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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 34. This is the beginning of the thread.
Posted by katherpoo on March 25, 2005, at 16:53:02
Has anyone ever heard of this? Bipolar 6? My shrink says it's an alternative way of thinking about my anxiety/pnaic/hypomania... that I'm on the other end of the "biploar spectrum" where I'm about 98% manic/anxious and 2% depressed... whereas many of you know Bipolar I is unipolar depression...
Apparently at this time this is just a "theory" with growing research and strength, and with my OCD tendencies I even went as far as to call the American Psychiatric Association, and they said if anything beyong Bipolar I and II is added to the DSM it wouldn't happen until the next version is released in 2012. Until then, I am frantically trying to find others like myself... I feel very alienated by having been given this "diagnosis" and although I try to think of it as "just anxiety" I can't shake the gravity of the big B.
I know a lot about the field, having worked in it for years myself and having suffered for years, doing my own research... yet this new take on my own diagnosis has really left me shaken. Has ANYONE out there heard anything about this? Is anyone out there like me??
Thanks--
K
Posted by Spriggy on March 25, 2005, at 17:07:40
In reply to Biploar VI (6), posted by katherpoo on March 25, 2005, at 16:53:02
Well, I sound just like you.
My MAIN problem is anxiety. I've had several panic attacks as well. After having the most horrific anxiety/inner restlessness of my life that lasted 8 weeks, I THEN fell into a very deep, very dark depression that I had never experienced before.
My theory is that the constant anxiety is what triggered me to be depressed. The anxiety was SOO bad at one point that I could not eat, could not sleep, or leave my house. This is when the depression started kicking in.
My doctor says I have bipolar 2 but this confuses me because I don't and never have been manic. So I don't know.. there are so many different varities of this disorder that I am confused as ever.
Posted by SLS on March 25, 2005, at 17:51:09
In reply to Biploar VI (6), posted by katherpoo on March 25, 2005, at 16:53:02
Hi.
It's been a few years since it was outlined to me, but yes, there are multiple subtypes of bipolar disorder to be described in the DSM V. I have bipolar III, in which I am depressed all of the time except for when I have a manic reaction to medication. I had a list of the proposed DSM schedule, but I can't seem to find it. I do recall, however, that one of these included a persistent hypomania. I guess this can include the mixed-states your doctor probably sees in you.
It is important to differentiate bipolar disorder from unipolar depressions and anxiety disorders, including OCD. While giving an antidepressant to a unipolar is indicated, giving one to a bipolar can sometimes make the situation worse. To treat a bipolar as a bipolar would indicate the use of mood stablizers or perhaps drugs like Zyprexa. Many people whom are diagnosed unipolar and for whom antidepressants don't work or work only briefly later demonstrate a bipolar diathesis.
It might take a little bit of time for you to accept that you are bipolar (even if the diagnosis is wrong). The first stage is usually shock. This can be followed by denial, anger, depression, and finally acceptance. It is a process that no one should expect you to accomplish in one day.
Please continue posting.
- Scott
Posted by Larry Hoover on March 25, 2005, at 17:51:21
In reply to Biploar VI (6), posted by katherpoo on March 25, 2005, at 16:53:02
> Has anyone ever heard of this? Bipolar 6? My shrink says it's an alternative way of thinking about my anxiety/pnaic/hypomania... that I'm on the other end of the "biploar spectrum" where I'm about 98% manic/anxious and 2% depressed... whereas many of you know Bipolar I is unipolar depression...
There is one proposed categorization system that defines Bipolar VI as unipolar mania. There are other systems, so I'm hoping to avoid confusion here. This system seems to be the one that fits.
About 5% of bipolar individuals really aren't bipolar at all, as they do not have moods that drop into the depressive region. They're normal, hypomanic, or manic.
What that means is that you would not benefit from certain common treatments, such as antidepressants. Your therapy would be targetted towards the hypomanic/activated symptoms. Panic and anxiety could be seen as irritable aspects of hypomania.
The diagnosis is useful to the pdoc because they treat based on diagnosis. You present with symptoms (sx). The doctor categorizes those symptoms (dx). That suggests a treatment (tx), and a prognosis (px).
It's all jargon. But hopefully, that jargon will lead to successful treatment.
