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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 42. Go back in thread:
Posted by morganator on December 15, 2009, at 21:44:36
In reply to Re: Atypical Depression versus Bipolar Depression » morganator, posted by SLS on December 15, 2009, at 6:03:02
That's funny, I see the pot-kettle thing. I also know that these things have not just helped me but a few other people I know suffering from bipolar and depression. This is one reason why I really believe exercise and therapy may be helpful for many sufferers, not all, but possibly a significant number. Anyway, I know this is not the topic.
>What symptoms or features of your illness suggests that you are bipolar?
>What symptoms or features of your depression do you think might help one differentiate it from unipolar depression?
I think answering the first should answer the second. I have had 3 periods of mixed states in my life, I am sure of this. The last mixed state was horrific and if it went on any longer I may have started to experience psychotic symptoms. It went on much much longer without being treated than it ever should have. I finally had to decide I was going to the hospital after not being able to find a psychiatrist who had the ability or balls to try to give me the right medication to bring me out of the episode. What symptoms did I experience during this last episode? I could not stop obsessing and regretting things I had done. I could not slow my mind down. I could not sleep for more than 3 hours a night. I was extremely agitated, depressed, and manic all at the same time. Actually, I was probably feeling the agitation and mania more than the depression. You could say that the racing thoughts, extreme fear, agitation, and mania were a manifestation manifested out of a very deep but fairly brief state of depression that came first.
Over the years I've been able to stay on an antidepressant alone and function at a fairly high level. But when I look back on my behavior during those I realize that I was hypomanic much of the time. I often engaged in risky sexual behavior and I at times acted like a raging lunatic(it was all in fun and entertained people around me but it was definitely indicative of a certain type of bipolar. Actually, most of the friends I grew up with and hung out with through the years were on the crazy wild side with very exuberant personalities, including my brother. None of them were bibolar. I tended to take it to the next level and was less in control of it). I had a ton of energy throughout the years and often could go without sleep easier than the average person. I would experience this even more sometimes when I was drinking heavily, believe it or not.
I have always had issues with depression and anxiety and they always coexisted. I remember in college when I was very depressed and obsessed with death I reacted to it by behaving in a more hyperactive manner and I would stay up very late(I know, everyone stays up late in college). No one would have ever guessed I was that depressed. I remember thinking about death and getting old at a very very young age. Not sure if this has anything to do with having a bipolar predisposition.
People who have unipolar depression simply experience the depression and maybe some anxiety. They do not have tons of energy, periods of hypomania or mixed mania, and they do not cycle in and out of depression in brief periods of time. Unipolar depressives are not likely to go around having unprotected sex like stray dogs in an alley.
Posted by morganator on December 15, 2009, at 21:52:34
In reply to Re: Atypical Depression versus Bipolar Depression, posted by SLS on December 15, 2009, at 17:02:17
If I am depressed and something good happens, at least in the past, I most certainly felt good about it. I could probably say that over the years I often needed good things to happen to feel good. While on Zoloft and feeling young and strong, I did not get depressed very severely. If I did feel depressed, I had to do something to make myself feel better. Going to the gym played a major role in constantly making me feel good :).
I have to say, I have been more on the hypomanic and anxiety side of bipolar than the depressed side, until just recently. My life has take a turn for the worst and I do not have the same things to feel good about that I believe protected me from this depression for so many years. If I could erase all the damage from the last 3 years, I would be a pretty damn happy bipolar right now.
Posted by morganator on December 15, 2009, at 22:00:03
In reply to Re: Atypical Depression versus Bipolar Depression » SLS, posted by bleauberry on December 15, 2009, at 18:34:01
My recent dignosis has not only not helped me, but because of the time in my life and the way I was diagnosed, it has been detrimental to me in ways. Maybe I will elaborate later.
