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The right diagnosis ? bipolar, schizoaffective, severe anxiety or autistic spectrum

Posted Oct 22 2010 12:00am
I know three people who diagnosis of bipolar is almost wrong. Nothing about their experience suggests extreme moods of high exuberance, deep depression and extreme behaviours of spending, extravagance, promiscuity and delusions of grandeur. And yet all of them have a diagnosis of bipolar disorder. What does this mean?


This is because psychiatry has lost its way. It has lost its intellectual framework and treatments are increasingly random and pragmatic and given out like to smarties.

The psychiatric algorithm is now

Mild Symptoms - treat with the latest and cheapest antidepressants you know the name of eg - Citalopram Severe Symptoms - treat with antipsychotics eg olanzapine orquetiapine

No thought required

Yet it is impossible to not to believe that a person's personality in some way contributes to their psychiatric problems. Tall people are at risk from bumping their heads on low doorways, short people may not be able to get food from the top shelf. There is no right or wrong, it just happens this way.

The personality type at risk of grandiose and extreme moods of true bipolar disorder is Talk and Do.
The personality type at risk of severe depression and even schizoaffective disorder is Think and Be.
The personality type at risk of severe and generalised anxiety and even Obsessional compulsive disorder is Talk and Be
Finally, the Think and Do personality type is likely to become embedded in their routines, distressed by change and at risk of Autistic spectrum disorders.

In all of these cases, a person's moods may be unstable, but unstable moods are not on their own, enough to make the diagnosis of bipolar disorder. Unstable moods indicate stress rather than bipolar disorder.  

The wrong diagnosis leads to the wrong treatment which at best is unhelpful and at worst destructive. A person with an already flat affect and low mood is not helped by a mood stabilising drug. It will make their mood flatter and make it harder for them to "do" those things that they need to do to in order to solve the problems they face.

People with a naturally flat mood are made worse by a mood stabiliser. Their problem is not Bipolar Disorder, they do not experience the extremes moods of the Talk and Do personality. Neither do they spend money extravagantly, behave promiscously, drive fast and hard or endanger their own or other peoples' lives.


The right diagnosis is a critical step to understanding yourself and managing your own mental health. Without the correct "label" it is hard to understand what has happened to you and your treatment is random. 

Come to a MoodMapping workshop, first and third Saturdays of the month and discuss this further.
The next workshop is Saturday November 6th 2010  10.00am - 4.30 pm in Fulham, London - all welcome
Cost £20 and concessions are available



Mood Mapping - Available Now!! UK and International readers



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Copyright (c) Dr. Liz Miller
http://www.moodmapping.com/ www.drlizmiller.info www.moodmapping.com
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