Talk:Bipolar disorder

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 26 April 2019. Further details are available on the course page. Student editor(s): Reidster12 (article contribs). Peer reviewers: Tmatkins19, Mojoad33.

New RfC on the mask image

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.

(non-admin closure) Closing without a decision on account of the wording being vague and open to many different responses. WP:RFC and WP:WRFC demand that the opening statement should contain a straightforward question which is as specific as possible. This has been a discussion, incidentally a very informative and productive one, IMVHO, but it cannot be assessed as an RfC. -The Gnome (talk) 07:40, 16 September 2018 (UTC)

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Bearing in mind the two edit requests above, who actually likes this image? Should we look for another one?--♦IanMacM♦ ^{(talk to me)} 19:00, 26 July 2018 (UTC)

Well, I have bipolar disorder, and I like the image. I think the solution is not so much to delete the image, as to replace it with a better image. Something like an image of a tree in summer in full leaf and bearing fruit alongside the same tree in winter with its branches bare would seem good to me, (perhaps something like this or this) but I have not yet found such an image with appropriate use rights. File:Four Poplars in four seasons.JPG, and its source images, also on Commons, seems to be suitable source material for creating such an image. -- The Anome (talk) 10:28, 27 July 2018 (UTC)

I think that File:Four Poplars in four seasons.JPG has problems with WP:IMAGERELEVANCE, which says "Images must be significant and relevant in the topic's context, not primarily decorative". The trees image doesn't convey much of value.--♦IanMacM♦ ^{(talk to me)} 14:15, 27 July 2018 (UTC)

I wasn't thinking of that image itself: I was thinking of a graphic, using it for reference, symbolizing the stark contrast between the extreme plenitude of mania and the extreme paucity of depression. -- The Anome (talk) 12:23, 29 July 2018 (UTC)

Older readers may remember when this image was in the infobox, which I thought was OK and had some sort of consensus. Unfortunately it was deleted because of WP:NFCC concerns, leaving some users scraping the barrel over at Commons because the article must have an infobox image. Actually, WP:IMAGERELEVANCE says "not every article needs images".--♦IanMacM♦ ^{(talk to me)} 13:11, 29 July 2018 (UTC)

• What do you all think about a graph such as these? I think it would be possible to make them with English labels.

The theatre masks could be moved to the 'Society and culture' section, with a properly sourced explanation of the symbolism and its relative accuracy. (If you don't like the exact image used in this article, then there are many more at c:Category:Comedy and tragedy mask icon.) WhatamIdoing (talk) 05:53, 1 August 2018 (UTC)

• I am happy with the current mask. This is a commonly used image for this condition. I am also happy with the prior tree image but their was copyright concerns. I am not a fan of the graphs. Doc James (talk · contribs · email) 09:34, 1 August 2018 (UTC)

• I can see how the masks would be considered offensive. I really like the prior image noted by IanMacM that had copyright issues. If that was acceptable to everyone in the past, maybe we can find someone to create a similar image and submit it to CC. I'd be willing to give it a shot if everyone here agreed to use it. § Music Sorter § (talk) 04:29, 4 August 2018 (UTC)
• I would prefer a suitable "trees" image - or one showing a wheatfield in summer and in winter. The masks image doesn't seem quite right, the tragedy part is near enough, but comedy doesn't really align with mania. The graphs convey nothing that isn't better conveyed by text. Maproom (talk) 07:02, 9 August 2018 (UTC)
  • For someone who sees people with mania fairly frequently, yes they often smile or grin excessively.
  • The APA uses a similar image but with images of a real person.[1] NAMI also uses this type of image[2] as do multiple university sites.[3]
  • It is the most common method of illustrating the condition in fact. Doc James (talk · contribs · email) 08:12, 9 August 2018 (UTC)

agree w/ doc James, it is the most common manner...IMO--Ozzie10aaaa (talk) 11:18, 9 August 2018 (UTC)

If it's kept, I think the caption should be expanded a little to explain that this is frequently-used imagery. -165.234.252.11 (talk) 19:10, 13 August 2018 (UTC)

Having said that, though, my gut reaction is that it's pretty weird to present a stylized logo for a mental disorder. -165.234.252.11 (talk) 15:43, 14 August 2018 (UTC)

• Tree image is a better representation. Not a fan of the masks. That they are often used isn't a good reason to use them here as I'm sure the reason many articles use them is simple laziness. It can be used lower in the prose and explained, but I don't really see the need and that would be beyond the scope of this RFC anyway. Don't like the graphs at all. Way too simplistic of a representation, to the point of being misleading. Dennis Brown - 2¢ 20:28, 13 August 2018 (UTC)

To add, I know more than a couple of people who are bipolar and would consider the idea of using masks to be just a little offensive. That doesn't stop the press from using them, but using representations of Comedy and Tragedy to demonstrate (hypo)mania and depression is rather crass and should not be done in an encyclopedia. Having no image is infinitely better than using the masks. Dennis Brown - 2¢ 20:50, 14 August 2018 (UTC)

• I think the mask image should be removed, regardless of whether another image is put in its place. I'd also like to throw in the idea of using an image of Kraepelin (e.g. File:Emil Kraepelin 1926.jpg) or someone else relevant to the discovery of the disorder. — Bilorv_(c)(talk) 18:51, 16 August 2018 (UTC)

@Dennis Brown (to others)—I agree that the bifurcated tree image is better—in my opinion, a pefect metaphor for the bipolar spectrum. The Comedy/Tragedy mask as now used are just crude knockoffs of the classical representations and show the typical limitations of clip art whose only virtue is being free. Ib this case it's not even decorative(as it might be at the bottom of a high school play program. This article deserves a better effort—it deserves an image that serves as in introduction to bipolar spectrum itself, not just one of the first medical professional to describe it. The bio is the place for that.