I do think that being diagnosed much sooner may have been very helpful. If I was diagnosed at the right time I may have made decisions as far as how I approached certain things differently. I do not think I would have taken myself of Zoloft 2 and a half years ago. I may have tried to drink less alcohol at times. I may have been more aware of my behavior and tried to modify it. So I think, Bleauberry, in some cases, a diagnosis can be very helpful. But I definitely see where you are coming from.
Posted by kirbyw on December 16, 2009, at 0:05:11
In reply to Atypical Depression versus Bipolar Depression, posted by SLS on December 14, 2009, at 7:26:02
In my most recent psychiatric consultation with Dr. Goldberg in New York, he found traits of bi-polar illness in both of my parents, based on their histories. But I have no manic states at all ever. I have had severe
"endogenous" depressive states, which have generally responded well to Parnate, but to no other AD's at all. Dr. Goldberg diagnosed me as having Atypical Depression, and recommended adding Lithium to my Parnate. When depressed I can sleep for 20 out of 24 hours, have ruminations, and a high degree of anxiety. When normal, that is not depressed, I am not manic but am "high functioning" in term of social relations, career etc. I have a Doctorate,and have had an interesting career. Generally I don't lose a job when i am severely depressed. I just go to work distracted, ruminating, and highly anxious but am able to keep it hidden from my peers. Its stressful. I get enough done, to avoid drawing attention to myself.I also am always very sensitive to rejection, but extremely sensitive when more depressed. Both Dr. goldberg and Dr. Scheftner at Rush Medical Center in Chicago feel that there is a latent and 'invisible' bi-polar component to my depression. Both have recommended the Lithium.
I am having a tough time with Lithium because I already have a bladder problem with a urinary frequency problem, and I have the impression that Lithium is making this worse. So, temporarily, since I will be traveling over the holidays, I am limiting the Lithium to 300 mg per day, only in the morning. Will try again at 600 mg when I get back home.
Rick
Posted by morganator on December 16, 2009, at 1:56:57
In reply to Re: Atypical Depression versus Bipolar Depression, posted by kirbyw on December 16, 2009, at 0:05:11
If both of your parents were bipolar, it is likely that you did not have the best childhood. This could result in a lower self esteem, which may be one of the reasons for your issues with rejection. Have you ever addressed or thought about addressing this in therapy. Group psychodynamic therapy would most likely be best suited for addressing this issue. Also, any issues in childhood could have made whatever predisposition you have towards depression much much worse. I'm not saying that addressing these issues will solve anything, I'm just saying I may not hurt to consider looking into addressing them. These things just don't go away. They linger inside of us for the rest of our lives if not addressed in some way.
Sorry, maybe I should have just kept my thoughts to myself. I hope you are not offended.
Posted by SLS on December 16, 2009, at 6:42:12
In reply to Re: Atypical Depression versus Bipolar Depression, posted by kirbyw on December 16, 2009, at 0:05:11
Hi Rick.
Thanks for responding.
Good luck on your lithium treatment. In the past, Parnate was considered a particularly good drug to augment with lithium in unipolar depression, and one of the best treatments for bipolar disorder as well.
From what I have read, rejection sensitivity can manifest in both atypical and bipolar depressions. However, I am most interested in whether both types of depression share mood reactivity as a presenting feature or if it can be used as a symptom to differentiate between the two depressive subtypes.
Are there situations, events, or other experiences that can elicit a substantial improvement in your depression greater than 50%?
- Scott
Posted by SLS on December 16, 2009, at 6:53:14
In reply to Re: Atypical Depression versus Bipolar Depression » SLS, posted by bleauberry on December 15, 2009, at 18:34:01
I think I understand better what you are trying to communicate.
I would agree that many, if not most, psychiatrists do not check for organic or other explanations for the symptoms they are presented with, even though the DSM is very specific to suggest that such a step be taken to diagnose major depressive disorder.
"D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism)."
I don't think that the concept of diagnostics is irrelevant. It just might not be implemented properly.
