Posted by SLS on July 24, 2004, at 18:05:50
In reply to Re: Major Depression May Be Relative of Bipolar Disord » SLS, posted by BarbaraCat on July 24, 2004, at 12:54:28
Hi Barbara Cat.
> > I bet there is a tendency for bipolar depression to be subtly, but consistently different from unipolar depression in its expression. Basically, I think bipolar depression resembles anergic atypical unipolar depression except that there is no mood reactivity.
> **Not my experience of it, Scott.I am probably guilty of generalizing in part because the description fits my experience, but much of what I have encountered in the literature describes bipolar depression as resembling atypical unipolar depression in that it usually presents with anergia, psychomotor retardation, hypersomnia, hyperphagia, and reverse diurnal variation (relative to classically defined endogenous depression).
> My depressions have gone all over the spectrum. I occasionally get the 'oh what's the use' anergic gray blob depression,
When you are in this state, does it resemble atypical depression? Is morning your best time or your worst time?
> but what I've come to recognize as the pure bipolar form is a bleak, very weird, agitated and psychotically nightmarish experience that can sometimes last for months at a time.
Perhaps this is a mixed-state and not pure depression.
> The best way to describe it is Edgar Allen Poe on a bad acid trip. Mixed states, and extremely mood reactive.
How do you describe your mood reactivity? Can you be brought out of your depression temporarily if something good happens?
> My point is that no generalizations can be made.
I'm not convinced of that yet. :-) I do understand that the spectrum of presentations is highly variable, but I think the wide range of recipes include a relatively small number of ingredients.
> > Some people with bipolar disorder might never express mania. However, their depression might not respond sufficiently to years of antidepressant treatment until someone gets the bright idea of adding a mood stabilizer.
> **I didn't consider myself bipolar until I started going way back and reframing all those wild and crazy times, all the unfinished projects, the mystical experiences of the Divine, the irritability and insomnia, and thought hmmmmm, well maybe. But the proof in the pudding is how worse I was getting on solo antidepressants and how dramatically lithium changed my life.This is exactly why I think it is so important to diagnose accurately bipolar depression and differentiate it from unipolar depression if it is at all possible as soon as possible. Perhaps there are some common, although subtle, features of bipolar depression that can be recognized or generalized in a majority of cases. I hope so.
> I don't know, maybe what it comes down to is that if you're depressed and taking an antidepressant, chances are that antidepressant will eventually poop out without a mood stabilizer.
Gosh, I hope not. I don't think one can use the communities of people posting on Internet websites like this one as a reflection of the total population of people being treated for depression. I think the population here on PB is skewed towards people who have failed treatment, and it would be difficult to extrapolate from it to what degree "poop-out" occurs generally.
> Maybe a mood stabilizer should be given, de rigeur, along with an AD.
What does "de rigeur" mean?
> Here's a very good site with great info on bipolar. You can spend days following the links.
>
> http://www.psycheducation.org/Thanks for the link. I really, really hope I'm right about the bipolar depression thing. If there is any way to tease out a tell-tale symptom profile, it will save a lot of anguish. Of course, finding a bioligical test would be even better.
- Scott
poster:SLS
thread:368550
URL: http://www.dr-bob.org/babble/20040724/msgs/370062.html