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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 20 to 44 of 44. Go back in thread:
Posted by AMenz on June 24, 2001, at 15:00:00
In reply to Re: What's worked 4 folks 4 BP II or other maladies? » MM, posted by Mitch on June 23, 2001, at 17:13:23
I have always cycled too frequently to have 4 days of anything, yet have BPII dx. Are severe periods of irritability hypomania? I think they are acompanied by racing thoughts etc but not euphoric at all. Is this really hypomania? Is it a mixed state. And how can I be sure of diagnosis.
This BTW is the diagnosis I've had for over 10 years. I do cycle on AD's and get into mixed states.
Like you anxiety (social not panic) kicks up when on mood stabilizers and very low AD's (so I can keep from cycling). I'm beginning to think that behavioral therapy which seems to work for some anxiety disorders with no BPII comorbidity might be the way to go.
> > Well I'm not sure I've had a hypomanic episode, but if I did, it was because of anti-depressants. How do I know if it was a hypomanic episode, or just antidepressants helping with depression and anxiety?
>
> That's a tough one. So, whatever the *episode* was it occured while on AD's right? I *think* the definition for hypomanic episode is at least four days of elevated mood-racing thoughts, impulsivity or hostility, difficulty sleeping, agitation, etc. But, didn't require hospitalization and you didn't get psychotic.
>
> If I go off of antidepressants entirely my mood cycling settles down and don't have any problem with hypomania. But, I get panic attacks/depression. It is a "sticky" problem.
> I don't know just how to solve the dilemma.
> Mitch
Posted by Chris A. on June 24, 2001, at 18:01:55
In reply to Re: What counts as hypomania Mitch, posted by AMenz on June 24, 2001, at 15:00:00
Mitch,
July L. just shared this link on another thread that addresses your concerns. Registration is required, but worth it.
http://www.medscape.com/Medscape/CNO/2001/APACME/Story.cfm?story_id=2248 >
Chris A.
Posted by Mitch on June 24, 2001, at 18:42:57
In reply to Re: What counts as hypomania - Mitch, posted by Chris A. on June 24, 2001, at 18:01:55
Chris, Went there and checked it out, very interesting. I actually had it wrong (in my mind). The DSM-IV excludes diagnosis of hypomania (BPII) if it is a result of antidepressants. The article below in the link believes that even if AD's cause hypomania-then that persons *should* be diagnosed with BPII.
In my case I have had hypomania in the past without antidepressants so there is not question of my BPII diagnosis. However it apears that *technically* speaking if AD's are the only trigger that is present then BPII should not be considered the diagnosis.Here is the American definition of hypomanic episode:
Hypomanic Episode
A 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.
Mitch> Mitch,
>
> July L. just shared this link on another thread that addresses your concerns. Registration is required, but worth it.
>
> http://www.medscape.com/Medscape/CNO/2001/APACME/Story.cfm?story_id=2248 >
>
> Chris A.
Posted by Chris A. on June 25, 2001, at 13:04:21
In reply to Re: What counts as hypomania - Mitch » Chris A., posted by Mitch on June 24, 2001, at 18:42:57
Not all American psychiatrists and researchers are satisfied with the DSM 1V R bipolar classificaltions. They believe that they are too arbitrary, provide clear categories for easy answers to research, but don't serve those of us who are ill very well. On a technicality I am diagnosed BP I, but don't really fit that category at all because I've never been truly manic. Prozac caused hypomania followed by a horrible crash that I've never fully recovered from. Since I have mixed symptoms and was hospitalized in the midst of that I am considered BPI. My experience always seems to be closer to BP II, though. Some, like Askidal would say BP III since hypomania initially occurred in response to an AD. In all the screening tests I don't even qualify for bipolar. Even so my moods shift suddenly. I'll be doing fair one day and suicidal the next. Hence, I won't fight the BP diagnosis so that I can get the right treatment. ADs make the depressions worse, so I'll stick to the mood stabilizers.
Blessings,
Chris A.