- Scott
Posted by SLS on December 16, 2009, at 7:02:58
In reply to Re: Atypical Depression versus Bipolar Depression, posted by morganator on December 15, 2009, at 21:44:36
> People who have unipolar depression simply experience the depression and maybe some anxiety. They do not have tons of energy, periods of hypomania or mixed mania
Yes. But what differences are there between the depressive states of atypical depression and bipolar depression that would allow one to differentiate them? When a doctor is presented with a patient complaining of depression, it often occurs that they are looking at a case of bipolar disorder for which mania has not yet manifested. It would be ideal to be able to recognize such cases early and apply treatments that are more appropriate for bipolar disorder and that would not make the situation worse.
I think that this is really a critical issue.
- Scott
Posted by bulldog2 on December 16, 2009, at 16:52:40
In reply to Atypical Depression versus Bipolar Depression, posted by SLS on December 14, 2009, at 7:26:02
> Atypical depression and bipolar depression look very similar. Anergia and reverse vegetative symptoms predominate (hypersomnia, hyperphagia, and leaden paralysis). However, mood-reactivity seems to be a feature specific to atypical depression, although it does not always manifest. This is still being debated. It may be that there is a great deal of misunderstanding between posting members of Psycho-Babble when an atypical compares themself to a bipolar and doesn't understand why the bipolar is not reactive to the same things that they are. Perhaps this includes psychotherapy and exercise.
>
> Has anyone noted other differences between atypical and bipolar depressions?
>
>
> - ScottCan one have both atypical depression coexisting with bipolar depression? In other words have explosive periods of reactive depression but also have separate periods of mania? If so how would that be treated?
Posted by morganator on December 16, 2009, at 21:25:34
In reply to Re: Atypical Depression versus Bipolar Depression » kirbyw, posted by SLS on December 16, 2009, at 6:42:12
I think mood reactivity is present in both bipolar and atypical depression. At least my friend and I both have experienced it pretty regularly. We both agree that we could be thrust out of feeling depressed fairly quickly and suddenly feel more on the hypomanic side in reaction to something good happening to us.
Posted by kirbyw on December 17, 2009, at 0:30:52
In reply to Re: Atypical Depression versus Bipolar Depression, posted by kirbyw on December 16, 2009, at 0:05:11
Not at all offended by Morganator's comment.
I am 62 years old. My childhood was somewhat paradoxical. There were a lot of good points, but my verbally abusive father, made life very difficult. My mother was a suicide when I was 19 and the Doctor suspects that she was bi-polar. After she died I became a virtual orphan, but survived mostly by bonding with friends and with their families, because I couldn't stand to be with my Dad and my step-mother. I call them my adoptive families.I had loads of therapy, almost constantly between the age of 21, up to about 40, mostly individual but some group. For the last 22 years I have had almost no therapy and that is something I miss. I was hospitalized for a severe depressive crisis in 1982 which is when I went on Parnate, and this cleared up the depression. I was able to get a Masters and a Doctorate in Psychology and have worked for 40 years, almost without interruption. I have done a lot of interesting things, in terms of my work, and have generally had a successful career. But I am single (gay) and did not wind up in a permanent relationship so I feel isolated in that sense.
I had long term relationships (3, 5, 6 years, etc) but eventually all of them ended.
I have close friends and good peer relationships, but I am currently living out of the U.S. which is a big disadvantage in terms of a lot of factors. I liked it for most of the 20 years that I have been here in Costa Rica, but now I am missing a lot of things about the U.S., but I really can't afford to move back at this point.The depression I have been going through off and on for the past six months, is the worst since my 1982 hospitalization, but Parnate still helps.
Anyway, I could go on, but that's a brief response to your comment.
Rick
Posted by SLS on December 17, 2009, at 6:39:09
In reply to Re: Atypical Depression versus Bipolar Depression, posted by morganator on December 16, 2009, at 21:25:34
> I think mood reactivity is present in both bipolar and atypical depression. At least my friend and I both have experienced it pretty regularly. We both agree that we could be thrust out of feeling depressed fairly quickly and suddenly feel more on the hypomanic side in reaction to something good happening to us.
