Q: I am 16 years old and was diagnosed with bipolar disorder when I was a child. I had a very difficult childhood. I never quite got to be a teenager or was able to be a child. I have always made the right choices but some were not so smart. I always sit back and listen to what people like doctors and therapists have to say about me. My mother uses the fact that I have bipolar disorder to her full advantage. It may seem strange to say this but I feel like I am a 20 years old woman trapped in a 16 year olds body. For all my life I have been labelled with some disease or diagnosis. I have been compared to my father and sister and brother my whole life but no one has bothered to look at me - the person that my life has made me now. No one understands what its like to be me for a day or what its like to have my mind. I don’t feel like I have a disorder or disease, I just feel misunderstood. How do I explain myself? How can you explain a life of heartache, and pain and betrayal to a person? How do I explain that I am an independent and a person not an experiment? I would like to know if there is any sure way to see for myself if I do have bipolar disorder?

A:I understand and fully empathies your viewpoint. It is a universal understanding these days that we do not treat labels, but we treat the individual. Besides the symptom control of any psychiatric illness, lies the larger world view of making the individual functional as anyone else. In your specific case, you raise numerous issues: the doubt of the diagnosis, the issue of stigma, the complete management and support of you as an individual. The validity of any psychiatric diagnosis is based on collating the subjective experience with the objective behaviour as seen by significant others, looking into the clustering of symptoms, ruling out other causes which might cause similar symptoms. Thus we can have a cross-sectional diagnosis and a life-time diagnosis. While a cross-sectional diagnosis implies that it fitted best when there was an acute episode, there is nothing to suggest that an individual cannot and would not completely remit with respect to symptoms at a further point of time. The acute episode is obviously not occurring when the symptoms are under control completely. Stigma is again a universal phenomenon, and there are campaigns worldwide to deal with stigma. But, it starts with self and the family to be able to eradicate stigma and give the dignity to the individual to keep on carrying on with life with respect and self esteem. What is required is education for close family members regarding criticality and comparison and how it does not solve but creates more issues. It seems the best help you would be able to receive is from a Clinical Psychologist to deal with the ongoing conflict. And also if you tend to develop any symptoms at a later stage please visit a Psychiatrist, preferably where you can get admitted and your behaviour and mental state can be observed to rule out or confirm a particular diagnosis.