Posted by judy1 on June 25, 2001, at 22:03:52
In reply to Re: What counts as hypomania - Mitch, posted by Chris A. on June 25, 2001, at 13:04:21
Chris,
At the recent BP conference in Pittsburgh, one of the shrinks from the Stanley Foundation said that mood stabilizers turn BP1's into BP2's- that is get rid of the mania and have predominantly depressive symptoms (which seems to be your case). I think my hormones are really kicking in here, it's a great feeling. Take care, judy
Posted by Chris A. on June 25, 2001, at 23:47:26
In reply to Re: What counts as hypomania - Mitch » Chris A., posted by judy1 on June 25, 2001, at 22:03:52
Dear Judy,
I would agree that the researcher at the Stanley Foundation is right. Hopefully more research will be focused on bipolar depression and more interventions will be available for those of us who can't take ADs. Geodon seems to be promising towards that end. If I could only tolerate the akithisia.
I am very happy that you are feeling well during your pregnancy. You deserve it after all of the struggles you have been through. Those were the most euthymic times in my life.
Take good care of the baby and yourself.Blessings,
Chris A.
Posted by Cece on June 27, 2001, at 14:11:02
In reply to Re: What counts as hypomania - Mitch » Chris A., posted by judy1 on June 25, 2001, at 22:03:52
Hi Judy-
Very interesting re BPI to BPII.
I haven't seen your posts re being pregnant. I'm curious, if you don't mind saying, what your diagnosis is, and what meds you are able to take during pregnancy? Also, what are your and your pdoc's thoughts re the possibilities of post-partum depression in a person with an affective disorder?
Thanx, and best wishes,
Cece
> Chris,
> At the recent BP conference in Pittsburgh, one of the shrinks from the Stanley Foundation said that mood stabilizers turn BP1's into BP2's- that is get rid of the mania and have predominantly depressive symptoms (which seems to be your case). I think my hormones are really kicking in here, it's a great feeling. Take care, judy
Posted by judy1 on June 27, 2001, at 18:45:42
In reply to Re: Pregnancy and meds in BP's » judy1, posted by Cece on June 27, 2001, at 14:11:02
Hi Cece,
I'm dxed bp1, rapid cycling and panic disorders. I think my shrink is leaning towards PTSD though, because I have a lot of dissociation problems. Thank you for the best wishes. This was an unexpected pregnancy and as soon as I found out I went off lamictal, risperdal and one other (can't remember). I did stay on klonopin (and still am) with xanax prn. Recently I've been taking zyprexa because I developed TD with risperdal, but I plan on tapering off that also. My pdoc basically treats 'fires' with me, and uses a great deal of psychotherapy. I see him weekly and e-mail him a lot (we have a very good relationship that took a good year to develope). I did have a psychotic depressive episode after my son was born and he and I are aware that there is a strong probability that I will have it again. So I guess we are working on maintaining a strong therapeutic relationship- my biggest problems are lack of insight when manic, and taking each day as it comes (never dull in bipolar disorder!) Hope this answers your questions. Take care, judy
Posted by Cece on June 28, 2001, at 5:10:32
In reply to Re: Pregnancy and meds in BP's » Cece, posted by judy1 on June 27, 2001, at 18:45:42
Thanx for replying. I was curious because post-partum psychosis seems to run in my family (both my mother and sister had it). My mom was probably undiagnosed BP, my sister tends toward anxiety and some depression (rarely admitted to).
I am past the age where pregnancy is an issue (52), and never found the right person to do it with, so never had to deal with the issues. I think that partly I subconsciously held back because of fear re post-partum (I didn't get right diagnosis and good tx. until about 8 years ago). I tried to do some research in my 30's, but couldn't find much.
My neice is BPI and young enough to still hope to have kids, so I wanted to get your info for her.
Thanx again- you sound well-prepared, with your feet on the ground and good support. I'm sure that you will make it just fine!
Cece
P.S. My mother and sister both had PPP with only one of their children: my mother with her second (me), and my sister with her first (my neice). Hopeful news for you.