Hypomanic?
Sounds intense.
Do you think that you can learn to seek out hypomania through psychotherapy?
- Scott
Posted by morganator on December 17, 2009, at 8:44:22
In reply to Re: Atypical Depression versus Bipolar Depression » morganator, posted by SLS on December 17, 2009, at 6:39:09
> > I think mood reactivity is present in both bipolar and atypical depression. At least my friend and I both have experienced it pretty regularly. We both agree that we could be thrust out of feeling depressed fairly quickly and suddenly feel more on the hypomanic side in reaction to something good happening to us.
>
> Hypomanic?
>
> Sounds intense.
>
> Do you think that you can learn to seek out
hypomania through psychotherapy?I may be biased, but yes I think I can. It may depend on the individual though.
I'm not sure how hypomanic I was. I certainly had plenty of periods of feeling fairly laid back and calm(especially after playing basketball for 3 hours straight-hypomanic?) I think there are many high functioning hypomanics out there. I tended to fluctuate I think. I was not the type that was super productive and didn't require or didn't get much sleep on a regular basis. I got sleep, I just had lots of energy and I was on the wild and crazy side. Then I would go through periods of being more calm and focused, especially when I was staying away from the drinking. Let's just say I think there are different levels of hypomania.
>
>
Posted by SLS on December 17, 2009, at 8:49:12
In reply to Re: Atypical Depression versus Bipolar Depression, posted by morganator on December 17, 2009, at 8:44:22
> > > I think mood reactivity is present in both bipolar and atypical depression. At least my friend and I both have experienced it pretty regularly. We both agree that we could be thrust out of feeling depressed fairly quickly and suddenly feel more on the hypomanic side in reaction to something good happening to us.
> >
> > Hypomanic?
> >
> > Sounds intense.
> >
> > Do you think that you can learn to seek out
> hypomania through psychotherapy?
>
> I may be biased, but yes I think I can. It may depend on the individual though.
>
> I'm not sure how hypomanic I was. I certainly had plenty of periods of feeling fairly laid back and calm(especially after playing basketball for 3 hours straight-hypomanic?) I think there are many high functioning hypomanics out there. I tended to fluctuate I think. I was not the type that was super productive and didn't require or didn't get much sleep on a regular basis. I got sleep, I just had lots of energy and I was on the wild and crazy side. Then I would go through periods of being more calm and focused, especially when I was staying away from the drinking. Let's just say I think there are different levels of hypomania.
You are fortunate in this regard. If my mood were that reactive, I would try and use Maslow's hierarchy of needs to understand self-actualization and to work towards increasing my frequency of having peak experiences and reducing my exposure to depressogenic ones. The quality of mood enhancement is probably greater during these times than that which one would experience when using psychotherapy or exercise alone. It would be more consistent, too.You should look into it. It might reduce or obviate your need of using somatic treatments to resolve your depression.
- Scott
Posted by morganator on December 17, 2009, at 8:52:34
In reply to Re: Atypical Depression Morganator, posted by kirbyw on December 17, 2009, at 0:30:52
As beautiful as Costa Rica can be, I bet it is hard for you to find someone there. Sorry to hear your depression has been much worse lately.
Yeah as far as therapy goes, evidently certain types of group therapy are best for helping us have better relationships, romantic and otherwise. So if you had a chance to get back into it, I would definitely consider group therapy.
What brought you down to Costa Rica?
That's too bad it is difficult for you to come back to the states right now. It sounds like being here might be good for you for a few reasons.
I hope you find relief from this recent bout soon.
