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Today, according to the NIMH, bipolar illness affects one in every forty adults in the United States, and so, before we review the outcomes literature for this disorder, we need to try to understand this astonishing increase in its prevalence.9 Although the quick-and-easy explanation is that psychiatry has greatly expanded the diagnostic boundaries, that is only part of the story. Psychotropic drugs--both legal and illegal--have helped fuel the bipolar boom.