Posted by SLS on November 9, 2001, at 18:07:57
In reply to Re: Atypical Depression Actually Very Typical » SLS, posted by Elizabeth on November 7, 2001, at 12:19:57
Sorry I took so long to get to this.
> I would chart out the course of my depression except I'm afraid it would be really long and complicated!
Maybe it would prove edifying to get a hold of a NIMH life-chart. I don't remember where to get one. You could try the U of Pitt Stanley site.
> Basically I've had some problems all my life (attention deficit, generalized anxiety, and social phobia), episodic major depression started around age 10 or 11, had residual symptoms after the first remission (the residual and major depression got worse with each episode), PTSD at 17, panic disorder at 20, anhedonia-anergia at 21.
I wonder if bipolar depression can overly dysthymia? I guess this would be difficult to differentiate from an incomplete remission of bipolar depression. It is possible, I think. A friend of mine suffers from unequivicol bipolar disorder. Her first major depressive episode occurred at age 18. It was severe and required hospitalization. ECT was employed, and the depression remitted. Supposedly, it is more common for a juvenile or adolescent bipolar to experience a manic episode first. I don't recall whether she did or not. She may have. I vaguely remember her describing a time prior to the depressive episode when she thinks she was hypomanic. Certainly, she did experience a manic episode later on, although it was not severe. Her sister is definitely bipolar I, having had several florid manic episodes, at least one of which required hospitalization. My friend did well on lithium for over 8 years. A new doctor told her that she didn't need it anymore, and it was tapered gradually. Within three months, a severe depression emerged. It was not mood-reactive, although she experienced reverse-vegetative symptoms. She was also suicidal. The reintroduction of lithium had no effect. She responded briefly to Nardil, Parnate and doxepin. Over the last 9 years, she has experienced two mood states: severe depression and dysthymia. Severe depression occurs when effective medications are discontinued (in search of a more complete response). Wellbutrin effectively resolves the severe depressive episode. She is left with a residual minor depression that has thus far remained refractory to treatment, including with mood-stabilizers. Lamictal and Topomax are somewhat helpful. She is not mood-reactive during the severe depressive episodes but is mood-reactive while dysthymic.
Bipolar depression can look like a mixture of atypical and melancholic. For me, my depression was more melancholic initially and grew more atypical later. My mood was not reactive. How can someone be both? If I weren't pressed for time, I would try to research it and try to produce details. I am interested to find out.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9893154&dopt=Abstract
"The cardinal clinical manifestations of major depression with melancholic features include sustained anxiety and dread for the future"
This was me.
I put together a post for someone else regarding bipolar I versus bipolar II symptomology. I came across a few things that indicate that bipolar depression can present as a mixture of melancholic and atypical. You might find a few of the links and quotes informative. Do you see any of yourself there?
I'm just poking at you with a stick. :-)
http://www.dr-bob.org/babble/20011104/msgs/83672.html
By the way, I came across a recent article that defined bipolar III as expressing mania only in association with drug intervention. If this is a separate entity of which I suffer, then it deviates greatly from bipolar II in that the manias can become severe and psychotic. Yours would qualify.
A quick note. My circadian rhythm is triphasic:
morning - better
afternoon - worse
evening - betterSort of like overlapping melancholic and atypical?
- Scott
poster:SLS
thread:83164
URL: http://www.dr-bob.org/babble/20011104/msgs/83707.html