Posted by pandey_m on January 8, 2001, at 17:27:48
In reply to im gonna regret posting this!!, posted by dennis on January 1, 2001, at 21:24:45
Generalized anxiety disorder is one manifestation of Bipolar II (Akiskal's definition of Bipolar II, not DSM IV's). In some cases of Bipolar II depression (like mine), for many years the only symptoms could be pathological brooding and self-doubt.
But OCD is excluded in even Akiskal's definition of bipolar II; in fact excluded from depressive disorders.
The distinction is important because the therapies have little overlap. (though there is overlap in some medication - e.g. Prozac, Anafranil are used for both [though only with caution in bipolar II depression] - but diffferent regimens.)
Older texts use the term "obsessive thoughts" in both cases, which does not help. I will call the bipolar II ruminations "micromanic brooding", and the OCD symptoms "obsessive thoughts". Here is how one distinguishes them:
[I'll use *I* for the sufferer because it helps me focus when talking about obsessive thoughts. But what follows is primarily based on published mainstream material; not my personal experience.]"obsessive thoughts" [indicating OCD] are *right from the outset* intrusive in nature. It is not that they feel like "not my thoughts" - *that* would be a schizophrenia symptom. But *right from the outset*, "obsessive thoughts" feel like, "they are my thoughts, but I can't control them, *and* I wish I could control them [in short, 'intrusive']; they are irrational thoughts; and they are seriously interfering with my attempts to think out and do things I actually have to / want to do.
"micromanic ruminations" [indicating bipolar II] are not *at the outset* intrusive. They start off with my worrying about things that I are "actually" troubling me - but the worries become excessive and encompass more and more things and I find I cannot think those things through; so I want to stop thinking of those things; but I can't. [i.e. the thoughts now feel 'intrusive']. If this continues for a year or two, then it is so exhausting, enervating, that it may become difficult to remember that all this began with *non-intrusive* worries - worse, the time when the broodings started feeling 'intrusive' might be remembered as 'when the troubles started'.
[The last rambling part of my post on this board PSB, not this thread, about 24 hours ago, is an example of what it was like for me (mainly 1977-1979). It wasnt relevant there: but citing it here might be relevant. I had assumed I had ocd (or maybe schizophrenia) but even then p-docs were clearer on this than texts; the very first p-doc I saw (1980) explained the difference between OCD brooding and my sort of i.e. bipolar II depressive brooding. [not in these words: the term bipolar was not prevalent then]Both cause considerable-to-debilitating anxiety; severity diffrering from person to person. I think both can cause serious self-doubt, but I am not at all sure about this for OCD.
I hope this is of some help.
poster:pandey_m
thread:3671
URL: http://www.dr-bob.org/babble/social/20010105/msgs/3786.html