Talk:Bipolar disorder

24.58.228.xxx makes the assertion that

Psychohistory is a highly unreliable and dubious enterprise generally promoted by less than reputable psychologists and psychiatrists, patients who wish to be in good company, and organizations that stand to benefit from contributions made by those whose sympathies would be aroused by such "diagnoses at a distance".

The leading author of books on mental illness in history, Kay Redfield Jamison, is a Professor of Psychiatry, at The Johns Hopkins University School of Medicine. She is a MacArthur Fellow. She has been published extensively in peer-reviewed journals. Her book on the subject, 'Touched with Fire', has been favourably reviewed by Herbert Pardes, Dean of the Faculty of Medicine at Columbia University, and James. D. Watson, the Nobel Prize winning discoveror of DNA. Hardly 'less than reputable'.

24.58.228.xxx, your contributions on this subject seem to be remarkably forceful, as if you are speaking with authoritative professional expertise on a subject of which previous authors have little knowledge.

Can you tell us what your qualifications as a medical doctor are?

-- The Anome (who is not a medical doctor)

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Reply to Anome: I have entered this reply twice and once in another location for Talk, but for some reason it is not taking. Hence I repeat my reply here, again: For some reason the person who made the original entries on bipolar disorder and depression (you, I take it) deleted my corrections of these and snidely challenged my credentials (assuming that like himself, I was unqualified), while acknowledging that he was not an MD. Somehow my reply to his comment was deleted. The fact is, I am an MD, a neuropsychiatrist and an officer of a society on the history of psychiatry. As I explained, it would not seem appropriate for him to go in and on his own authority delete everything that I have written because he assumes that I am no more qualified than he. I assume that there is a reconciliation to be done between the (rather obvious) misinformation he has been providing and the detailed and accurate information I have provided. Where appropriate I have given chapter and verse for my explanations. Despite the fact that his work was riddled with errors and misleading information, I did not take it upon myself to delete any of his work, and I should appreciate his giving me the same courtesy. (SE)

I have therefore replaced the last version of the bipolar and depression entries with the last version which included what I have written. If you wish to correct anything that you have written, or suggest anything incorrect in what I have written, I welcom you to re-enter these as separate comments. I trust that you will not delete or in any way alter what I have written without informed authorization from the owner/editor of the Wikipedia site.

For some reason, my restoration has not taken in the bipolar and depression entries, so I will replace them again. I trust that you are not purposely erasing my work a second time.

I will attempt to inform the owner/editor of the problem

Thanks, SE

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Hey, SE! Please don't just revert my changes - I am trying to merge in your point of view. Please don't just write CORRECTION all over the place: it breaks up the article, and forces others to edit the article back into readable shape. Please either:

• boldly edit the article to what you think it should be (but be aware you may be boldly edited in turn) or
• (better) where there are differing points of view, mention it: 'some say this, others say that' or 'medical opinion now generally considers x to be true; some disagree and say y'

This is particularly true of the several different meanings assigned to 'Manic Depression' over time. Remember, your view is not the only view - and even if you consider yourself to be correct, others may not - so cite evidence for your opinions.

You will find that I have 'authorization from the owner/editor of the Wikipedia site'. As do you. Please see Welcome, newcomers and Most_common_Wikipedia_faux_pas

I am glad to hear that you are an MD. We could use your informed point of view. But please don't assume that non-experts in a given field have nothing to contribute - we are after all the intended audience for Wikipedia, and are generally competent at editing text.

I am sorry that you are upset by my request to state your qualifications - I am more likely to take your point of view seriously as an expert in the field, rather than as another non-expert.

But you do need to _work with_ other authors.

-- The Anome (who is a recognised expert in a number of non-medical fields)

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SE, please see my edits to Depression, with matching commentary, in talk:Depression. See how Wikipedia works: the striving for consensus and NPOV? It's not my text, or yours: it belongs to Wikipedia, and via the GFDL, the world. -- The Anome

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Right, now watch the same process applied to Bipolar disorder, in a number of logically defensible stages. -- The Anome

• The first edit: I entirely remove the paragraph you complain about, and replace it with your corrected text. I change the formatting slightly to make it prettier, and remove the start of the first sentence as it no longer needs to state that it is a correction. -- The Anome

• The second edit: now I change an assertion that Bipolar II is milder, to the assertion that 'some consider it to be milder'. Now, this is a statement of the opinions of others, that I am willing to give cites for. -- The Anome

• The third edit: now I cite your opinion, in your own words, as the opinion of 'other doctors', representing your opinion as that of an MD, rather than that of 'some people'. (You change from 'a doctor' to 'other doctors', as I assume that you are not the only MD that has this opinion.)

• The fourth edit: I qualify 'manic people losing insight' with the word 'some' as per your correction.

• The fifth edit: I remove the sentences requesting the correction above, as they are now redundant. I leave in the rest of the correction paragraph.

• The sixth edit: I take the rest of your qualification to the statement in the para above, and I insert it in-line into the text. I remove your sentence regarding what it is correcting, as it now follows it as an extensive qualification in-line. Note that the qualified statement has always stated that the drugs 'can' prevent episodes, not 'can always'.

• The seventh edit: I weaken the qualified statement to 'can sometimes'

• The eighth edit: I remove the rest of your correction, as the above I believe incorporates its sense into the text

• The ninth edit: I consider G+J to be a classic; you consider the Kraepelin text to be a classic - let's make a list!