> Hi Cece,
> I'm dxed bp1, rapid cycling and panic disorders. I think my shrink is leaning towards PTSD though, because I have a lot of dissociation problems. Thank you for the best wishes. This was an unexpected pregnancy and as soon as I found out I went off lamictal, risperdal and one other (can't remember). I did stay on klonopin (and still am) with xanax prn. Recently I've been taking zyprexa because I developed TD with risperdal, but I plan on tapering off that also. My pdoc basically treats 'fires' with me, and uses a great deal of psychotherapy. I see him weekly and e-mail him a lot (we have a very good relationship that took a good year to develope). I did have a psychotic depressive episode after my son was born and he and I are aware that there is a strong probability that I will have it again. So I guess we are working on maintaining a strong therapeutic relationship- my biggest problems are lack of insight when manic, and taking each day as it comes (never dull in bipolar disorder!) Hope this answers your questions. Take care, judy
Posted by Ron Hill on June 28, 2001, at 11:12:44
In reply to Re: What's worked 4 folks 4 BP II or other maladies?, posted by MM on June 22, 2001, at 18:50:23
> I'm recently (like a month ago) diagnosed with BPII, and I'm still not sure it's right
MM,
Use the link below to bring up a good (and free) dx test. It was accurate in my case (BP II). I found it helpful to have someone that knows me well sit with me as I took the test so she could add her perspective regarding the answer most applicable for my behavior.
http://www.mentalhealth.com/fr71.html
-- Ron
Posted by MM on June 28, 2001, at 11:21:16
In reply to Re: What's worked 4 folks 4 BP II or other maladies? » MM, posted by Ron Hill on June 28, 2001, at 11:12:44
> > I'm recently (like a month ago) diagnosed with BPII, and I'm still not sure it's right
>
>
>
> MM,
>
> Use the link below to bring up a good (and free) dx test. It was accurate in my case (BP II). I found it helpful to have someone that knows me well sit with me as I took the test so she could add her perspective regarding the answer most applicable for my behavior.
>
> http://www.mentalhealth.com/fr71.html
>
> -- RonThanks Ron
Posted by Ron Hill on June 28, 2001, at 11:42:51
In reply to What's worked 4 folks 4 BP II or other maladies?, posted by Kingfish on June 21, 2001, at 10:32:20
> Hi all! I just thought it would be great to get a thread going on folks' successful, or somewhat successful, cocktails for Bipolar II ...
> I, myself, am getting frustrated again because my mix of Celexa, 40 mg, Neurontin, 2400 mg, and Topamax, 250 mg, has worked, except for sedation (caused by the Topamax) which is getting worse again, and, frankly, it doesn't seem to be working as well as it was.
---------------------------------------Dear Ms. Kingfish:
I am BP II and doing very well on 600 mg/day Lithobid, 100 mg/day Wellbutrin, and 10 mg/day Paxil. I would like to be able to increase the dose of my SSRI (Paxil in my case, Celexa in yours) because at my current low dose I am somewhat "anal" and somewhat irritable. At 20 mg/day of Paxil I am not anal nor irritable at all, however, I lose almost all of my motivation, energy, and enthusiasm. Further, I want to sleep most of the day. I may try 15 mg/day to see what happens.
In your case, could your sedation problem be due to too much Celexa? I, of course, have no idea. I'm just throwing out the question for you.
-- Ron
Posted by Kingfish on June 28, 2001, at 13:35:55
In reply to Re: What's worked 4 folks 4 BP II or other maladies? » Kingfish, posted by Ron Hill on June 28, 2001, at 11:42:51
Ron:
Thank you for your post. I like the name Ms. Kingfish. :) How'd you know I was a Ms.?
I just switched from Celexa to Prozac. The Celexa wasn't the culprit because when on it alone I didn't have trouble HOWEVER, the Prozac seems to be activating because I haven't been tired the last few days. Then again my pdoc pointed out I seemed quite depressed when he saw me, so it's all quite complicated, isn't it.
What is y Lithobid, if I may ask?
Sounds like you have a similar problem with the sedation and low-motivation. If depression was a big problem for you, you are probably very tired of being tired like I was. :( I have heard Paxil can do that. But then so can Celexa. It's just so frustrating that everyone reacts differently.
- K.
Posted by geekUK on June 28, 2001, at 19:25:25
In reply to Re: What's worked 4 folks 4 BP II or other maladies? » Kingfish, posted by Ron Hill on June 28, 2001, at 11:42:51
I did the test, i dont beleive its very robust. too robotic. said - substance abuse related, I really dont think so. just because the doctors have thought my drug use was possibly causal. thats the problem, I am fairly clean now and generaly 'its' in an episode not before. I am just writing to vent doc related anger. they seem to have a system like this test. no best fit, just 'unspecifyed'. its a pretty 'dont give a damn' type of response. I just hate the entire damn system, nhs -not helping sorry.
