Posted by SLS on December 6, 2004, at 8:28:06
In reply to Re: Bipolar II, posted by ed_uk on December 6, 2004, at 5:48:28
Bipolar II might be misdiagnosed often due to its current fashionability, but it makes it no less a syndrome with well defined boundaries and probably a distinct physiological etiology. I think the differential responses to lithium and valproate help make a case for this. The DSM IV is specific as to what constitutes bipolar II, and describes hypomania as follows:
Hypomanic EpisodeA distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
inflated self-esteem or grandiosity
decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
distractibility (i.e., attention too easily drawn to unimportant or
irrelevant external stimuli)increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
The disturbance in mood and the change in functioning are observable by others.
The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder
- Scott
poster:SLS
thread:422741
URL: http://www.dr-bob.org/babble/20041206/msgs/425177.html