For quite some time, I have been noticing that many of the
individuals who visit my disability site (often through my http://www.disabilitysecrets.com/questions.html>FAQ page on
social security and ssi disability) are looking for
disability benefit information, primarily as it relates to
bipolar disorder.
While I haven't found it surprising that this would happen
(bipolar disorder is a terrible neurochemical illness and is
much more than its constituent parts--depression and manic
behavior--would imply), I have to admit, I have been surprised
at the level of occurrence. Put simply, there are many more
bipolar cases out there than even I would have thought.
You may be wondering: why was I surprised and what is my
particular background to account for this surprise. Well, I am a
former medicaid caseworker and, more relevantly, I am a former
disability claims examiner for the social security
administration. In that latter capacity, it was my function to,
on a daily basis, receive new disability cases, send off for
medical records, review the records when they came in, and,
then, in consultation with a physician, render a decision on a
claim.
I did this job for several years and, as a consequence, I may
have come across nearly every (though, certainly, not all)
medical condition for which a person might imaginably file for
disability benefits. And without a doubt, I came across a fair
number of cases for which bipolar disorder was a primary
allegation. But I don't recall seeing as many bipolar cases then
as I currently see now.
What could be the reason for the rise in bipolar disorder cases?
I've wondered about that many times. Some individuals might say
that the illness is being overdiagnosed, and that opinion has
been leveled at ADHD. But, I don't think this is the case and
here's why: Bipolar disorder typically requires the use of
prescription medication for proper management. Bipolar also
frequently occurs in combination with other illnesses, such as
OCD, or obsessive compulsive disorder and ADHD, or attention
deficit hyperactivity disorder (and, yes, it is not unheard of
for a patient to be concurrently treated for all these
conditions). Of course, ANYONE who has ever been put on a
medication treatment regimen that attempts to treat multiple
conditions simultaneously will know automatically what sorts of
problems this may pose.
What are those problems? For starters, a medication that works
just fine for ten million other patients may not work at all for
just one. Or, it may work fine for awhile and then not work at
all. Or there may be side effects to the medication that are
somewhat unpleasant and/or stimulate other psychological issues
(weight gain, sexual performance issues, to name a couple).
Throw in more prescription meds to treat other conditions (in
our example, we cited OCD and ADHD) and you enter into the
equation even more variables: will med A negate the potency of
med B, will med B overenhance the effects of med C, will med C
in combination with med A cause other physical or mental issues
to surface, etc, etc.
For these reasons (all boiling down to the fact that very strong
medications with very strong effects and consequences are being
prescribed), I sincerely doubt that bipolar disorder is being
overdiagnosed, or is even misidentified on a large scale. In
fact, quite the opposite may be happening. That is, mental
health professionals may simply be improving in their ability to
properly diagnose this condition. Additionally, individuals with
bipolar disorder may, as a consequence of greater recognition
and understanding of their illness, be more willing to initiate
disability applications.
One might ask "Why would someone not file for disability
benefits when they have a condition that affects them so
profoundly"? This may go back to that "greater recognition and
understanding part". I'll reference this example, which, in my
case, comes from my personal life. I have an in-law who
currently is treated with outpatient shock therapy. For the sake
of confidentiality, I'll refer to him as Bob. Among his various
diagnosed conditions, Bob has a particularly severe case of
bipolar disorder. And for many years, he was unable, despite
many attempts, to maintain employment for longer than 90 days.
Yet, despite this fact, despite his many problems with getting
the right medications, and despite the fact that he has been
receiving ECT (electroconvulsive therapy) for more than a
year---he still has at least two family members who somehow
think "he should have tried harder".
Such thinking is incomprehensible, of course, given the facts of
Bob's situation. However, the stance taken by these family
members probably had much to do with why Bob did not file a
disability application much sooner. Also, the pressure put on
Bob by members of his family to "keep trying to work" may have
hastened his descent into auditory hallucinations and shock
therapy.
Therefore, "if" the rise in disability applications filed on the
basis of bipolar disorder can be accounted for by either or both
of the following---
1. an increased ability of mental health professionals to
recognize the disease.
2. an increased empathy and understanding of bipolar disorder on
the part of family members.
---then this is certainly a good thing.
Whether this is actually happening, of course, is a matter that
is subject to debate. But, in any event, more information is
always, intrinsically and inherently, valuable. And to this end,
the following information may be helpful to a bipolar patient
who has either filed for disability benefits or is considering
filing: http://www.nosscr.org/hallfaq.html>the Nosscr
Social Security Disability FAQ.
About the author:
The author of this article is Tim Moore, who maintains a site
that focuses on the http://www.fibrofactpage.com> Social
Disability known as Fibromyalgia
Written by: Tim Moore
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Bipolar Disorder and Disability Assistance Benefits
