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Re: Major Depression May Be Relative of Bipolar Disord » SLS

Posted by BarbaraCat on July 24, 2004, at 23:52:31

In reply to Re: Major Depression May Be Relative of Bipolar Disord » BarbaraCat, posted by SLS on July 24, 2004, at 18:05:50

> Hi Scott,
>
> When you are in this state, does it resemble atypical depression? Is morning your best time or your worst time?
>
**I don't really know what typical vs. atypical might be. I characterize unipolar depression as being more typical of low energy, low affect, low, low, low. But this hypo-everthing is more the description of 'atypical'. I have two forms of mood disorder. One is the 'Life sucks and then you die and I could give a sh*t' brand, the other is hopeless despair with high anxiety, the most extreme case being mixed states. Both kinds are worse in the morning, and get better throughout the day. Perhaps something to do with cortisol. My levels are mid-range, not high. But things get so much better in the evening that cortisol is the major thing that would seem to influence it.
>
> Perhaps this is a mixed-state and not pure depression.

**Yes, it is a mixed state. But hard to distinguish from good old agitated depression with psychotic features. The only thing that tells me it's probably bipolar is my dramatic response to lithium and the aggravation from SSRIs.
> >
> How do you describe your mood reactivity? Can you be brought out of your depression temporarily if something good happens?

**Very temporarily. However, if I won the lottery, I don't care what they say, I would be one happy camper. If that didn't work, at least I'd prefer to cry on a silk pillow than a ratty one.
>
> > My point is that no generalizations can be made.
>
> I'm not convinced of that yet. :-) I do understand that the spectrum of presentations is highly variable, but I think the wide range of recipes include a relatively small number of ingredients.

**This got me started on a flight of theoretical fancy. If you have a few ingredients - say flour, butter and milk - you can make different kinds of foods. Cookies, cream sauce, shortbread. But they all have a similar taste. It's hard to get different flavors from the ingredients, just different textures and shapes. So, where was I going with this? Seemed important at the time.
>
>
> This is exactly why I think it is so important to diagnose accurately bipolar depression and differentiate it from unipolar depression if it is at all possible as soon as possible. Perhaps there are some common, although subtle, features of bipolar depression that can be recognized or generalized in a majority of cases. I hope so.

**Me too. So many other symptoms are now being attributed to the bipolar spectrum that it's difficult, especially for someone whose memory and judgement is impaired. It was a major shock to finally recognize that I was bipolar since I couldn't remember myself as anything but depressed when the questions were asked. We have to come up with something better than a subjective quiz.
>
> >Gosh, I hope not. I don't think one can use the communities of people posting on Internet websites like this one as a reflection of the total population of people being treated for depression. I think the population here on PB is skewed towards people who have failed treatment, and it would be difficult to extrapolate from it to what degree "poop-out" occurs generally.
>
**Of the many people with whom I've been acquainted who have mood disorders, the poop-out rate from SSRIs is pretty dang high. A long-term run of the same med at the same dosage is the exception. I'm referring specifically to SSRIs, not the older ADs. Mood stabilizers are frequently given for 'AD augmentation' when they poop. Maybe just cut to the chase and prevent the poop by prescibing a MS along with the SSRI. Hey, an idea for some enterprising pharm company.
>
> What does "de rigeur" mean?

**From Encarta: Required, strictly required by the current fashion or by etiquette ( formal ). [Mid-19th century. From French, literally “of strictness.”]

> >
> > http://www.psycheducation.org/
>
> Thanks for the link. I really, really hope I'm right about the bipolar depression thing. If there is any way to tease out a tell-tale symptom profile, it will save a lot of anguish. Of course, finding a bioligical test would be even better.
>
**I'm waiting for that StarTrek phaser thingy that Dr. Beverly Crusher employed. You'd think with all the billions we're spending to blow people up we could do better by our mental health. The psycheducation.org website has a pretty good questionnaire that works alot better than the DSM-IV, which is pretty worthless considering how differently this thing presents. Shoot, how many different forms of bipolar are there now? Last count I think we were up to 4 or 5. I can't even tell if I'm BP-I or II. It'll probably all turn out to be mercury toxicity. - BarbaraCat


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