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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by AnotherAnon on April 5, 2006, at 16:03:31
Can someone please describe the difference? I think I am feeling a sort of generalized anxiety, where I feel a points during the day that I could have a panic attack. I have an almost constant "nervous stomach"...trouble sleeping, general feeling of uneasiness and dread, worry, and when I try to sleep I have had racing or pervasive thoughts. This comes on the tail end of some pretty traumatic events the past two weeks or so. My doctor thinks it's mania, but I'm not bipolar and don't think I've ever experienced mania.
Posted by linkadge on April 5, 2006, at 16:11:46
In reply to Anxiety vs. Mania, posted by AnotherAnon on April 5, 2006, at 16:03:31
This doesn't sound like mania to me it sounds like bad anxiety.
Linkadge
Posted by blueberry on April 5, 2006, at 17:48:53
In reply to Anxiety vs. Mania, posted by AnotherAnon on April 5, 2006, at 16:03:31
I'm like you, I can't tell the difference. Mostly when someone thinks of mania, they think of superman energy, no need to sleep, over doing everything, going fast. But I think there are other forms of mania that are extremely distressing, looking a lot like severe anxiety. I would guess if you went to 10 different doctors, some would say it is a form of mania and some would say it is anxiety. Don't know. I do know it is absolutely crushing, whatever it is.
Posted by linkadge on April 5, 2006, at 18:01:47
In reply to Re: Anxiety vs. Mania, posted by blueberry on April 5, 2006, at 17:48:53
I generally think of mania as being a positive experience for the individual, wherase anxiety is purely negitive.
I mean there is dysphoric mania, but that is characterized by things like rage and excessive
energy.There is a difference between can't sleep and don't want to sleep. There is a difference between a mind racing with a flight of ideas and a mind racing with fears.
I think that the diagnosis of mania has become clouded these days with all of the factors of drug induced states.
I think that you know yourself best.
Linkadge
Posted by Phillipa on April 5, 2006, at 21:56:59
In reply to Re: Anxiety vs. Mania, posted by linkadge on April 5, 2006, at 16:11:46
I agree sounds like me. Love Phillipa
Posted by greywolf on April 6, 2006, at 0:21:05
In reply to Anxiety vs. Mania, posted by AnotherAnon on April 5, 2006, at 16:03:31
That really doesn't sound like a manic episode. There is definitely a euphoric component to mania, and while the after-effects may cause unpleasant anxiety, while you're manic you're generally super-empowered (at least with BPII).
Posted by tizza on April 6, 2006, at 0:31:17
In reply to Re: Anxiety vs. Mania » blueberry, posted by linkadge on April 5, 2006, at 18:01:47
> I generally think of mania as being a positive experience for the individual, wherase anxiety is purely negitive.
>
> I mean there is dysphoric mania, but that is characterized by things like rage and excessive
> energy.
>
> There is a difference between can't sleep and don't want to sleep. There is a difference between a mind racing with a flight of ideas and a mind racing with fears.
>
> I think that the diagnosis of mania has become clouded these days with all of the factors of drug induced states.
>
> I think that you know yourself best.
>
> Linkadge
>You have a fantastic way of putting things into perspective, that sounds like severe anxiety to me. I used to think that I might be manic but I never enjoyed a single second of it, which most manic people do sometimes but they just don't realise they have entered an episode because they feel so good and need no sleep. Very preoccupied with grandiose ideas or theories. Paul
Posted by SLS on April 6, 2006, at 8:11:06
In reply to Anxiety vs. Mania, posted by AnotherAnon on April 5, 2006, at 16:03:31
> Can someone please describe the difference? I think I am feeling a sort of generalized anxiety, where I feel a points during the day that I could have a panic attack. I have an almost constant "nervous stomach"...trouble sleeping, general feeling of uneasiness and dread, worry, and when I try to sleep I have had racing or pervasive thoughts. This comes on the tail end of some pretty traumatic events the past two weeks or so. My doctor thinks it's mania, but I'm not bipolar and don't think I've ever experienced mania.
