Posted by BarbaraCat on August 15, 2002, at 13:29:46
In reply to Re: I would revise your categories » BarbaraCat, posted by Abby on August 15, 2002, at 11:46:43
Thanks Abby,
I'm still confused, though. I have varying kinds of 'depression', and have come to suspect that the *crazier* brand is the bipolar mixed-states variety. This seems to be hypomania overlayed with classic depressive symptoms. It has a nightmarish quality all its own and goes way beyond unipolar in sheer terror factor. The only differentiation I can come up with where mixed states differs from unipolar with axiety is that I have had periodic text-book cases of hypomania (not as many as I would like, alas). These hypomanic and a few manic episodes put me in the bipolar category, even though major depression is the primary symptom. Since starting lithium, I've had depression with anxiety but thank God, none of the mixed states stuff. I believe that we, the sufferers of such, and not the textbooks, are likely to be the expert sources on this topic.> >
> > BarbaraCat Unipolar: Dragging, heavy, sitting on the couch for hours too exhausted or disinterested to move, don't give a rip. No interest in anything, cynical, sarcastic, critical, sleep alot, feel like I'm moving though mud. Feel flat and grim, no joy, everything is a burden and a struggle. Hate life and myself, quiet despair. Body hurts and feels sick. Energy stagnant.
> >
> > BarbaraCat Bipolar: Desperate, frantic, doom and destruction, insomnia, nightmare quality to everything, frantic pacing, hysterical anguished sobbing, hypersensitive, hyper aware of 'existential pain', being sucked into the void, horrible hopelessness. Feel abandoned, cast out and lost in a hostile universe. Scary, black images of decay and desolation. Falling apart, nerves and brain feel inflamed. Not as much somatic distress as with unipolar. Energy frenzied.
> >
> >
>
> Barbara,
>
> I have to agreewith jazzdog's classification:
>
> "It's my understanding that unipolar depression is the anxious, insomniac, losing-weight variety, and bipolar depression involves sleeping too much, having no energy, and gaining weight. But there are also mixed states, anxious hypomanias, etc., so who knows?"
>
>
> Let me say that I am a confirmed Akiskalian with a Bipolar NOS diagnosis. (Bipolar spectrum essentially--not as picky about length of episode.)
>
> I think your description of unipolar depression is closer to bipolar type. My pdoc would say that in bipolar patients sluggishness and fatigue, slowness are all attributes of depression.
>
> The other stuff is a mixed state--hypomanic restlessness mixed in.
>
> "Classical" 20th century definitions count insomnia as a symptom. In my opinion this only applies to typical major depression (which really ought to be called atypical, because it seems to be anything but the norm.
>
> My hypothetical case of a patient presenting with typical major unipolar depression. White male aged 50 at first onset, no history of cardiac disease or substance abuse.
>
> Abby
poster:BarbaraCat
thread:107896
URL: http://www.dr-bob.org/babble/20020814/msgs/116541.html