Take Care,
Morgan
Posted by polarbear206 on December 17, 2009, at 10:41:17
In reply to Re: Atypical Depression versus Bipolar Depression, posted by kirbyw on December 16, 2009, at 0:05:11
> In my most recent psychiatric consultation with Dr. Goldberg in New York, he found traits of bi-polar illness in both of my parents, based on their histories. But I have no manic states at all ever. I have had severe
> "endogenous" depressive states, which have generally responded well to Parnate, but to no other AD's at all. Dr. Goldberg diagnosed me as having Atypical Depression, and recommended adding Lithium to my Parnate. When depressed I can sleep for 20 out of 24 hours, have ruminations, and a high degree of anxiety. When normal, that is not depressed, I am not manic but am "high functioning" in term of social relations, career etc. I have a Doctorate,and have had an interesting career. Generally I don't lose a job when i am severely depressed. I just go to work distracted, ruminating, and highly anxious but am able to keep it hidden from my peers. Its stressful. I get enough done, to avoid drawing attention to myself.
>
> I also am always very sensitive to rejection, but extremely sensitive when more depressed. Both Dr. goldberg and Dr. Scheftner at Rush Medical Center in Chicago feel that there is a latent and 'invisible' bi-polar component to my depression. Both have recommended the Lithium.
> I am having a tough time with Lithium because I already have a bladder problem with a urinary frequency problem, and I have the impression that Lithium is making this worse. So, temporarily, since I will be traveling over the holidays, I am limiting the Lithium to 300 mg per day, only in the morning. Will try again at 600 mg when I get back home.
> RickHi Rick. Glad to hear you are one of Dr. Goldbergs patients. He is exceptionally one of the finest in the business. I have corresponeded with him in the past and he has been of great help. You are very lucky and in good hands. All the best to you.
Posted by polarbear206 on December 17, 2009, at 10:43:13
In reply to Re: Atypical Depression versus Bipolar Depression, posted by polarbear206 on December 17, 2009, at 10:41:17
Posted by polarbear206 on December 17, 2009, at 11:01:32
In reply to Re: Atypical Depression versus Bipolar Depression, posted by kirbyw on December 16, 2009, at 0:05:11
I follow all of Akiskal's writings, etc.. on this topic. You can find alot of info on pubmed from Akiskal. Here's some info too.
http://www.mcmanweb.com/mood_spectrum.html
Posted by morganator on December 17, 2009, at 15:02:16
In reply to Re: Atypical Depression versus Bipolar Depression » morganator, posted by SLS on December 17, 2009, at 8:49:12
Well that's why I got off Zoloft in the first place. I was doing so many things that were good for me. Unfortunately, in the same time I did some things that ended up being really bad for me and I found myself in a horrific mixed episode. I truly believe that Zoloft would have help to prevent this episode from happening at all. I do think I need some type of medication to help keep me balanced somewhat. I don't need medication to bring me out of depression or mania completely. I am fortunate enough to do other things to treat my illness.
I think over the years I continually did things to keep me going and make me feel good, some were healthy and some not so healthy. Unfortunately, as I got older, I began to find myself unable to escape reality the way I once did and I had damaged my body in a way that I could no longer benefit from playing basketball and simply feeling good physically.
Now, I need to try to heal as much as possible-mind and body, find the right medication/medications-which I believe I am getting close to, get a job and figure out what the heck I'm going to do with my life, get back into individual and group therapy, start trying to enjoy going out with friends again-hopefully be able to dance comfortably again(I love dancing), take some art classes maybe, and just find a way to accept what I have lost over the last 3 years and move on.
I guess I am lucky in many ways. I know I don't have anything close to what you have going on, Scott. I think I have just been spoiled by some things. As much as I have struggled in life-3 mixed episodes, lots of anxiety issues, never took advantage of my true talents at the age when I should have been, feel like I lost my youth-there are many things that have come easy to me. Unfortunately, those things that came so easy to me are not so easy for me now. So, I am lost. This is also a transitional age for me especially since I have no career and never had one, my body is a wreck, and I'm single with no living with my brother. Seriously, If I didn't run triathlons professionally, become a dancer at a young age, maybe get into acting, maybe do something in the fine arts, or become a therapist-I just couldn't see myself doing anything else. I'm just one of those people. I don't know if I will ever have the mind and energy to go to grad school and get my master's in social work. That is the only thing I can do at this point. Unless I worked at a restaurant or wholefoods and eventually got into management-I'm really good with people.