Lar
Posted by SLS on March 25, 2005, at 17:54:10
In reply to Re: Biploar VI (6) » katherpoo, posted by Larry Hoover on March 25, 2005, at 17:51:21
Hi Larry.
Where can I find the proposed classification scheme?
Thanks.
- Scott
Posted by Maxime on March 25, 2005, at 17:55:45
In reply to Biploar VI (6), posted by katherpoo on March 25, 2005, at 16:53:02
Bipolar 1 is NOT unipolar depression. Bipolar 1 is manic-depression where during the manic state the person can be psychotic. Bipolar 2 is hypomanic. The highs are not as highs and often the "high" is irritability, rage, and racing thoughts. During hypomania a person does not go psychotic.
I know that some doctors in the UK defines these 6 or 7 types of bipolar illness. But most places it is Type 1 or Type 2 with Type 2 having a lot of various types/symptoms (rapid cycling, ultra rapid cycling, mixed states etc). There is also medication induced mania.
Maxime
Posted by SLS on March 25, 2005, at 17:58:46
In reply to Re: Biploar VI (6), posted by Maxime on March 25, 2005, at 17:55:45
MAXIME!!!
Look at how much you know, understand, and are willing to share with other people for their benefit! I learn stuff from you.
You are so cool.
- Scott
> Bipolar 1 is NOT unipolar depression. Bipolar 1 is manic-depression where during the manic state the person can be psychotic. Bipolar 2 is hypomanic. The highs are not as highs and often the "high" is irritability, rage, and racing thoughts. During hypomania a person does not go psychotic.
>
> I know that some doctors in the UK defines these 6 or 7 types of bipolar illness. But most places it is Type 1 or Type 2 with Type 2 having a lot of various types/symptoms (rapid cycling, ultra rapid cycling, mixed states etc). There is also medication induced mania.
>
> Maxime
>
>
Posted by Larry Hoover on March 25, 2005, at 18:05:01
In reply to Re: Biploar VI (6) » Larry Hoover, posted by SLS on March 25, 2005, at 17:54:10
> Hi Larry.
>
> Where can I find the proposed classification scheme?
>
> Thanks.
>
>
> - ScottI was using the Young and Klerman typology, as shown at this site:
http://bipolar.about.com/cs/faqs/f/faq_classifybp.htm
It's from work they published in 1992, I think.
Lar
Posted by katherpoo on March 25, 2005, at 18:16:56
In reply to Re: Biploar VI (6) » SLS, posted by Larry Hoover on March 25, 2005, at 18:05:01
I guess it's worth mentioning that I had BAD reactions to SSRIs and SNRIs... I was ready to jump out of my skin! Also with Effexor I gained about 50 lbs... very unusual I know but believe you me it happened.
My official diagnoses are GAD, Panic d/o, and Bipolar NOS. I have a very good relationship with doc and she hass also told me I have NO Axis II disorders (which is good because of course I was *worried* about it LOL), and my GAF is like 55. My IQ by the way is something like 135 and I guess it's not uncommon for people with bipolar to have high intelligence..?
I tried about 15 different meds/combinations before finding something that has begun to help. As I said in my intro, I also embrace healthy living, therapy, meditation, etc.
Right now I'm on a combination of Topamax and Lamictal, with Xanax XR to help with PA prevention. Doc wanted to add Seroquel for sleep but it didn't help and caused me to add another 15 lbs! We're working on scaling up the Topamax because I'm on a fairly low dose at the moment.
Anyway... thanks to those who have replied... I would like to keep the discussion going because for the first time I have finally found people who actually know what the heck I'm trying to say here!!!!
Thanks --- K
Posted by Spriggy on March 25, 2005, at 18:18:23
In reply to Re: Biploar VI (6) » SLS, posted by Larry Hoover on March 25, 2005, at 18:05:01
Can I just tell you that I come here everyday because I know first of all that;
1) you will listen and answer my questions- even when they are absurd.
2) you make me feel like I'm not alone in this.
I've been amazed to see how many other people feel this way. Misery truly does love company. ROFL3) I can learn more here than I can from reading any old book!
I just have to say that you all are the best. I pray for all of you each day and ask that one day, God will deliver all of us from this nasty mental darkness.
