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Re: atypical depression -how typical?

Posted by Scott L. Schofield on November 8, 1999, at 18:25:26

In reply to Re: atypical depression -how typical?, posted by Annie on November 8, 1999, at 9:44:01

> > > Some researchers are grouping the unipolar depressions with bipolar illness--because the "atypical" version is akin to the depressive states of those with bipolar. > I hope these researchers are put in their place as quickly as possible. There is no question that the epidemiology of unipolar versus bipolar depression is manifestly very different. If the response rates to mood-stablizers turns out to be different between the two, their conceptualization would be extremely counterproductive. My "current" psychiatrist is one of the proponents of the theory that there is no such thing as atypical depression. If a person exhibits the atypical subset of symptoms, like me, they are really bipolar whether or not they have ever experienced a manic or hypomanic episode.

... researching my depression online is manic, assertiveness is manic...

...You know, I just don't care anymore. Let him call it whatever he wants. I'm dying a little bit more every day and soon there won't be enough left to matter. When I am totally gone it won't matter what my dx was.
Annie <

Dear Annie,

Although your doctor may be accurate in his appraisal of your illness, I think his characterization of your conducting research as being manic is unfair. Because I have seen at least two recent posts regarding the concept that all presentations of atypical depression are actually bipolar, I decided to do a little research of my own. The attitude I expressed in my previous post may have been unfounded.

I was more than just a little surprised at how few studies have been conducted in this area. There is quite a bit more uncertainty now as to the existence of a true atypical unipolar depression than there was ten years ago. I found a few studies in which sequential patients meeting the DSM IV diagnostic criteria for atypical depression were evaluated for bipolar disorder. At least two studies demonstrated that roughly 40% of those meeting the definition of atypical depression were actually bipolar II.

I would like to see a study in which both the 40% bipolar group and the 60% non-bipolar group are first treated with Depakote alone.

Either way, it might not be a bad idea to act under the premise that you are bipolar. It may lead to a successful trial using other mood-stablizers in addition to antidepressants.

Please care for a little while longer.

- Scott

P.S. Today has been a very upsetting one for me. The story is too long to get into here, but I didn't care a whole hell of a lot either. I hope I'm strong enough to take my own advice.




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