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Re: Hypomania-- a solution to TR Depression? » Girlnterrupted

Posted by SLS on November 2, 2005, at 14:20:38

In reply to Hypomania-- a solution to TR Depression?, posted by Girlnterrupted on November 2, 2005, at 6:45:53

Hi.

For someone in your position, hypomania is not something psychiatrists should be afraid of. If they can get you hypomanic, the battle is all but won. All that is left to do is to add an antimanic or mood-stabilizer and voila...

Why bother with mood stabilizers at all?

1. Prevent depression
2. Augment antidepressants

As someone has already explained, if you are truly bipolar II with hypomania, preventing the hypomania might also prevent the depression that often follows. Bipolar disorder is a disease of oscillation. The neurobiology in bipolar disorder seems to shift from one pole to the other unless this oscillatory progression is interrupted medically.

I think it is important to diagnose properly your affective disorder. As C_M suggested, perhaps what others characterize as "hypomania" is really your euthymia - normal. In your case, diagnosis can be made in one of two ways: retrospectively or prospectively. If your current doctor observes hypomania in the future, whether spontaneous or as the result of treatment, this would be prospective. This might not happen for quite some time. However, an accurate retrospective examination of your history using life-charting might be the only way to reveal bipolarity. Again, the importance of descriminating between unipolar and bipolar will be the basis upon which one chooses whether or not to use mood stabilizers as part of therapy. Sometimes, a bipolar depression being treated with an antidepressant will not remit until a mood stabilizer is added.

Now that I have given you a good reason to treat the hypomania should it actually occur, I will also argue in favor of allowing a hypomania to continue uninterrupted. This does not apply to people who oscillate between depression and hypomania, but rather, to people who spend all of their time in hypomania. If the hypomania is not dysphoric and allows the person to function (or hyperfunction) in life without leading to self-destructive behavior, it is sometimes best left alone.

If Lexapro makes you hypomanic - use it, but search for a mood-stabilizing regime to interrupt the cycle into depression. In my opinion, euthymia is the goal in your case, not hypomania. However, hypomania might be the first step along the way.


- Scott

 

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