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Re: I would revise your categories » BarbaraCat

Posted by Abby on August 15, 2002, at 11:46:43

In reply to Bipolar/Unipolar depression - differences?, posted by BarbaraCat on May 28, 2002, at 21:21:44

>
> BarbaraCat Unipolar: Dragging, heavy, sitting on the couch for hours too exhausted or disinterested to move, don't give a rip. No interest in anything, cynical, sarcastic, critical, sleep alot, feel like I'm moving though mud. Feel flat and grim, no joy, everything is a burden and a struggle. Hate life and myself, quiet despair. Body hurts and feels sick. Energy stagnant.
>
> BarbaraCat Bipolar: Desperate, frantic, doom and destruction, insomnia, nightmare quality to everything, frantic pacing, hysterical anguished sobbing, hypersensitive, hyper aware of 'existential pain', being sucked into the void, horrible hopelessness. Feel abandoned, cast out and lost in a hostile universe. Scary, black images of decay and desolation. Falling apart, nerves and brain feel inflamed. Not as much somatic distress as with unipolar. Energy frenzied.
>
>

Barbara,

I have to agreewith jazzdog's classification:

"It's my understanding that unipolar depression is the anxious, insomniac, losing-weight variety, and bipolar depression involves sleeping too much, having no energy, and gaining weight. But there are also mixed states, anxious hypomanias, etc., so who knows?"
 

Let me say that I am a confirmed Akiskalian with a Bipolar NOS diagnosis. (Bipolar spectrum essentially--not as picky about length of episode.)

I think your description of unipolar depression is closer to bipolar type. My pdoc would say that in bipolar patients sluggishness and fatigue, slowness are all attributes of depression.

The other stuff is a mixed state--hypomanic restlessness mixed in.

"Classical" 20th century definitions count insomnia as a symptom. In my opinion this only applies to typical major depression (which really ought to be called atypical, because it seems to be anything but the norm.

My hypothetical case of a patient presenting with typical major unipolar depression. White male aged 50 at first onset, no history of cardiac disease or substance abuse.

Abby


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