Posted by MM on June 28, 2001, at 23:11:22
In reply to online self assesment, posted by geekUK on June 28, 2001, at 19:25:25
I did the test too and after 2 questions it said Diagnosis not made due to absence of elation for 4 days, or irritable enough to throw things or hit someone for 4 days. hmmm.
Posted by Ron Hill on June 29, 2001, at 10:54:05
In reply to Re: What's worked 4 folks 4 BP II or other maladies? » Ron Hill, posted by Kingfish on June 28, 2001, at 13:35:55
> Thank you for your post. I like the name Ms. Kingfish. :) How'd you know I was a Ms.?In an earlier post you mentioned your husband.
> I just switched from Celexa to Prozac. The Celexa wasn't the culprit because when on it alone I didn't have trouble HOWEVER, the Prozac seems to be activating because I haven't been tired the last few days. Then again my pdoc pointed out I seemed quite depressed when he saw me, so it's all quite complicated, isn't it.Prozac is more activating for me as well. I'm taking Paxil now because I am not currently covered by medical insurance (self employed) and I have a boat load of Paxil in my med reserve vault. Overall, I think I like Prozac better than Paxil since I can take a higher dose of the former without losing my motivation, energy, enthusiasm, etc. And I need the higher SSRI dose to alleviate symptoms of irritability, quick temper, and being anal.
> What is y Lithobid, if I may ask?Lithobid is an extended release form of lithium carbonate. As such, it has less side effects than other lithium medications. Have you ever used lithium as a mood stabilizer? It has been a first line medication for BP since the 1940's. It does not work for everyone, but I have had very good success with it. The AED's gave me bad rashes. Perhaps you could talk to you pdoc regarding lithium if you have not tried it before and if you are not happy with your current mood stabilizer.
> Sounds like you have a similar problem with the sedation and low-motivation. If depression was a big problem for you, you are probably very tired of being tired like I was. :( I have heard Paxil can do that. But then so can Celexa. It's just so frustrating that everyone reacts differently.Actually, I'm doing extremely well on my current meds. But, I was in the place you reference in the past and it was not fun!
-- Ron
Posted by Ron Hill on June 29, 2001, at 10:57:23
In reply to online self assesment, posted by geekUK on June 28, 2001, at 19:25:25
GeekUK,
Venting is ok! That's part of what we do here, isn't it?
-- Ron
---------------------------------------> I did the test, i dont beleive its very robust. too robotic. said - substance abuse related, I really dont think so. just because the doctors have thought my drug use was possibly causal. thats the problem, I am fairly clean now and generaly 'its' in an episode not before. I am just writing to vent doc related anger. they seem to have a system like this test. no best fit, just 'unspecifyed'. its a pretty 'dont give a damn' type of response. I just hate the entire damn system, nhs -not helping sorry.
Posted by Mitch on June 29, 2001, at 12:17:40
In reply to Re: online self assesment, posted by MM on June 28, 2001, at 23:11:22
To all BPII people:
I am just curious if you *don't* satisfy the requirement for a hypomanic episode for four full days then what? I have never woke up hypomanic and went that way all day and went to sleep that way. Usually it may be a great morning after talking to somebody I like or getting something done that I am happy about, or a good work experience. But usually it just lasts for a few hours. But I *HAVE* experienced seasonal major depressive episodes (many of them). So what would you call that "cyclothymia" with "seasonal affective disorder"?????
I think the whole "BP-II" "spectrum" is nothing but a syndrome of sorts that is unique that hasn't gotten *reasonably* figured out yet (like classic BPI or schizophrenia). I wonder if it is an overlapping of several manifestations of *other* disorders or there is a masked neuro-endocrine disturbance that is triggering it.Mitch
> I did the test too and after 2 questions it said Diagnosis not made due to absence of elation for 4 days, or irritable enough to throw things or hit someone for 4 days. hmmm.
