As most people know, when a drug is developed, the drug manufacturer receives a patent on that drug. The patent means no one else may produce that drug for a period of time. Drug patents in the US are 20 years, but these patents begin before clinical testing, so really, the drug manufacturer has about 7-12 years of patent protection once the drug is on the market. After the patent expires, other companies may produce the drug, these are called generics. Do you really need to pay the high price for brand name Prozac or is the generic, fluoxetine, just as good?

This week saw the passing of Schizophrenia Awareness Day and I think it's time to take a moment to learn some facts about this much stigmatized mental illness.

Recently I read a great article on the use of brand names when referring to drugs. The author, a doctor, decries the practice and says doctors should use the name of the drug rather than the brand name. The brand name of the drug, after all, was chosen by a marketer and a focus group and is really just advertising for the drug. The only trouble is, patients don't know, or can't remember, the actual names for drugs.

I recently read an impassioned plea from a doctor for health care professionals to stop referring to drug by their brand name. The brand name, he argued, was basically just an advertisement for the drug. This got me to thinking, how do drugs get their names anyway? The answer is marketers, researchers, doctors, focus groups, the FDA and about $2 million. Really.

If you follow me here, or particularly elsewhere, you might have noticed there are some very vocal people who hate me. Mental illness is contentious, and some people take it to a personal level. That’s people for you. Sometimes I talk about these people. I call them “the nasties.” But today is not about them. Today is about celebrating all the wonderful, amazing people who support me, Breaking Bipolar and the mental health community in general.

I’ve written about this several times, but never said it quite this directly: No one is a diagnosis. No one fits the criteria for “bipolar” or “depression” exactly. No one is a “Patient Like You.” It’s why someone only has to have five out of eight characteristics to be diagnosed with depression. Because there is recognition within the medical community that “depression” isn’t a single thing, much as “bipolar” isn’t a single thing. Those words represent diagnoses that exist along a spectrum. In writings elsewhere I have suggested what I call a “dimensional” diagnosis. (And this is probably because I’m a computer science-y kind of gal.) Basically you have symptoms and diagnoses that exist along multiple axes. Then, depending on where the dots cluster, you essentially have a Venn diagram of diagnoses. It’s OK if you didn’t quite follow that. I know. It’s complicated. But humans are complicated creatures. I like chocolate ice cream, you like vanilla. Humans are a heterogeneous bunch. Why then, if we understand this, do we have names in the first place? Is the term “bipolar” really even useful? In short, yes, it is. And yes, we need those labels, even if they are ill-fitting.

If you’re in treatment for depression and have ever mentioned a desire to die, you’ve probably heard these questions: How would you commit suicide? Have you make a plan to commit suicide? And others. So a commenter recently mentioned that this is just a way of “covering their backs,” and “. . . if I were serious about killing myself and had made a plan, why on earth would I tell them?” This is a logical question, but an uninformed one. In studies, we know that people who attempt suicide do reach out for help and do not really want to die.

In response to some of the comments I see here and elsewhere, here is my response to another ten myths about bipolar disorder.

Antipsychotic medications were so named as they were initially used to treat psychosis in disorders like schizophrenia. Antipsychotics include medications like Haldol, Thorazine, Seroquel, Abilify and Zyprexa. These medications are now being used, more and more, in the treatment of other disorders like bipolar disorder and major depression. One of the major problems with these medications is a side effect called tardive dyskinesia. Tardive dyskinesia is a disorder involving involuntary muscle spasms and can be (but isn’t always) permanent – even if the medication is discontinued. How can you and your doctor look for the signs of tardive dyskinesia?

I hate shrinks. Shrinks should die. Shrinks are evil. (Thank the commenters (not an individual) for that.) OK I get it, you don’t like psychiatrists. Personally, I would find a more intelligent way to express an argument, but your point is clear nonetheless. You’re ranting. I get that. I rant. We all do. It’s a healthy expression of the frustration seen when dealing with so many things outside of our own control. But at some point you have to stop hating, wishing for murder and committing moral condemnation and actually do something useful.