Maybe my problems don't sound that bad. As far as I am concerned, I have been living a nightmare that I made into an even bigger nightmare. No one should be making the decisions I was making on my own while in a continued state of moderate mixed mania after my first hospitalization 2 years ago. It's really sad how families react to mental illness sometimes, even fairly loving connected families.
Sorry for going on that little rant-if it was a rant.
Scott, I really feel for ya brotha. You are obviously dealing with a bigger monster that just won't go away for whatever reason/reasons. I do think I can relate to feeling as depressed as you have felt. I just thing it does not last as long and I have something different going on that allows me to recover easier. Geeze, for me it's been my sensitivity to meds and all the med trials over the last 2 years, the fact that I am a few years older but feel more like 20 years older, I have not life or career, my ego has been shot, and I am obviously bipolar. I also have had this incredible fear of getting old and dying since I was very young, maybe 5. So taking everything that is going on with me and adding it to this fear makes for a bad combination.
Scott, I hope you find significant relief soon and get your life back. It's too bad we all don't live near each other I think it would help if some of us could become friends and meet up regularly. I am a true believer that being around people is healing. While it may not make a major dent in some people's illness, hopefully human connection/intimacy at least gives them something to look forward to and feel good about. I understand that for those in really bad states it may not be possible to get out and see people. Or, even if they were able to or people came to visit them, they may feel so bad and disconnected that they are unable to benefit from it.
Wow I have rambled enough. You bring up some good ideas about managing mood. You are a highly intelligent person Scott. Whatever you feel your depression has done to your mind it does not show in your posts.
Peace,
Morgan
Posted by morganator on December 17, 2009, at 15:04:05
In reply to Re: Atypical Depression versus Bipolar Depression » SLS, posted by morganator on December 17, 2009, at 15:02:16
Sorry if my last post was a bit self indulgent and strayed from the topic
Posted by inanimate peanut on December 18, 2009, at 20:46:26
In reply to Re: Atypical Depression versus Bipolar Depression, posted by morganator on December 17, 2009, at 15:04:05
I know I'm throwing my 1.5 cents in a little late in the thread, but I've mostly just been absorbing thus far. I wish my mood was reactive-- anything to get me out of this deep depression that I wonder if I'll just live in until I die. It's actually quite funny-- my last boyfriend of a couple years broke up with me about 2 weeks after the Geodon started working. In the normal mood state brought on by the Geodon (no, I wasn't hypomanic or manic), I knew this was the best thing for us, moved on emotionally, found a new apartment, etc. It's only now that I'm so depressed again (Geodon stopped working several months ago) that I'm wishing I had him (or anyone really) back again because I'm so lonely with this depression. I think you could bring him back now though and it wouldn't change the depression. After all, I was just as depressed with him before the Geodon. You could send me on a cruise or gift me a large sum of cash and my depression wouldn't change substantially. It's terribly unfortunate that it doesn't react, because I guarantee I would be chasing whatever key it was that it needed to change, even for a few days!!!
Posted by inanimate peanut on December 19, 2009, at 22:57:13
In reply to Re: Atypical Depression versus Bipolar Depression, posted by inanimate peanut on December 18, 2009, at 20:46:26
Sorry-- I forgot to add that my dx is bipolar, mixed type, so you may or may not believe that makes a difference
Posted by PC_Load_Letter on December 20, 2009, at 13:31:09
In reply to Atypical Depression versus Bipolar Depression, posted by SLS on December 14, 2009, at 7:26:02
My depression is atypical unipolar, and it is not at all mood-reactive - that is to say it does not improve when positive events occur. It does, however, respond modestly to psychotherapy and exercise.