Posted by gdog on June 29, 2001, at 14:14:45
In reply to Re: online self assesment » MM, posted by Mitch on June 29, 2001, at 12:17:40
When my docs diagnosed me with BPII, the litany of questions they asked me did not include a symptoms of any particular length. so if i had exhibited the symptoms at all, for any length of time, at any point in my life, they considered that to support the diagnosis. which really makes me wonder. . .because is there anyone who hasn't felt all the BPII symptoms at one time or another in their lives? my docs tell me no, that these types of symptoms are not experienced by so-called "normal" folks, at least not all of them. my primary symptom is major depression, but have had periods of rage, alcohol/drug abuse, anxiety, hyperactivity, impulsivity, bad judgment, etc. but the looseness of the diagnostic requirements has always left me sceptical. . .it does seem like the dx requirements overlap with manifestations of a lot of other disorders. . . kinda like a catch-all dx. all i know is that i have struggled with the dx since it was given to me. ..not surprisingly, the docs tell me that that is also part of BPII.
gdogTo all BPII people:
>
> I am just curious if you *don't* satisfy the requirement for a hypomanic episode for four full days then what? I have never woke up hypomanic and went that way all day and went to sleep that way. Usually it may be a great morning after talking to somebody I like or getting something done that I am happy about, or a good work experience. But usually it just lasts for a few hours. But I *HAVE* experienced seasonal major depressive episodes (many of them). So what would you call that "cyclothymia" with "seasonal affective disorder"?????
> I think the whole "BP-II" "spectrum" is nothing but a syndrome of sorts that is unique that hasn't gotten *reasonably* figured out yet (like classic BPI or schizophrenia). I wonder if it is an overlapping of several manifestations of *other* disorders or there is a masked neuro-endocrine disturbance that is triggering it.
>
> Mitch
>
>
> > I did the test too and after 2 questions it said Diagnosis not made due to absence of elation for 4 days, or irritable enough to throw things or hit someone for 4 days. hmmm.
Posted by AKC on June 29, 2001, at 14:21:55
In reply to Re: What's worked 4 folks 4 BP II or other maladies? » Kingfish, posted by Ron Hill on June 29, 2001, at 10:54:05
I finally took the time to read through this thread - and I am so glad I did. My pdoc has been trying to convince me for some time I am BPII - and for some reason I have been quite resistent. Still am, but now I have a better understanding of her position and mine. I am going to take some time this weekend to think through what has happened over the past decade - and then really go for that med or meds that solves the problem, not the diagnosis.
Long before I took any meds, I was an active alcoholic who had terrible anxiety and terrible bouts of depression. But since sobering up, I have had one suicide attempt and have tried many a combination of medication. Everytime there is a hiccup, it is a different dosage or a different med. I have reached the point of no more. My heart is set on the new med in my life - topamax - for no other reason than the hope that the 70+ pounds I have put on in the past 1 1/2 years may be shed. I am on Effexor XR at a low dosage, 75 mg - and understand fully on how it may be contributing to symptoms of hypomania, but am scared to go off it completely - I just came out of the worse bout of depression since my suicide attempt of almost 2 years ago. I truly believe Effexor XR saved my life.
I am being weaned of the lithium (YEAH - never liked, never will). And am on seroquel - I do think it helps me with some very bad distorted thinking. But I don't know if I have any side effects from it. I have all sorts of problems with lack of energy and sedation. I think all my meds contribute to that, including the seroquel. As I write this I realize I don't know much of anything about seroquel. Hmm . . . maybe a new thread is warranted here?
I take trazadone from time to time for sleep problems, but am realizing it can also contribute to some hypomania symptoms (think that happened in this last episode). So like all on this board, I am a mesh of meds currently - not sure what is working exactly or why. But I feel more empowered by what you have shared with me. I just keep getting gushy each time I read what people share on here! Thanks.
Posted by MM on June 29, 2001, at 18:41:34
In reply to Re: What's worked 4 folks 4 BP II or other maladies?, posted by AKC on June 29, 2001, at 14:21:55
Mitch can you explain what a neuro-endocrine disturbance is? (you don't have to go in to detail)
I think that BPII is a trendy diagnosis right now, or at least I've heard it is. It doesn't seem like anyone should be diagnosed based on the fact they've had a rage, or they've had a really good day. It doesn't seem like pdoc's want to take the time to go through life events that could have an effect on how we feel. Is normal being immune to being effected by bad things happening to you? The theory is that your brain chemicals are already messed up, but it is possible that your brain chemicals are reacting to the way you feel about a certain thing happening. It usually takes a stressful event to "bring out" the dormant (already there) disorder, but how do they know any "normal" person wouldn't react the same way? The manifestations of a bunch of different disorders being called BPII kind of scares me after reading that pdoc's think BP is schizophrenia, just with different symptoms. I wish I could read a lot of the research in BPII. If anticonvulsants work, then wouldn't the theory that BP is related to epilepsy, and therefore could throw off certain functions of the brain make sense? I really have no idea what I'm talking about. I guess all we can do is look for meds that work for this catch all dx, but that makes me wonder how you know a med is working? What does that look like? Especially with BPII, or mild bp, or cyclothmia?