Of the three images DocJames mentioned, the APA image is ok. The image with the mirror is lit too much like part of an ad. The capering figures image is perhaps ok for a brochure cover aimed at a child with a bipolar parent, but not for an encyclopedia article that gets pretty technical.

I suggest no image until a properly free and expressive image can be found. — Neonorange (Phil) 07:31, 17 August 2018 (UTC)

The image of Emil Kraepelin does not clue one into what this page is about and therefore IMO would be inappropriate.

If the image was so controversial as some are claiming than why would so many medical organizations be using it? Doc James (talk · contribs · email) 23:57, 19 August 2018 (UTC)

Not every design decision is made by a doctor, and not every bipolar person is going to make an unsolicited comment about it. Bipolar diagnosing and treatment is still way behind the times, I don't find it shocking that some are using images that really aren't appropriate, even if they mean well. Dennis Brown - 2¢ 23:01, 4 September 2018 (UTC)

• Not every article needs an image, and its better to have none rather than the mask which some people find offensive or disrespectful. (Also, I think the current image is simply not encyclopedic and sets a wrong tone.) Lack of consensus what should the replacement be should not hinder simply removing the mask image. I agree with points made by Neonorange. — bieχχ (talk) 19:00, 3 September 2018 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Please Remove "BPD" From this page

Hi,

While 'Bpd' is used as an abbreviation for bipolar, the abbreviation "BP" is more clear, as "BPD" is frequently used for "Borderline Personality Disorder".

"BP" is just as accepted, but is more clear. Eswales (talk) 11:29, 9 September 2018 (UTC)

•  Done This was added recently in this edit in late August 2018. There is a risk of confusing it with Borderline personality disorder which is the more usual acronym, and it isn't a WP:COMMONNAME for bipolar.--♦IanMacM♦ ^{(talk to me)} 12:28, 9 September 2018 (UTC)

Antidepressants

I don't know why antidepressants for associated symptoms was removed from the infobox, as atypical antipsychotic medication, such as risperidone, olanzapine, quetiapine, or aripiprazole, are typically augmented to enhance the effectiveness of the SSRI antidepressant, including sertraline, fluoxetine, paroxetine, or fluvoxamine, especially in the treatment of bipolar disorder. ATC ^{. Talk} 08:35, 10 November 2018 (UTC)

Ref says "A recent meta-analysis of 15 RCTs found no significant benefit for antidepressants over placebo in the treatment of bipolar depression"

What ref were you using? Doc James (talk · contribs · email) 07:18, 11 November 2018 (UTC)

That's because there has been little research on combining the SSRI antidepressant with the antipsychotic but psychiatrists frequently prescribe antipsychotics to enhance the effectiveness of the antidepressant. See this article here: https://www.ncbi.nlm.nih.gov/m/pubmed/12392350/ ATC ^{. Talk} 04:49, 12 November 2018 (UTC)

That source is from 2002 and thus too old. A discussion of antidepressants belongs in the body of the article not the infobox. Doc James (talk · contribs · email) 02:12, 13 November 2018 (UTC)

Semi-protected edit request on 27 January 2019

I am looking at this sentence in the introduction of the article: "Due to poor lifestyle choices and side effects from medications, the risk of death from natural causes such as heart disease is twice that of the general population."

It should be amended to read something along these lines: "Due to common behavior patterns among those afflicted with bipolar disorder, as well as to the side effects of medications frequently used to treat the disorder, the risk of death from natural causes such as heart disease is twice that of the general population."

There are a few problems with the sentence as it stands, but the main problem is the phrase "poor lifestyle choices." This phrase is judgmental, vague, and altogether un-encyclopedic. Another problem is this: Side effects are *of* medication, not *from* medication. Another problem is this: Among whom is the risk of natural causes twice that of the general population? The answer to that question is: among sufferers from bipolar disorder. That should be included in the sentence.

I recognize the sentence I've constructed might sound a little awkward to some, but it's a start. LeRichard11 (talk) 04:28, 27 January 2019 (UTC)

Sounds reasonable - you should be able to edit this page as it is only semiprotected not full-protected...? Cas Liber (talk · contribs) 06:11, 27 January 2019 (UTC)

• He's not autoconfirmed yet. And I agree the changes are an improvement. I've made the changes myself. Dennis Brown - 2¢ 18:30, 28 January 2019 (UTC)

We do not use the term "afflicted" per WP:MEDMOS. Will adjust further. Doc James (talk · contribs · email) 18:35, 28 January 2019 (UTC)

Adjusted to "Due to lifestyle choices and the side effects of medications, the risk of death from natural causes such as heart disease in people with bipolar is twice that of the general population." Doc James (talk · contribs · email) 18:40, 28 January 2019 (UTC)

Semi-protected edit request on 19 February 2019

In the Bipolar Disorder page please move the paragraph under "Causes" to the "Genetics" paragraph. Please remove the title "Causes". Please remove the first and last sentences under "causes" (please see below for reference): Please remove the first sentence "The causes of bipolar disorder likely vary between individuals and the exact mechanism underlying the disorder remains unclear.[42]". Please remove the last sentence "Estrogen in women, has been linked to bipolar disorder.[46][47]

After these edits are done the first sentence under the Genetics title should read "Genetic influences are believed to account for 60-80 percent of the rick of developing the disorder indicating....:

Thank you very much-flamingo2019 Flamingo2019 (talk) 18:44, 19 February 2019 (UTC)