Page last updated at 07:36 GMT, Wednesday, 16 June 2010 08:36 UK

Why patients are saying 'I want to be bipolar'

Dr Diana Chan
Diana Chan
Psychiatrist in mental health service for older people at St Ann's Hospital, London

Mental illness has long been considered a stigma, with people often going to great lengths to hide the fact that they have problems.

Stephen Fry
Stephen Fry's story has inspired others to come forward

But now there has been a new phenomenon.

In this week's Scrubbing Up psychiatrist Dr Diana Chan explains that some people are actually asking to be diagnosed with bipolar disorder.

For many years, there has been a huge stigma attached to mental illness.

This has evolved from the days of institutionalisation in the asylums, psychiatric treatments such as electroconvulsive therapy and media coverage of schizophrenia-related deaths.

Given the stigma, it seems highly unusual that there is now a group of people who are actively seeking out a diagnosis of a mental disorder and want to be known as bipolar.

Celebrity Effect

Such presentations were rare until about three years ago.

Dr Lester Sireling and I have looked into the popularity of bipolar disorder as a self-diagnosis. We believe the phenomenon could be due to increased public awareness through the internet, radio and TV, coupled with the willingness of celebrities to talk about their own personal experiences of mental illness.

This appears to have made the disorder less of a stigma, and more acceptable to the public.

A new diagnosis of bipolar disorder might also reflect a person's aspiration for higher social status and a feeling that by having the condition they too are creative.

Not only has the celebrity effect increased public awareness of the disorder, bipolar disorder has now become a desirable diagnosis.

Indeed, the highly intelligent and creative Stephen Fry, who has talked very frankly about his own experiences certainly appears to have promoted bipolar disorder as less stigmatising and more acceptable to the public.

Since he went public psychiatrists have been reporting more patients diagnosing themselves.

One person who presented to us with self-diagnosed bipolar disorder had previously been treated for depression. She had also been using alcohol and illicit drugs to control her 'mood swings' and reported embarrassing and disorderly behaviour.

We later diagnosed her with bipolar disorder.

Psychiatrists will inevitably see more people coming to them with self-diagnosed bipolar disorder.

'Desirable diagnosis'

Not only has the celebrity effect increased public awareness of the disorder, bipolar disorder has now become a desirable diagnosis.

But this brings with it its own problems.

Bipolar disorder is a mental disorder that presents with recurrent episodes of mood instability of feeling 'high' (mania or hypomania) and 'low' (depression).

It is a serious condition that may significantly impair relationships, work and social functioning.

It is important for psychiatrists to make the diagnosis when valid. Conversely, it is equally essential to help people that desire the diagnosis to understand that having 'mood swings' or chaotic and disorderly behaviour does not necessarily mean that they are suffering from bipolar disorder.

The new challenge for the psychiatrist is in either making or excluding the diagnosis and then sensitively dealing with the person who just 'wants to be bipolar'.

The celebrity effect has increased public awareness of bipolar disorder, but now more work is needed for the public to gain a better understanding of other illnesses such as schizophrenia.

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