Posted by Phillipa on March 25, 2005, at 18:35:38
In reply to I love you people, posted by Spriggy on March 25, 2005, at 18:18:23
Just got home from the pdocs. I picked up a magazine in her office. It is called BP magazine, hope and harmony for people with bipolar.Carrie Fisher was on the cover. I brought it home with me to read, but I left about 10 other magazines in her office for others to read. Have any of you heard of a magazine for Bipolar illness? Fondly, Phillipa
Posted by sheer on March 26, 2005, at 9:40:05
In reply to Biploar VI (6), posted by katherpoo on March 25, 2005, at 16:53:02
this is a very interesting discussion! hope you all will permit me to be the resident unipolar/ casting my "counter" vote, just for the sake of "variety."
first off, thanx to maxine for clarifying that bipolar I is indeed NOT unipolar - of very basic importance, to be sure.
secondly, i'd like to see if anyone else senses, as i do, that bipolar of all kinds - but, perhaps, at ths point in time - particularly bipolar II, is NOW being over diagnosed....as if the pendulum has swung too far to the other side, as opposed to years ago and for decades, when it was underdiagnosed and/ or misdiagnosed?
here is my own experience: about 15 years ago, i was misdiagnosed as having - they had to get as extreme as possible right out of the gate - bipolar I and with rapid cycling. 9-10 yrs later, an adept and compassionnate female pdoc finally listened to me and said, eureka/ by george!... i believe you're right - you ONLY have unipolar.
(for decades prior, unipolar major depression had always been my diagnosis). around this same time, it was brought to my attention by another professional in our community, that the pdoc who had origianlly dxed me with bipolar, ONLY dxed bipolar, never unipolar, or, for that matter, anything else(!!!) he has since been run out of town "on a rail." but, here's how insideous this can be: once bipolar was on my record, 5-6 pdoc in 2 states thought it was the gospel & for nearly a decade. thus, i was treated with mood stabilizers that i never needed in the first place...enduring all manner of heinous side effects, both physical and mental.now, let me back up here and state clearly: i did not, nor do i now, feel there should be any stigma attached to having bipolar (nor any other mental illness). that is a "luxury" afforded to the uninformed (being nice here) and to those who want to feel superior. being an artist, i actually thought having bipolar was "neat" (please forgive me that!) and perhaps to be expected/ only a matter of time. and, yes, having a high IQ is, as detective monk says, both a blessing and a curse. mine is 160.
another point i want to make is this: when i was thought to be bipolar, pdocs gave me ALOT more "attention." it was like their egos were VERY involved. i was a "challenge" to them, that they were determined to "rise to the occasion of." since, as a "lowly" unipolar, i have been much more on "my own", but the good news is i have HAD to learn a LOT about both.
thoughts? similar experinces? (i do often still feel too alone, in having had this happen)
Posted by Ritch on March 26, 2005, at 10:43:04
In reply to Re: Biploar VI (6) » katherpoo, posted by Larry Hoover on March 25, 2005, at 17:51:21
> > Has anyone ever heard of this? Bipolar 6? My shrink says it's an alternative way of thinking about my anxiety/pnaic/hypomania... that I'm on the other end of the "biploar spectrum" where I'm about 98% manic/anxious and 2% depressed... whereas many of you know Bipolar I is unipolar depression...
>
> There is one proposed categorization system that defines Bipolar VI as unipolar mania. There are other systems, so I'm hoping to avoid confusion here. This system seems to be the one that fits.
>
> About 5% of bipolar individuals really aren't bipolar at all, as they do not have moods that drop into the depressive region. They're normal, hypomanic, or manic.
>
> What that means is that you would not benefit from certain common treatments, such as antidepressants. Your therapy would be targetted towards the hypomanic/activated symptoms. Panic and anxiety could be seen as irritable aspects of hypomania.....
Whenever I was first diagnosed a long time ago and successfully treated for a mixed-state with lithium and doxepin, I developed a nearly consistent hypomania with few depressive dips at all. I remember my therapist asking me at the time: "Are you *always* high"? In retrospect it probably was doxepin induced hypomania.
Posted by Spriggy on March 26, 2005, at 12:09:24
In reply to Re: Biploar VI (6) » Larry Hoover, posted by Ritch on March 26, 2005, at 10:43:04
can someone explain the main difference between unipolar and bipolar?