I agree with the other posters that what you have described does not sound like mania or hypomania.I am disturbed by the notion that some doctors express that the mere presence of anxiety with depression is sufficient for a diagnosis of bipolar disorder. I think it represents laziness on the part of the physician to not attempt to tease-out a differential diagnosis by performing a thorough interview and perhaps some life charting and a review of family history.
As Linkadge has indicated, the description of "racing thoughts" is not sufficient to diagnose a manic state. Fear and anger can produce racing thoughts in mentally healthy people.
Although it is probably understudied, there is such a diagnosis as unipolar depression with racing/crowded thoughts. It seems to have a younger age of onset and a higher incidence of suicidal ideation. Still, this diagnosis remains contraversial, as some researchers place this presentation along a bipolar spectrum.
Speaking from experience, I think the content of the thoughts is as important as their rapidity. I tend to find manic thoughts to be "expansive", although not necessary positive. It isn't insomnia per se that is an indicator of mania. It is that there is a reduced need for sleep. People with mania and hypomania can average 3-4 hours of sleep per night and still feel energetic.
- Scott
Posted by AnotherAnon on April 6, 2006, at 8:37:44
In reply to Re: Anxiety vs. Mania, posted by SLS on April 6, 2006, at 8:11:06
I definitely haven't felt anything positive from the situation. I think not being able to sleep compounded the problems. It's the nervous stomach (like iron butterflies) that causes me not to be able to eat. My body is very agitated and shivers a lot, which seems anxiety related to me. I often feel like I am on the verge of a panic attack. My doc had me try Seroquel which was a nightmare. Last night she gave me 2mgs of Ativan and it worked like a charm! I slept through the night, woke up on time, no racing/invasive/persuasive thoughts or tossing and turning in bed. A good night's sleep has done wonders form my state of mind this morning so far. Could the drug that solves the problem be an indicator of the problem?
Posted by TylerJ on April 6, 2006, at 10:06:45
In reply to Anxiety vs. Mania, posted by AnotherAnon on April 5, 2006, at 16:03:31
> Can someone please describe the difference? I think I am feeling a sort of generalized anxiety, where I feel a points during the day that I could have a panic attack. I have an almost constant "nervous stomach"...trouble sleeping, general feeling of uneasiness and dread, worry, and when I try to sleep I have had racing or pervasive thoughts. This comes on the tail end of some pretty traumatic events the past two weeks or so. My doctor thinks it's mania, but I'm not bipolar and don't think I've ever experienced mania.
I think this is some pretty bad anxiety you're dealing with, not mania. A patient with mania is usually extremely energetic, hyperactive and talkative. Mania can cause increased sex drive, little need for sleep and the patient may become grandiose. Anxiety on the other other hand usually causes nervousness, tension, excessive worrying, and difficulty sleeping. I'm no doc. but it really sounds like anxiety to me.Tyler
Posted by AnotherAnon on April 6, 2006, at 13:17:00
In reply to Re: Anxiety vs. Mania » AnotherAnon, posted by TylerJ on April 6, 2006, at 10:06:45
I managed to convince her that it's anxiety and not mania, so I've got a script for more ativan. Thank heavens. I know it works and don't want to deal with other meds that don't work like Risperdal and Seroquel.
Posted by Caedmon on April 7, 2006, at 17:08:04
In reply to Re: Anxiety vs. Mania, posted by SLS on April 6, 2006, at 8:11:06
> It isn't insomnia per se that is an indicator of mania. It is that there is a reduced need for sleep. People with mania and hypomania can average 3-4 hours of sleep per night and still feel energetic.
You beat me to it Scott. Average hours of sleep, and perceived need for sleep, are my personal litmus test for mania/hypomania. Dysphoria *can* look much like anxiety, and vice versa. There is a spectrum element to this. I generally can only tell the difference when I look at sleep. (That, and impulsivity.)
When I've been hypomanic I was sleeping 4 hours or less (sometimes 2, sometimes zero!) for several days in a row, no stimulants involved. And I wasn't tired or sleepy. Mind you, I get dysphoric, I felt absolutely terrible and had intense mood swings, but I didn't feel drowsy at all.
So Anon, it doesn't sound quite like hypomania to me. And even if it's hypo-hypomania, Ativan is a good choice (for anxiety, it's a great choice).
- C
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