• The tenth edit: not only do I consider G+J to be a classic, so do all these others: (see http://www.oup-usa.org/isbn/0195039343 ). I will just let two stand here:
  • "The best treatise on the subject since Kraepelin."--Journal of Clinical Psychiatry
  • "A classic work--a textbook in scope, but literate, readable, and compassionate. Sets a new standard in scientific medical writing."--Myrna M. Weissman, Columbia University College of Physicians & Surgeons

Oh look, these people are Medical Doctors too. In my opinion, four named MDs, and a number of writers in peer-reviewed medical journals beats the opinion of one anonymous MD, using the well-known techniques of 'meta-review'. So I will delete your comment deriding the G+J book.

• the eleventh edit: I downgrade the assertion re historical figures and bipolar disorder to an opinion, and cite that others are skeptical

• the 12th edit: I move your sentences qualifying this statement in-line

• the 13th edit: I remove your comment deriding those who attempt to consider whether historical figures were bipolar, as there is evidence (see the top of /Talk above) that (at least some) highly regarded medical authorities have taken part in this activity, and the comment appears ad hominem.

• the 14th edit: s/Unlike/Compared to/; s/have/are more likely to have/; moved comment re schiz. patients inline; removed CORRECTION notice, as its sense (and some text) is now incorporated into the text

• the 15th edit is a pure copyedit, removing dividing lines that are now redundant, and restoring the bullet-list structure of the external link list

• the 16th edit: Moved external link to end of article, put comment pointing to end of article in its place

• the 17th edit: mentioned your opinion that psycho-historical stuff is dubious

Now I'm done - for now. I hope that I have fairly incorporated all your opinions into the article. If you disagree, please feel free to edit - and please justify your changes here!

-- The Anome

"Many famous people are believed to have been affected by bipolar disorder, including Spike Milligan...There is no definitive scientific basis for classifying any of the above deceased persons ..." Does Spike Milligan know he's dead? The internet doesn't seem to think so. Verloren

Ah yes, but Milligan's not a medical doctor - he and I only think he's alive. An MD's opinion overrides that of a layman, therefore, as non-qualified people, we should accept Milligan's death as a fact. The alternative of thinking that an MD might be wrong about anything is too appalling to contemplate. If I was to believe that, next thing I'd be believing that MDs might actually disagree with one another! And at that point, we'd have to use our tiny brains to work out which doctor was right. I guess that might involve 'cites', or 'literature research', or somefin' -- The Anome

Fixed up the wording cited above as a kindness to SE (s/any of the above deceased persons/dead people/) -- The Anome

I haved moved an earlier version the text before the SE/Anome edit wars to An older, deprecated, version of this page[?] - please note that it contains text that SE, who is a doctor, claims to be inaccurate, and is only there as a temporary copy for comparison purposes, to check if there is any non-contentious material there that might be useful. I will delete it when this is done. -- The Anome

Several more edits made to recreate wiki links: see changelog for details -- The Anome

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Changed some of the text to emphasis more the difference between BP in remission and schizophrenia in remission. It's often the case that someone with BP disorder who is not being medicated will appear normal between distrbances and to be fully functional and independent. It's rather uncommon for people with schizophrenia who have undergone several episodes to be fully functional and independent without medication.

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Thanks for that. I've since made a couple of (I hope) non-controversial edits: see the changelog comments for details. -- The Anome

I have now added the words associated with mania]] or hypomania to the first sentence - this seems justified as the diagnoses for Bipolar I and Bipolar II (as cited by SE) appear to require an incidence of either mania or hypomania, respectively.

I'm also going to move the 'ups and downs' paragraph up the article to a more logical place, and delete its first word 'futhermore' -- The Anome

There are two essentially identical one-sentence paragraphs crediting Kraepelin with the discovery - replacing/merging the first one with the slightly more detailed second one. -- The Anome

I have now added subheadings, hopefully applying some structure to what is now becoming a reasonable length article -- The Anome

Added note re incorrect, but common, usage of term 'manic depression':

Note: Bipolar Disorder is also commonly (and wrongly) called manic depression by laymen (and by some psyciatrists in the twentieth century) although this usage is now unpopular with psychiatrists, who have now standardised on Kraepelin's usage of the term to describe the whole bipolar spectrum.

Please, SE, note that I am recording usage here, and noting that it is incorrect. -- The Anome

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Many famous people are believed to have been affected by bipolar disorder, including Spike Milligan, Lord Byron and Winston Churchill, based on evidence in their own writings and contemporaneous accounts by those who knew them.

I think that Spike Milligan was actually diagnosed with bipolar disorder - in any case, I remember something in one of his books about him being diagnosed "manic depressive" (this wasn't the war books, it was, I think, the intro to a books of his letters, probably published around the 70s). I think he talked about it elsewhere as well - anybody know for sure?

There's a book written by him and Anthony Clare, based on his appearance on Clare's BBC Radio 4 programme. That's where I read about it. -- Tarquin

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Dysphoric mania is not the same thing as manic depression / bipolar disorder: it's one of the possible phases of bipolar disorder. Recent thinking is that depression and mania are two different axes, thus creating four possible extremes:

• euthymia (ie normal): not manic, not depressed
• depression: not manic, depressed
• mania: manic, not depressed
• mixed state / dysphoric mania: manic and depressed

-- The Anome 07:08 24 Jun 2003 (UTC)

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