), Vibropuncture, FIR Onnetsu and Acupuncture-Aromatherapy have much to offer in combination with nutritional medicines, whether based on either individualized biochemistry panels, or the TrueHope broadspectrum approach.
©Nicholas Corrin & Eclectic Healing Arts, 2009
This article is meant to inform, and is for educational purposes only. In no way is it intended to diagnose or to treat any condition or disease, nor is it intended to prescribe or to suggest to prescribe anything. It is recommended that no actions be taken independently of a consultation with a qualified medical health professional. It is strongly recommended that no-one seek to self-diagnose or to discontinue or replace any medication they may be on without full discussion with their physician.