African Americans & Bipolar Disorder

How Racial Disparity Impacts on Diagnosis

There is a great deal of misinformation presented in the media concerning bipolar disorder. This is especially true when one looks at the problem of misdiagnosis of individuals with this disorder. Typically, what happens with topics such as Bipolar disorder is that the media will exaggerate an issue or even misinterpret studies surrounding the issue. A strong example of this problem can be seen in the media reporting of Bipolar disorder in African Americans.

Bipolar Disorder is classified by the DSMVI as mood disorders. Bipolar disorder is marked by mood swings ranging from manic to depressive states. People with bipolar disorder experience unusually strong emotional states that are referred to as ‘mood episodes’. There are two opposing episodes called manic and depressive. It can occur where; a mood episode combines symptoms that are manic and depressive. This is known as a mixed state. This variance makes it possible for an individual with bipolar disorder to experience a period of unstable moods rather than distinct episodes exhibiting depression or mania (NIMH, 2010). A person could be diagnosed with having an episode of bipolar disorder if he or she exhibits manic or depressive symptoms for a majority of time during a one to two week period. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home.

Jena Lowe, a reporter for the Austin Weekly News reported this problem in May of 2010. Her report discussed the problem that many people in the African American community are apathetic towards medical treatment due to racial discrimination and past mistreatment. Lowe points out that most African Americans are afraid to be stigmatized further by having a mental illness and this complicates treatment, forcing many to seek less effective alternative ways to deal with their illness,

We have research that indicates they wind up being homeless or in the criminal justice system,” she said. “If a problem is not diagnosed or treated, the person is often unable to carry a household, may not have friends or family to support them. This may lead them to substance abuse (LOWE, 2010).

According to Lowe (2010), many African Americans will be classified in other ways such as being a drug addict or alcoholic. This problem is a direct result of the African American community being victims of discrimination and apathy. While Lowe seems to be making a point concerning African Americans she is distorting the facts of the situation. Like most groups, African Americans have issues with being misdiagnosed with Bipolar disorder.

Grandin, Alloy, Lyn, & Abramson (2007), reported in their study of Bipolar disorder that one in six Americans is at risk of becoming bipolar. Their hypothesis was that Bipolar disorder was impacted by traumatic environmental conditions more significantly than by genetic or social conditions such as wealth or status. Their research crossed all demographic lines and further showed that the disease was widely misdiagnosed amongst most demographics. Furthermore, demographics such as race or class impacted results less significantly than did the environment.

Specifically, we tested the harsh environment and stress generation explanations of the childhood stress and bipolar disorder relationship. The final sample included 155 bipolar spectrum participants and 155 demographically matched normal controls. These findings suggest that the relationship of childhood stressors and bipolarity may be best explained by a harsh environmental effect (Grandin, Alloy, Lyn, & Abramson, 2007).

This research provides evidence that racial disparity was not significant in bipolar disorder prevalence. While treatment options for different racial and ethnic groups might be limited the actual misdiagnosing of the disease is pervasive in all demographics. The researchers further showed that family background such as abuse and traumatic childhood experiences increased the risk of bipolar disorder. Teen African Americans were shown to have a slightly elevated level of risk most likely due to conditions such as increased poverty and social issues.

Further evidence of Lowes’ misinformation, comes in the form of a 2007 report in which researchers found,

…a forty-fold increase in the number of office visits in which children had a diagnosis of bipolar disorder (BP)[1]. The researchers estimated that whereas in 1994–1995, in about 25 out of every 100,000 visits a child had a bipolar diagnosis, the number increased to 1,003 per 100,000 by 2002–2003 (Paarens & Johnston, 2007).

This finding was believed to be caused by new clinical techniques which allowed for more accurate assessments of children with bipolar disorder. Such a large increase can only be contributed to a lack of comprehensive understanding of the disease. While Lowe might be correct that African Americans are being misdiagnosed, this correct reporting would be due to the fact that most people are misdiagnosed when it comes to bipolar disorder. Scientists in the report admitted that prior to the 1990’s most researchers thought that bipolar disorder could not be diagnosed in children (Paarens & Johnston, 2007).

Despite research that contradicts reporters such as Lowe, the media continues to present misinformation concerning bipolar disorder. The most likely cause of this problem is the perpetuation of the myth that takes place within the media based on prior misunderstandings in neuroscience. At one time, Bipolar disorder was lumped in with a variety of other disorders and the information from that time period continues to be found in the media. In reality, Bipolar disorder is a mostly treatable disease which affects all demographics of people. The problem is that the expansion of scientific knowledge concerning bipolar disorder does not filter into the media at the same rate with which it is growing in the medical profession. This creates many problems primarily with reporters using faulty information or reporting circumstances in a misleading fashion.

References

Paarens, E., & Johnston, J. (2007). Controversies concerning the diagnosis and treatment of bipolar disorder in children. Retrieved from http://www.capmh.com/content/4/1/9

Louisa D. Grandin, Lauren B. Alloy, Lyn Y. Abramson (2007) Childhood Stressful Life Events and Bipolar Spectrum Disorders Journal of Social and Clinical Psychology, 26 (4), 460– 478

LOWE, J. (2010, May 5). Misdiagnosis of bipolar disorder in blacks common, experts say. Retrieved from http://www.austinweeklynews.com/News/Articles/5-5- 2010/Misdiagnosis-of-bipolar-disorder-in-blacks-common,-experts-say/

NIMH. (2010). Bipolar disorder. Retrieved from http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

NIMH. (2010). Major depression . Retrieved from http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml