![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by D minor on January 12, 2005, at 23:39:41
Hi guys,
you are probably tired of me asking the same old questions. But this Bipolar thing is still so hard for me to accept.
I asked this question of my pdoc and psychologist "can a person be hypomanic for one day?" They both said yes. My diagnosis of BP was made based on syptoms of hypomania that only lasted for a day at a time. I just wanted feedback from the group as to whether this sounds realistic or not.Sorry to be a bore.
dm
Posted by bipolarspectrum on January 13, 2005, at 0:06:57
In reply to Can you be hypomanic for one day?, posted by D minor on January 12, 2005, at 23:39:41
Hi,
You can absolutely be hypomanic for one day.. I had my first hypomanic experience after taking wellbutrin... it lasted more than one day, but that first day was very intense and it wained off over time...
bps
ps. just my opinion though
Posted by SLS on January 13, 2005, at 9:20:22
In reply to Re: Can you be hypomanic for one day?, posted by bipolarspectrum on January 13, 2005, at 0:06:57
> Hi,
> You can absolutely be hypomanic for one day.. I had my first hypomanic experience after taking wellbutrin... it lasted more than one day, but that first day was very intense and it wained off over time...
> bps
> ps. just my opinion though
Since psychiatry has already recognized that ultra-dian (several times a day) cycling exists, I don't know how one can dismiss so easily the possibility that an episode of hypomania can occur for periods of one day or less. Even Ronald Fieve in his book "Mood Swing" describes a patient with a 48-hour cycle.
- Scott
Posted by banga on January 13, 2005, at 9:26:27
In reply to Re: Can you be hypomanic for one day?, posted by bipolarspectrum on January 13, 2005, at 0:06:57
You definitely can be hypomanic for one day. YOu are right, that according to the DSMIV you need to be hypomanic for four days in a row to "Officially" get a diagnosis of bipolar, but our pdoc might be among the many that feel the line of four days is arbitrary.... they may have felt this is the closest diagnosis.
And of course there is insurance--they have to name the illness in order to treat it. They can theoretically give your doc a hard time if they prescribe medication that doesn't fit the illness,though usually they don't (my insurance didnt make a peep about what meds are prescribed until I wanted Provigil, then they wrote a letter saying they wont cover it because it is not indicated for depression).
Posted by Ritch on January 13, 2005, at 10:52:06
In reply to Can you be hypomanic for one day?, posted by D minor on January 12, 2005, at 23:39:41
> Hi guys,
> you are probably tired of me asking the same old questions. But this Bipolar thing is still so hard for me to accept.
> I asked this question of my pdoc and psychologist "can a person be hypomanic for one day?" They both said yes. My diagnosis of BP was made based on syptoms of hypomania that only lasted for a day at a time. I just wanted feedback from the group as to whether this sounds realistic or not.
>
> Sorry to be a bore.
> dmNot a bore, interesting question! IMO, if that "one day" of hypomania, when charted over time, just happens randomly and doesn't show any kind of *cyclic pattern* or increasing frequency.. I think there are probably a lot of pdocs that might question a BPII diagnosis. Have you mood charted? Are there a relatively fixed number of days that you are down before the one day of hypomania kicks in again?
Posted by SLS on January 13, 2005, at 13:10:29
In reply to Can you be hypomanic for one day?, posted by D minor on January 12, 2005, at 23:39:41
> Hi guys,
> you are probably tired of me asking the same old questions. But this Bipolar thing is still so hard for me to accept.
> I asked this question of my pdoc and psychologist "can a person be hypomanic for one day?" They both said yes. My diagnosis of BP was made based on syptoms of hypomania that only lasted for a day at a time. I just wanted feedback from the group as to whether this sounds realistic or not.
Out of curiosity, are these days of hypomania followed by a period of increased depression?
- Scott
Posted by D minor on January 13, 2005, at 15:06:32
In reply to Re: Can you be hypomanic for one day? » D minor, posted by SLS on January 13, 2005, at 13:10:29
Thanks all for responding,
in the past, before I was dxed, I had these intensely "hyper" days that seemed to come out of the blue. But now I've been mood charting, and there was a pattern. While I was off of any mood stabilizer I had a day of hypomania followed by two days of normalcy, then two days of moderate depression, then back to normal. This cycle lasted for two weeks at which point my pdoc put me on Depakote. It stopped abruptly. But I wondered if Depakote could work that fast or if it were a placibo effect.I'm off the Depakote now and on 25mg Topamax for about a week. Everything normal so far.
