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Re: mood disorders, ketoconazole, etc - Scott, Cec

Posted by SLS on October 3, 2001, at 11:07:12

In reply to Re: mood disorders, ketoconazole, etc - Scott, Cec SLS, posted by Zo on October 2, 2001, at 15:26:55

> > For me, 9 years ago seems more like 9 months ago. I think >being so vegetative and without the varied activities that >most people experience daily has caused time to slip >away for me and somehow become compressed. By >contrast, a single day in an improved state can contain >more life in it than a full year of my depressed state.
> Yes!
> > This also applies to personal growth and >self-actualization.
> Oh yes!
> > During this time, there were not enough hours in a day >to do everything I felt like doing. Every moment became >an actualization of my potential mental and physical >experience.
> Ahem. I too have had many such golden times. Every symptom of my Chronic Fatigue is *gone*, I think I'm cured, I have posture , I am free of pain, a busy, happy little bee. . .and, god damn it, they've all been one form of mania or another.
> And since my Bipolar has gotten spectacularly worse, I am now on a forced search for a Feel Good that isn't mania. Of course, as my pdoc said, they are only the tiniest degree apart.
> Zo

Dear Zo,

Thanks for your response. It is in some way comforting to know that I have "comrades" in this frustrating and painful struggle. I'm sure other people posting on Psycho-Babble profit in this way as well.

I wanted to make one remark about the *hypomania* that is part of a true bipolar II. It very rarely becomes severe and is sometimes very manageable. I'm probably not up to date with this stuff, but by definition, severe mania does not occur with bipolar II. If such a mania occurs without being precipitated by medication, I think the illness must necessarily be reevaluated and diagnosed as bipolar I.

The point is this. Many people lead productive lives in a chronic state of hypomania. I think some doctors find that for some individuals, allowing it to continue is preferable to the results of the medical treatments tried. Perhaps the hypomania is resistant to mood stabilizing drugs or that these drugs produce unacceptable side effects or produce depression. Maybe this is an option for you.

Trying to read between the lines, it sounds to me like your hypomania is somehow impairing your judgment and functioning sufficiently to be treated. Do you feel this is true? Even if your episodes of hypomania are manageable and don't impact negatively upon your life, should they consistently be a prelude to or facilitating a depressive episode, it is important that it be treated and your cycling minimized.

What do you think? How would you describe your mania? How often do you get depressed, and how severe are these episodes? Does depression always follow mania? Do you ever experience periods of normalcy?

Please don't answer my questions if you feel they are too personal.

It is quite possible that antidepressants only make things worse, and that treatment with mood-stabilizers alone is indicated.

- Scott




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