Posted by Ilene on March 9, 2003, at 21:07:09
In reply to From Dr. Bowden: Bipolar II, posted by Dr. Bob on March 9, 2003, at 19:01:57
> Dear Jack,
>
> I cannot give you a full answer to your question. However, bipolar II is not hogwash. What makes it difficult to diagnose, as well as for some to understand, is that people with it are depressed much more of the time than they are overactive or up. Even when "up", for some this is fully positive, for others only expressed as grumpiness, and for others so brief (just hours in duration) that it does not register as illness to the patient or the psychiatrist.
>
> Charles L. Bowden, M.D.
This is interesting. I always thought I had atypical unipolar depression. A few months ago I found some articles on the internet about BPII (which I had never heard of) and the confused taxonomy of bipolar disorders. I brought them in to my psychiatrist, but neither of us could decide whether I was bipolar or not. We had been discussing augmenting ADs with a mood stabilizer anyway. It was really a process of trial and error.I've been at 200 mg. Lamictal for about 2 or 2 1/2 weeks now, and for about a week I've had more energy and less suicidal ideation, etc. I'm beginning to think I'm responding to it (at last! something)
So I wonder--since BPII is misdiagnosed so often, shouldn't every psychiatrist try to differentiate unipolar vs. bipolar right away? Especially when a person isn't sure how "normal" feels, and has a hard time recalling how things felt in the past?
I read about mental illness in the family, even if it's not BP, as one indicator of BP. One more relative with a disorder would be the swing vote in my self-diagnosis. But it can be so hard to determine! E.g., my mother suffered from migraines and I wonder if she also had a mood disorder...not many people liked her. (I know there's some correlation between migraine and mood disorders.) Even so, I don't recall any psychiatrist asking me about the mental status of my relatives. And when you don't like your mother it doesn't mean she is loonytoons!
How do *you* diagnose BPII? Would "responds to mood stabilizer" equate to "is bipolar"? Is it even meaningful once you are at the point of truly refractory depression, or do you continue experimenting with different meds?
Sorry to ramble on so.
--I.
poster:Ilene
thread:205791
URL: http://www.dr-bob.org/babble/20030306/msgs/207592.html