Posted by Ritch on March 11, 2003, at 9:32:48
In reply to Re: For Dr. Bowden: More Q's on BP II, posted by SLS on March 11, 2003, at 6:36:01
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> > 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.
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> > So I wonder--since BPII is misdiagnosed so often, shouldn't every psychiatrist try to differentiate unipolar vs. bipolar right away?
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> Hi.
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> Over the last few years, the concept of the existence of a "bipolar spectrum" had been gaining acceptance. Some psychiatrists use the term "soft bipolar" to describe presentations that exhibit bipolarity, but do not qualify as bipolar I, bipolar II, or cyclothymia according to the DSM IV diagnostic manual. One of the biggest proponents of these concepts is Hagop Akiskal, MD. I would recommend doing a Google search using the keywords "Akiskal" and "bipolar" to find out more about this.
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> Regarding the misdiagnosis of atypical depression for bipolar II, there are some researchers who believe all presentations of atypical depression are actually bipolar depression. I don't believe this is true, as *true* mood reactivity seems to be exclusive to unipolar depression. Bipolar depression most often resembles atypical unipolar depression, as anergia and reverse vegetative symptoms predominate. I would say that mood reactivity would be useful in coming to a differential diagnosis. Speaking for myself, there are times and situations in which I become aroused and more animated, but it does not reduce in the slightest the dementia and anhedonia that are most prominent in my case of bipolar disorder. This is in contrast to atypical depression, where the sufferer reports a temporary lifting of all aspects of depression in reaction to environmental stimuli.
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> - Scott
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>Scott, whenever I have my bipolar seasonal depressions (which are very atypical depressive in nature) good/bad news events can change my mood very markedly. In the case of good news making me feel better during a depression it is primarily the *duration* of the positive reaction that is stymied and short-lived. Sometimes it can last a few days, but more often the temporary positive response is just a few hours. I can feel quite good in contrast to how I was previously feeling. It feels kind of like a rubber band that "snaps" me back into my default mood for the time (when it fades).
poster:Ritch
thread:205791
URL: http://www.dr-bob.org/babble/20030310/msgs/208026.html