Posted by Maxime on March 6, 2005, at 22:45:02
In reply to Re: BP II and anxiety??????, posted by shoebox on March 5, 2005, at 9:00:00
Actually sometimes it is hard for pdocs to diagnose anxiety versus bipolar type 2 (see link below). However, many of the meds people have suggested will help the symptoms you describe. I don't know if Seroquel was mentioned, but it is good for anxiety and hypomania.
Maxime
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From:http://www.psycheducation.org/depression/frameset.html
Anxious depression could be "bipolar"?!Warning: leaving DSM-IV territory
The remainder of this "diagnosis" discussion cannot be found in the DSM. I will repeatedly reference mood disorder experts, but many of these views are controversial. You must evaluate for yourself the validity of what follows.
Unfortunately, "hypomania" is quite a mis-naming. There are many patients whose "hypomanic" phases are an extreme and very negative experience. As noted above by Dr. Jamison, mania can be negative as often as it is positive. The "racing thoughts" can have a very negative focus, especially self-criticism. The high energy can be experienced as a severe agitation, to the point where people feel they must pace the floor for hours at a time. Sleep problems can show up as insomnia: an inability to sleep, rather than decreased need. (If you or a friend or doctor is skeptical about anxiety as a "bipolar" symptom, try that link for more details and references.)
In my experience most of these people come to treatment with a combination of agitation, anxiety and self-criticism — and they can’t sleep well. Is this "anxiety?" Is this some mood variation? How could you tell the difference? Is there a difference? What is really going on chemically? Unfortunately, this is still almost completely unknown. See the appendix "What’s the latest on why?", which I will try to keep updated frequently, for the latest research about the cause of this illness.
Again, my opinion: you can’t easily distinguish "anxious depression" from bipolar II in a mixed state. I doubt that there is a distinction to be made, ultimately (when we know, hopefully someday relatively soon, what the chemical basis for anxiety with depression really is). For example there is nearly complete overlap between Generalized Anxiety Disorder and Bipolar II.
For now, the only way to tell is by how treatment turns out. Depression that is not bipolar can get better and stay better: with time, or counseling, or formal psychotherapy, or antidepressants. If you get better — great! If you don’t, you may need this new understanding of mood disorders in order to consider mood stabilizers medications, discussed in detail below, as an option.
Meanwhile, at least one experienced mood researcher warns that anxiety in someone who is depressed is associated with a high suicide risk.Fawcett(b) So although there is diagnostic confusion, there are tremendous stakes involved. Approaching this situation with an open mind seems wise, given this risk.
poster:Maxime
thread:466754
URL: http://www.dr-bob.org/babble/20050304/msgs/467610.html