This similarity between atypical and bipolar depression is, in my view, significant; it supports the hypothesis that both disorders are part of a common spectrum. Thanks for bringing it up.
> Atypical depression and bipolar depression look very similar. Anergia and reverse vegetative symptoms predominate (hypersomnia, hyperphagia, and leaden paralysis). However, mood-reactivity seems to be a feature specific to atypical depression, although it does not always manifest. This is still being debated. It may be that there is a great deal of misunderstanding between posting members of Psycho-Babble when an atypical compares themself to a bipolar and doesn't understand why the bipolar is not reactive to the same things that they are. Perhaps this includes psychotherapy and exercise.
>
> Has anyone noted other differences between atypical and bipolar depressions?
>
>
> - Scott
Posted by SLS on December 20, 2009, at 14:44:17
In reply to Re: Atypical Depression versus Bipolar Depression » SLS, posted by PC_Load_Letter on December 20, 2009, at 13:31:09
> > Atypical depression and bipolar depression look very similar. Anergia and reverse vegetative symptoms predominate (hypersomnia, hyperphagia, and leaden paralysis). However, mood-reactivity seems to be a feature specific to atypical depression, although it does not always manifest. This is still being debated. It may be that there is a great deal of misunderstanding between posting members of Psycho-Babble when an atypical compares themself to a bipolar and doesn't understand why the bipolar is not reactive to the same things that they are. Perhaps this includes psychotherapy and exercise.
> >
> > Has anyone noted other differences between atypical and bipolar depressions?> My depression is atypical unipolar, and it is not at all mood-reactive - that is to say it does not improve when positive events occur. It does, however, respond modestly to psychotherapy and exercise.
In what ways do you feel improved after exercise? How long does the improvement last for?
> This similarity between atypical and bipolar depression is, in my view, significant; it supports the hypothesis that both disorders are part of a common spectrum. Thanks for bringing it up.
Is there any family history of bipolarity?
Thanks for responding.
- Scott
Posted by PC_Load_Letter on December 26, 2009, at 14:33:44
In reply to Re: Atypical Depression versus Bipolar Depression » PC_Load_Letter, posted by SLS on December 20, 2009, at 14:44:17
> > > Atypical depression and bipolar depression look very similar. Anergia and reverse vegetative symptoms predominate (hypersomnia, hyperphagia, and leaden paralysis). However, mood-reactivity seems to be a feature specific to atypical depression, although it does not always manifest. This is still being debated. It may be that there is a great deal of misunderstanding between posting members of Psycho-Babble when an atypical compares themself to a bipolar and doesn't understand why the bipolar is not reactive to the same things that they are. Perhaps this includes psychotherapy and exercise.
> > >
> > > Has anyone noted other differences between atypical and bipolar depressions?
>
> > My depression is atypical unipolar, and it is not at all mood-reactive - that is to say it does not improve when positive events occur. It does, however, respond modestly to psychotherapy and exercise.
>
> In what ways do you feel improved after exercise? How long does the improvement last for?An overall increased sense of well-being and relaxation is the best way I can describe it; these effects are most likely the result of endorphins kicking in. I don't always experience this effect, however, and if I exert myself too much, exercise can have the opposite effect. In addition, I'm usually quite exhausted even after a workout that does have a beneficial effect on my mood.
>
> > This similarity between atypical and bipolar depression is, in my view, significant; it supports the hypothesis that both disorders are part of a common spectrum. Thanks for bringing it up.
>
> Is there any family history of bipolarity?Not that I know of, although I sometimes wonder if the significant irritability that I not infrequently exhibit could be a symptom of some degree of hypomania. Of course, this can also be a symptom of unipolar depression, so who knows.
>
> Thanks for responding.
>
No prob. Glad to be able to add one more data point to your survey.> - Scott
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