Psych Central


Recently, I heard the term decompensate for the first time. The therapist seemed surprised that I had never heard it.

Given the definition of compensate – to reimburse – I thought decompensate might mean something along the lines of having your disability payments taken away. You might say something like “Social security just decompensated me, now what am I going to do?” or “Bipolar disorder decompensated me, and now I have no money to pay the bills.”

The therapist explained that decompensation is what occurs when everything you’re doing to prevent a mood episode (to compensate for the illness) just isn’t enough.

When I mentioned to Dr. Fink that I had never heard the word, she said I must be a big dummy. Well, she didn’t actually use those words. Here’s what she really said.

4 Comments to
Have You Decompensated Lately?

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  1. I work in this field and have used this term.
    Very nice article!

  2. I just heard the term decompensated used for the 1st time today, regarding my brother who was diagnosed with a psychiatric condition over 40 years ago!
    Those of us not in the medical field do not know the terms, and acronyms, used in that industry on a daily basis. Would the people in the psychiatric/medical field know anything about the terms, and acronyms used in the technical, mechanical, engineering, automotive, manufacturing, or any other industries that are used daily? I think not. So who are the real dummies here?

  3. Other terms that are used:

    Axis 1, Axis 2, Axis 3 and Axis 4

    Axis is used to described your diagnosis. Primary diagnosis is Axis 1.

    For me, Axis 1 is Biploar 1, Axis 2 is personality disorder, nos (ah, nos, that’s another one. it means not otherwise specified)

  4. I think the word “decompensate” actually comes from an older meaning of “compensate” — to balance, or to keep in balance. The use of “compensation” to mean either “payment” or “taking action to prevent” derives from this original meaning of putting things into balance. Thus, to decompensate is to fall out of balance, in recognition that mental states, operation of the heart, etc. are normally maintained by various mechanisms that keep the system in balance; if they don’t work quite right, you get decompensation.

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Candida Fink, M.D. and Joe Kraynak are authors of
Bipolar Disorder for Dummies.


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