If one has unipolar, would they have the horrible agitated states?
Posted by Larry Hoover on March 26, 2005, at 12:37:27
In reply to explain the difference, posted by Spriggy on March 26, 2005, at 12:09:24
> can someone explain the main difference between unipolar and bipolar?
>
> If one has unipolar, would they have the horrible agitated states?Imagine mood lying on a scale of -10 up to +10, with zero being normal (euthymia).
A unipolar depressive would only experience moods that lie between 0 and -10. A unipolar manic would only experience moods that lie between 0 and +10 (That's the bipolar type VI that we've been discussing). A bipolar type one might experience moods between -5 and +10. A bipolar type 2 might experience those between -10 and +5.
I'm being very crude in my analogy, but it makes sense that the different ranges of mood swings might lead to very different treatment strategies.
Lar
Posted by Spriggy on March 26, 2005, at 12:49:31
In reply to Re: explain the difference » Spriggy, posted by Larry Hoover on March 26, 2005, at 12:37:27
Well, from Larry's point of view (which I thought was a brilliant analogy by the way! I'm still convinced you weren't bottle fed), I really must have Bipolar 2.
Thanks Larry.. You should win the genius of the psycho babble boards award.
I nominate you.
Posted by katherpoo on March 26, 2005, at 13:06:36
In reply to Re: Biploar VI (6), posted by sheer on March 26, 2005, at 9:40:05
I can't tell if you were taking a jab at me with your IQ point. Please forgive me, I'm new her and this was my first point beyond my intro. There was no "need to feel superior" going on here; rather I'm feeling quite hellish right now and am desperately looking for answers. I have enjoyed reading everyone's posts. Wasn't looking to ruffle any feathers...
Posted by sheer on March 26, 2005, at 15:21:17
In reply to Re: Biploar VI (6)scheer, posted by katherpoo on March 26, 2005, at 13:06:36
helllo? i don't see how you or anyone could think i was taking a jab at you re: high IQ. i thought it was very clear that i was agreeing and/ or empathizing with you that high IQ is indeed very common/ goes hand-in-hand with those who have a mood-disordered diagnosis. beyond that, i was injecting a bit of (general) levity - always helps me.
for the record, i don't take jabs at people or call them out...that is for attention seekers. i just wanted to get a dialogue going and took this opportunity to share my story....finally. (as it has seemed, in the past, to be far more common for a bipolar to be misdiagnosed as unipolar, instead of the "opposite," which is what happened to me.)
sorry to hear you are having a hard time. for the first time in ages, i am not.
regards, sheer
Posted by KaraS on March 26, 2005, at 16:44:21
In reply to Re: explain the difference » Spriggy, posted by Larry Hoover on March 26, 2005, at 12:37:27
> > can someone explain the main difference between unipolar and bipolar?
> >
> > If one has unipolar, would they have the horrible agitated states?
>
> Imagine mood lying on a scale of -10 up to +10, with zero being normal (euthymia).
>
> A unipolar depressive would only experience moods that lie between 0 and -10. A unipolar manic would only experience moods that lie between 0 and +10 (That's the bipolar type VI that we've been discussing). A bipolar type one might experience moods between -5 and +10. A bipolar type 2 might experience those between -10 and +5.
>
> I'm being very crude in my analogy, but it makes sense that the different ranges of mood swings might lead to very different treatment strategies.
>
> Lar
>
Lar,Your analogy talks about moods only though. What about the depressed agitated states? Can a unipolar experience those or does having those mean that one is bipolar?
K
Posted by Larry Hoover on March 26, 2005, at 17:06:54
In reply to Re: explain the difference » Larry Hoover, posted by KaraS on March 26, 2005, at 16:44:21
> Your analogy talks about moods only though. What about the depressed agitated states? Can a unipolar experience those or does having those mean that one is bipolar?
>
> KThat is a matter of much debate. It depends on whether you measure depression on multiple axies, or not. Irritability, physical agitation, sleep disturbance, cognitive activation....I can think of a host of associated symptoms which may or may not coincide with mood.
I guess that a true unipolar depressive, absent any activating characteristics, might be as rare as a unipolar manic.
