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Re: Never thought I'd hear this..... » detroitpistons

Posted by SLS on March 15, 2006, at 7:40:42

In reply to Re: Never thought I'd hear this..... » SLS, posted by detroitpistons on March 14, 2006, at 21:49:58

> Different points of view here about the bipolar diagnosis...

Some pretty heady people are now proposing that there is an affective-spectrum within which both bipolar and unipolar exist along a continuum. They propose that they really aren't separate disorders.

Another proposition that has been around for a long time is that there should be a bipolar III diagnosis for people who experience mania only in association with a biological intervention such as drug treatment. Here, mania can be quite severe, and even psychotic. Manic events are not limited to hypomania as they are in bipolar II. Supposedly, we will see this bipolar III diagnosis in the next DSM.

Although there might be a few instances where someone without a bipolar disorder can be induced to experience mania, my guess is that this represents a small minority of manic reactions to antidepressants. One way to help clarify this issue would be to identify the other signs and symptoms that cluster together to indicate bipolarity, and to determine the coefficient of correlation to determine the degree of association. For instance, with me:

1. Early age of onset - 10-13 years old
2. Ultra-rapid cyclicity - invariable 11-day period
3. Dexamethasone non-suppression
4. Reverse vegetative profile
5. Positive responses to lithium and valproatee

Although far from convincing, there are other features of my illness that indicate bipolarity. Here, there is a strong association between bipolar features and manic reactions to antidepressants.

> Only time will tell what the real deal is.

Yes.

> I'm just very impatient and I want an answer now...

The answer that I would give is that you must not ignore your manic reaction to medication and treat as if you were bipolar. It can't hurt. You would continue to explore antidepressants, but begin to apply mood stabilizers as augmentation strategies.

> If I ever have any kind of manic/ hypomanic episode with no drugs involved, then I will become a true believer in the bipolar II diagnosis.

It is possible that you are bipolar, but not bipolar II.

Can you describe your manic reaction in more detail?

It is possible that you will need some sort of biological treatment indefinitely. One can only guess. However, it does seem that you need it right now. The immediate goal is to find something that works.


- Scott

 

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