Posted by SLS on January 13, 2005, at 20:55:32
In reply to Re: Can you be hypomanic for one day?, posted by D minor on January 13, 2005, at 15:06:32
> Thanks all for responding,
> in the past, before I was dxed, I had these intensely "hyper" days that seemed to come out of the blue. But now I've been mood charting, and there was a pattern. While I was off of any mood stabilizer I had a day of hypomania followed by two days of normalcy, then two days of moderate depression, then back to normal. This cycle lasted for two weeks at which point my pdoc put me on Depakote. It stopped abruptly. But I wondered if Depakote could work that fast or if it were a placibo effect.Depakote can exert its anti-manic effects within hours of the first loading dose.
- Scott
Posted by banga on January 14, 2005, at 9:34:52
In reply to Can you be hypomanic for one day?, posted by D minor on January 12, 2005, at 23:39:41
Wht they are saying and what you seem to see is that your moods do fluctuate in an up and down way. This then could be logical that the pdocs think that, regardl;ess of diagnosis, you could be helped by mood stabilizers so yo feel more even-keel.
In terms of diagnosis, it is true that IF you went by the book, because your highs are not severe or very long, technically it may not be bipolar II.You would be tecnically speaking Mood Disorder NOS, with rapid cycling.
Or maybe, if the symptoms are not severe ( the depression nor hypomania don't totally disrupt your life) someone might say it is Cyclothymic Disorder--a condition where neither the highs don't qualify full mania or the lows full depression--if this problem doesnt totally disrupt yur life. Sort of like a mild bipolar. But again, because the length of your ups and downs aren't long enough, technically this wouldn't be right either.
This is all IF you went by the book, but many pdocs feel (and many patients!!) that the criteria are arbitrary, and give diagnoses even when you don't meet criteria because it is so similar, and you could be helped by treating it the same way.
But in any case it doesn't matter really, it sounds like your pdocs think it most appropriate to see it as needing the same treatment as bipolar disorder, regardless what the diagnosis is. And if it seems to help, that's the main thing.
Sorry if I got technical, this is probably way more than you wanted--but this knowledge was pushed into my mind and it's my technical resource I go to automatically. I myself don't meet criteria for bipolar--I dont have true hypomanias but am very depressed--but I feel I maybe should be treated as if I did have bipolar. I have a lot of relatives that have bipolar so maybe biologically I am like them. I wouldn't care what they said the diagnosis is--as long as it helped.
Posted by Ritch on January 14, 2005, at 9:43:50
In reply to Re: Can you be hypomanic for one day?, posted by D minor on January 13, 2005, at 15:06:32
> Thanks all for responding,
> in the past, before I was dxed, I had these intensely "hyper" days that seemed to come out of the blue. But now I've been mood charting, and there was a pattern. While I was off of any mood stabilizer I had a day of hypomania followed by two days of normalcy, then two days of moderate depression, then back to normal. This cycle lasted for two weeks at which point my pdoc put me on Depakote. It stopped abruptly. But I wondered if Depakote could work that fast or if it were a placibo effect.
>
> I'm off the Depakote now and on 25mg Topamax for about a week. Everything normal so far.Yes, Depakote can definitely hammer manic symptoms really quick! That's interesting that Topamax is working for you. I loved that med for the sleep, nice and dense and restful. I just couldn't shake the next day fogginess though. I'm glad that it's working for you and your cycling is settled down. Mine is starting to kick up again and adding more Depakote helps the cycling, but it doesn't seem to help my sleeping like Top did.
Posted by D minor on January 14, 2005, at 14:58:29
In reply to Re: Can you be hypomanic for one day?, posted by banga on January 14, 2005, at 9:34:52
Thanks for the reply, I like technical.
I was first diagnosed as MD w/psychotic features. My depression was really deep and disruptive, just not my "hypomanias." I don't know why its so hard to go from Major Depression to Bipolar. Maybe because of the implications for the impact on the rest of my life, ie taking antidepressants for a few months vs. taking mood stabilizers forever. I guess I shouldn't get so caught up in diagnosis as long as the treatment helps. But one thing we did discover was that Depakote didn't keep me from getting depressed. That's why I switched back to Topamax. But I really doubt what such a low dose can do.I also have a lot of relatives with mood disorders, including Bipolar. Which is what put the idea that I may be bipolar into my new pdoc's head. I asked him what type of Bipolar I was and he said "oh, I couldn't say," which I figure for now means NOS...
