Posted by SLS on November 6, 2001, at 19:46:48
In reply to Re: Atypical Depression Actually Very Typical, posted by Noa on November 6, 2001, at 17:48:18
> > Scott --
> >
> > I'd always wondered what the numbers were on that. Thanks for posting this.
> >
> > Say, any idea how someone could have atypical and melancholic features at the same time??? (The mood reactivity criterion seems to rule this out.)
> >
> > -elizabeth> well, if there can be mixed states in bipolar, why not mixed states in depression?
That sounds good to me. It might be sort of like double-depression, where a major depressive episode lies on top of chronic dysthymia. Another avenue of thought might be along the lines of some of the more recent conceptualizations of depressive illness in general. There are some doctors that subscribe to the idea that the course and presentation of mood illness for any one individual can be variable. The illness might be expressed as rapid-cyclicity during one time period and chronic during another. This is true in my case:Age 10-17: Chronic mild to moderate depression; anhedonia, no anxiety.
Age 17-20: Chronic severe depression; atypical and melancholic features, severe social anxiety, depressed mood, minor impairments of concentration and memory.
Age 20-22: Ultra rapid cyclicity; extraordinarily regular 11-day cycle (8 days severe depression followed by 3 days of near normothymia), atypical and melancholic features, depressed mood, moderate impairments of concentration and memory, anergia, anhedonia, moderate social anxiety.
Age 22 - today: Chronic severe depression; predominantly atypical, anergia, anhedonia, severe impairments of concentration and memory, slow-thinking, no depressed mood, little or no anxiety.
Elizabeth - In 1982, Fred Quitkin labelled my depression as unipolar "atypical reactive-type with endogenomorphic characteristics". At the time, the term "endogenous" was used as a synonym for "melancholic". Wilma Harrison was my primary psychiatrist, Dr. Quitkin being her boss. I don't think her evaluation of me as being mood-reactive was accurate. Sometimes, doctors don't ask the right questions. Mood-reactivity was never a feature of my illness. I did experience depressed mood and some melancholic thoughts. Although, I was able to laugh and become animated at times, my depressive symptomology did not abate at all. This, combined with a criminally positive outlook, confused them both. I think what they were really looking at was what is now recognized as typical of a chronic bipolar depression.
I sometimes get the impression that your depression demonstrates both melancholic and atypical features. Perhaps it falls into Nierenberg's "neither" category. In what ways, if any, do you think your presentation deviates from the classic melancholic profile?
- Scott
poster:SLS
thread:83164
URL: http://www.dr-bob.org/babble/20011104/msgs/83386.html