Posted by Larry Hoover on March 15, 2003, at 10:40:16
In reply to Bipolar or SAD?, posted by sedona on March 14, 2003, at 15:24:47
> Hi- I am going to try to keep this question as short as I can.(snip) I am starting to think that I fall somewhere in the bipolar spectrum. I have never been manic and I don't think I have been hypomanic, but there is a definite cycle going on.
From a strict application of the diagnostic criteria, the absence of hypomania or mania precludes a bipolar disorder diagnosis. Some diagnosticians accept that mania or hypomania can be agitated and dysphoric, so even those definitions vary from doctor to doctor.
I don't mean to be pedantic. Doctors think in terms of dx (diagnosis), whereas the patient thinks in terms of sx (symptoms). I don't know that dx much matters to the patient, in real terms (your opinion may vary from mine, of course).
The presence of a seasonal cycle is important. There are seasonal forms of bipolar, but also seasonal depressions.
> And I wanted to know if others have had this experience. Has anyone had success with mood stabilizers for seasonal patterns of depression? If so what helped?
> ThanksFor SAD, one unique form of treatment is phototherapy. Bright light seems to reduce or eliminate the seasonal cycle, if used routinely every day. Phototherapy works best as a prophylactic treatment, preventing SAD, rather than as a treatment once the symptoms have appeared each season. It's therefore important to begin phototherapy around the equinox in September. There is increasing evidence that suggests that sun exposure during the preceding summer may also influence SAD symptom intensity the following winter.
I highly recommend the economical and effective lights manufactured by Northern Light Technologies, particularly, the Sadellite.
Now, getting back to the Western medical paradigm:
a patient presents with sx (symptoms); the doctor slots the symptoms into a pattern to give a dx (diagnosis); the diagnosis informs the tx (treatment); the hope is to change the px (prognosis). From the patient's perspective, if the tx does not relieve the sx, then something's amiss. I think the biggest problem arises because so few patients fit neatly into the little intellectual "boxes of symptoms" that describe the different diagnoses. IMHO, most people straddle the lines. It's therefore important to emphasize your own impression of your symptoms. As you've apparently not been listened to about the seasonality component (am I reading you right?), it's perhaps time to hammer away at that issue with your doctor.
poster:Larry Hoover
thread:209127
URL: http://www.dr-bob.org/babble/20030314/msgs/209360.html