We think that my big MD episod may have been a mixed episod. Anybody had one of those? I was mostly down, but hypomanic one night and very irritable all the time.
Thanks for listening,
dm> Wht they are saying and what you seem to see is that your moods do fluctuate in an up and down way. This then could be logical that the pdocs think that, regardl;ess of diagnosis, you could be helped by mood stabilizers so yo feel more even-keel.
> In terms of diagnosis, it is true that IF you went by the book, because your highs are not severe or very long, technically it may not be bipolar II.
>
> You would be tecnically speaking Mood Disorder NOS, with rapid cycling.
>
> Or maybe, if the symptoms are not severe ( the depression nor hypomania don't totally disrupt your life) someone might say it is Cyclothymic Disorder--a condition where neither the highs don't qualify full mania or the lows full depression--if this problem doesnt totally disrupt yur life. Sort of like a mild bipolar. But again, because the length of your ups and downs aren't long enough, technically this wouldn't be right either.
> This is all IF you went by the book, but many pdocs feel (and many patients!!) that the criteria are arbitrary, and give diagnoses even when you don't meet criteria because it is so similar, and you could be helped by treating it the same way.
> But in any case it doesn't matter really, it sounds like your pdocs think it most appropriate to see it as needing the same treatment as bipolar disorder, regardless what the diagnosis is. And if it seems to help, that's the main thing.
> Sorry if I got technical, this is probably way more than you wanted--but this knowledge was pushed into my mind and it's my technical resource I go to automatically. I myself don't meet criteria for bipolar--I dont have true hypomanias but am very depressed--but I feel I maybe should be treated as if I did have bipolar. I have a lot of relatives that have bipolar so maybe biologically I am like them. I wouldn't care what they said the diagnosis is--as long as it helped.
Posted by D minor on January 14, 2005, at 15:02:20
In reply to Re: Can you be hypomanic for one day? » D minor, posted by Ritch on January 14, 2005, at 9:43:50
>
> Yes, Depakote can definitely hammer manic symptoms really quick! That's interesting that Topamax is working for you. I loved that med for the sleep, nice and dense and restful. I just couldn't shake the next day fogginess though. I'm glad that it's working for you and your cycling is settled down. Mine is starting to kick up again and adding more Depakote helps the cycling, but it doesn't seem to help my sleeping like Top did.Well, my parents did complain that when I was on 75mg of Topamax I just stared into space a lot. To try to avoid that my pdoc put me at 25mg this time. What's funny is that I feel the opposite of you. Depakote put me into such a deep sleep that I often couldn't get up in the morning and missed a lot of class and work. Topamax does nothing but give me a dry mouth. Go figure :-)
dm
Posted by ed_uk on January 14, 2005, at 16:07:48
In reply to Re: Can you be hypomanic for one day?RITCH, posted by D minor on January 14, 2005, at 15:02:20
Hello,
>I don't know why its so hard to go from Major Depression to Bipolar. Maybe because of the implications for the impact on the rest of my life, ie taking antidepressants for a few months vs. taking mood stabilizers forever.
Bipolar disorder isn't always chronic. My uncle had only one severe depression and only one mania- he took lithium for a few months.
Ed.
Posted by D minor on January 14, 2005, at 16:16:47
In reply to Re: Bipolar » D minor, posted by ed_uk on January 14, 2005, at 16:07:48
> Bipolar disorder isn't always chronic. My uncle had only one severe depression and only one mania- he took lithium for a few months.
>
> Ed.Thanks for sharing that Ed. That would be so cool if I didn't have to deal with this forever. I'm looking forward to the day when I can start weaning off some of these meds. It's just that all the books I've read all say "take your meds lifelong..." I hoped it wasn't always that way.
dm
Posted by woolav on January 15, 2005, at 23:11:59
In reply to Re: Bipolar, posted by D minor on January 14, 2005, at 16:16:47
Hi, just wanted to say that during my first 3-4 months of lamictal (increasing dosages) I would have a major depressive eposode that lasted 1 day. where i would get so bad i wanted to kill myself. But the next day i was okay. I told my pdoc about this and she raised my lamictal (mood stabelizer) and now I am not having these episodes. (not as severe at all) so you may want to ask your pdoc about that..
S
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.