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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by capricorn on November 2, 2006, at 13:11:17
http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=748
Posted by Phillipa on November 2, 2006, at 14:01:03
In reply to Unipolar v bipolar:Where do we draw the line?, posted by capricorn on November 2, 2006, at 13:11:17
I know you probably don't understand but I'd give anything for a few days of hypomania and not this horrible fatigue. Love Phillipa.
Posted by capricorn on November 2, 2006, at 14:15:39
In reply to Re: Unipolar v bipolar:Where do we draw the line? » capricorn, posted by Phillipa on November 2, 2006, at 14:01:03
> I know you probably don't understand but I'd give anything for a few days of hypomania and not this horrible fatigue. Love Phillipa.
I understand all too well about fatigue.It's one of the worst things about the free floating anxiety i am prone to.
Posted by deniseuk190466 on November 2, 2006, at 16:27:00
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by capricorn on November 2, 2006, at 14:15:39
I know all about free floating anxiety and dysphoria.
I think that Psychiatrists are too prone nowadays (allthough I'm not that familiar with how they used to be in the old days) to say somebody is bipolar just because suddenly they stop responding to antidepressants. I never suffer from highs (would dearly love to) but I do get awful agitation and anxiety but this is just a symptom of my unipolar depression as far as I'm concerned.
Denise
Posted by Phillipa on November 2, 2006, at 18:52:12
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by deniseuk190466 on November 2, 2006, at 16:27:00
Well I guess my fatigue is also from anxiety which leads to worse depression. But no med yet that works. So what you you two do about the fatigue? Love Phillipa
Posted by clint878 on November 2, 2006, at 19:58:36
In reply to Re: Unipolar v bipolar:Where do we draw the line? » capricorn, posted by Phillipa on November 2, 2006, at 14:01:03
Be careful what you wish for. While I can't speak for everyone, my experience is that mania is the worst possible condition a human can experience (perhaps with the exception of akathisia). Even though I'm not completely well yet, I count myself lucky to be alive after that experience.
Perhaps I was never depressed enough, but the episodes of depression that I had simply didn't compare to that experience at all.
Posted by capricorn on November 2, 2006, at 20:12:16
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by clint878 on November 2, 2006, at 19:58:36
I had akathisia during my first in patient stay at the age of 18 due to being on a largish dose of largactil with no disipal for the side effects.
It was hell on earth.
Posted by linkadge on November 2, 2006, at 20:30:30
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by clint878 on November 2, 2006, at 19:58:36
I suppose you experience dysphoric mania ?
Linkadge
Posted by BryanII on November 2, 2006, at 21:45:23
In reply to Re: Unipolar v bipolar:Where do we draw the line? » clint878, posted by linkadge on November 2, 2006, at 20:30:30
This is a useful perspective. It really helped me get a better diagnosis and more effective medication (and understanding for self-management).
My reading is that in the "new" approach, recurrence is central to diagnosis. Seems reasonable, and beneficial if it improves treatment.
That said, the whole bipolar/unipolar framework seems pretty lame (not useless, just wrong). There are any number of dimensions to these conditions, and this conceptual framework limits objective, neutral exploration by researchers, even those going to a spectrum perspective. The experiences reported on this site are enough evidence of the variety and "flavors" of depression and its cousins.
Posted by linkadge on November 3, 2006, at 6:50:41
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by BryanII on November 2, 2006, at 21:45:23
It also depends how you define hypomanic episodes. My doctor asked if I had ever felt "really good". Well sure, there have been times in my life that I've felt really good (even if just for a few moments). I think thats 'almost' universal.
Linkadge
Posted by polarbear206 on November 3, 2006, at 8:48:43
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by BryanII on November 2, 2006, at 21:45:23
There is a broad spectrum to bipolar disorders. It's very tricky to get a proper diagnosis. Some people on average don't get diagnosed for up to ten years or so. If numerous AD's have been used and poop out,this is usually a red flag that and underlying bipolar diagnosis should be heavily considered. You don't have to have full blown mania or hypomania to be diagnosed with a bipolar disorder. Some of the softer bipolars are the tricky ones and harder to diagnosis to find the right cocktail of medications. Antidepressants if required should be at the lowest possible dose to prevent mood cycling and be used in conjunction with a MOOD STABILZER. They won't give you a therapeutic response if not combined with a mood stablizer. Many bipolars are depression dominated and require a higher dose of an AD. A very detailed history is very important for diagnosis. As far as I'm concerned, the DSM needs revamped in this area for proper dianosis. Another important area is adhering to a proper wake-sleep cycle to prevent mood cycling.
Posted by linkadge on November 3, 2006, at 9:54:26
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by polarbear206 on November 3, 2006, at 8:48:43
I think that the problem is confounded by the fact that bipolar medication can sometimes be usefull in unipolar. This can be taken two ways, either the person has bipolar, or that like I said above it is just a unipolar person responding to a bipolar drug.
There are reasons this may be true. Drugs that are capable of modulating glutamatergic function have utility in unipolar as well.
So, if a diagnosis is sketchy, I don't think that response to a bipolar drug really means anything at all.
Linkadge
Posted by deniseuk190466 on November 3, 2006, at 14:15:39
In reply to Re: Unipolar v bipolar:Where do we draw the line?, posted by clint878 on November 2, 2006, at 19:58:36
Sorry, I shouldn't have said that about wanting to experience the highs, I can imagine they could get you into awful trouble and then you must have the lows where you're too depressed to sort out the trouble you got yourself into when you were high.
It's just that Stephen Fry (comic in Britain) did a TV documentary about bipolar (as he suffers from it) and all of the people he interviewed (bar one woman who I felt so sorry for) said if they had the choice and they could press a switch to turn it off then they wouldn't press it as they would miss the highs too much and wouldn't want to live a normal life.
All I know is that I'd give anything to be able to press a switch and turn off my depression (I sort of do it with Zyprexa) but I yearn not to have it full stop. The fact that it isn't just an episode and sometimes I feel that there is no end to it makes things worse. If I thought it was just an episode even a 2 yearly one I could maybe get through it better.
Denise
Posted by capricorn on November 5, 2006, at 16:36:49
In reply to Unipolar v bipolar:Where do we draw the line?, posted by capricorn on November 2, 2006, at 13:11:17
http://www.podcasternews.com/programs/10/mental-health-missives/2226/mania-isnt-always-happy/#
This is the end of the thread.
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