Lar
Posted by katherpoo on March 26, 2005, at 17:09:11
In reply to Re: Biploar VI (6) sheer, posted by sheer on March 26, 2005, at 15:21:17
> helllo? i don't see how you or anyone could think i was taking a jab at you re: high IQ. i thought it was very clear that i was agreeing and/ or empathizing with you that high IQ is indeed very common/ goes hand-in-hand with those who have a mood-disordered diagnosis. beyond that, i was injecting a bit of (general) levity - always helps me.
>
> for the record, i don't take jabs at people or call them out...that is for attention seekers. i just wanted to get a dialogue going and took this opportunity to share my story....finally. (as it has seemed, in the past, to be far more common for a bipolar to be misdiagnosed as unipolar, instead of the "opposite," which is what happened to me.)
>
> sorry to hear you are having a hard time. for the first time in ages, i am not.
>
> regards, sheer
>
>
Please accept my apologies for the misunderstanding. I, too, generally do not call people out - unless I feel I'm being attacked. There were elements in what you said that did not feel empathetic, but let's call it water under the bridge. As a newbie here you can imagine I have no idea how people "dialogue" around here. I will admit my guard is *way* up; in life, it has to be, quite necessarily.I am glad to hear that you're doing better than before, and that you had the chance to share your story. It's an inspiration for the rest of us.
Humbly - K
Posted by Ritch on March 26, 2005, at 17:26:14
In reply to Re: explain the difference » KaraS, posted by Larry Hoover on March 26, 2005, at 17:06:54
> > Your analogy talks about moods only though. What about the depressed agitated states? Can a unipolar experience those or does having those mean that one is bipolar?
> >
> > K
>
> That is a matter of much debate. It depends on whether you measure depression on multiple axies, or not. Irritability, physical agitation, sleep disturbance, cognitive activation....I can think of a host of associated symptoms which may or may not coincide with mood.
>
> I guess that a true unipolar depressive, absent any activating characteristics, might be as rare as a unipolar manic.
>
> Lar
>
There is a lot of debate right now about whether people who have traditionally been diagnosed with "anxious" or "agitated" depression are actually experiencing bipolar "mixed" symptoms instead. I'm definitely BPII, but my anxiety and panic tend only to happen during seasonal major depressive episodes. I'm not nearly as panicky and anxious in my "high" phases. If I get hostile, however, the panic tends to happen because I freak out about stuff I've said or done.
Posted by Phillipa on March 26, 2005, at 17:55:48
In reply to Re: explain the difference, posted by Ritch on March 26, 2005, at 17:26:14
Not to upset anybody, but I wish I could experience a hypomanic state. It happened to me once I think when i was restarted on Luvox. Of course it could have been that I was involved in a new venture. I would actually look forward to getting up early too, and was happy! My pdoc said I didn't know what it was like to feel "normal". If that was normal, then I must always be depressed. This is a very informative discussion and I'm learning a lot! Thanks to everyone, Fondly, Phillipa
Posted by KaraS on March 26, 2005, at 17:57:11
In reply to Re: explain the difference » KaraS, posted by Larry Hoover on March 26, 2005, at 17:06:54
Posted by KaraS on March 26, 2005, at 18:01:35
In reply to Re: explain the difference, posted by Ritch on March 26, 2005, at 17:26:14
> > > Your analogy talks about moods only though. What about the depressed agitated states? Can a unipolar experience those or does having those mean that one is bipolar?
> > >
> > > K
> >
> > That is a matter of much debate. It depends on whether you measure depression on multiple axies, or not. Irritability, physical agitation, sleep disturbance, cognitive activation....I can think of a host of associated symptoms which may or may not coincide with mood.
> >
> > I guess that a true unipolar depressive, absent any activating characteristics, might be as rare as a unipolar manic.
> >
> > Lar
> >
>
>
> There is a lot of debate right now about whether people who have traditionally been diagnosed with "anxious" or "agitated" depression are actually experiencing bipolar "mixed" symptoms instead. I'm definitely BPII, but my anxiety and panic tend only to happen during seasonal major depressive episodes. I'm not nearly as panicky and anxious in my "high" phases. If I get hostile, however, the panic tends to happen because I freak out about stuff I've said or done.
>
My depression is always extremely anxious if I'm not on any medication. I have a feeling the debate will eventually end with the bipolar supporters winning out.
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