Posted by MM on June 29, 2001, at 18:50:44
In reply to Re: What's worked 4 folks 4 BP II or other maladies?, posted by MM on June 29, 2001, at 18:41:34
> Mitch can you explain what a neuro-endocrine disturbance is? (you don't have to go in to detail)
> I think that BPII is a trendy diagnosis right now, or at least I've heard it is. It doesn't seem like anyone should be diagnosed based on the fact they've had a rage, or they've had a really good day. It doesn't seem like pdoc's want to take the time to go through life events that could have an effect on how we feel. Is normal being immune to being effected by bad things happening to you? The theory is that your brain chemicals are already messed up, but it is possible that your brain chemicals are reacting to the way you feel about a certain thing happening. It usually takes a stressful event to "bring out" the dormant (already there) disorder, but how do they know any "normal" person wouldn't react the same way? The manifestations of a bunch of different disorders being called BPII kind of scares me after reading that pdoc's think BP is schizophrenia, just with different symptoms. I wish I could read a lot of the research in BPII. If anticonvulsants work, then wouldn't the theory that BP is related to epilepsy, and therefore could throw off certain functions of the brain make sense? I really have no idea what I'm talking about. I guess all we can do is look for meds that work for this catch all dx, but that makes me wonder how you know a med is working? What does that look like? Especially with BPII, or mild bp, or cyclothmia?
I wish you could edit on here. I just was wondering if anyone knows why anti-anxiety meds were not given to me? That is the most, in fact maybe the only troubling symptom of mine (besides depression, but I wonder if the depression would lift if I didn't have such high anxiety). Is it REALLY true that if they treat the "BP" the anxiety will go away? Are anti-anxiety meds not reccomended when someone is suspected as having BPII?
Posted by Mitch on June 29, 2001, at 21:17:33
In reply to Re: What's worked 4 folks 4 BP II or other maladies?, posted by MM on June 29, 2001, at 18:41:34
AKC,
I mentioned that in a casual manner. I have had thyroid tumor and only have half a thyroid gland and I had some tremendous panic anxiety just before the tumor started growing. AND my TSH hormones, etc. showed normal. I guess the gist of what I am saying is: What if BPII is primarily "spikes" of hormones in your system that create the mood disturbance. In otherwords a complex interplay of the endocrine system that is not balanced that triggers problems with your brain? Say, your pancreas, thryoid, parathyroid, thalamus, adrenals, hypothalamus-in short, the glands that regulate your sleep/wake cycle, your alertness, your moods in an indirect manner are malfunctioning in a way that eludes measurement (such as hormone blood testing)? I mean has anyone taken someone who is dx'ed as BP-II for example and monitored ALL of their hormone levels *continuously* over a period of WEEKS before???
I don't know about any research findings regarding this, does anyone out there do?
Mitch
> Mitch can you explain what a neuro-endocrine disturbance is? (you don't have to go in to detail)
> I think that BPII is a trendy diagnosis right now, or at least I've heard it is. It doesn't seem like anyone should be diagnosed based on the fact they've had a rage, or they've had a really good day. It doesn't seem like pdoc's want to take the time to go through life events that could have an effect on how we feel. Is normal being immune to being effected by bad things happening to you? The theory is that your brain chemicals are already messed up, but it is possible that your brain chemicals are reacting to the way you feel about a certain thing happening. It usually takes a stressful event to "bring out" the dormant (already there) disorder, but how do they know any "normal" person wouldn't react the same way? The manifestations of a bunch of different disorders being called BPII kind of scares me after reading that pdoc's think BP is schizophrenia, just with different symptoms. I wish I could read a lot of the research in BPII. If anticonvulsants work, then wouldn't the theory that BP is related to epilepsy, and therefore could throw off certain functions of the brain make sense? I really have no idea what I'm talking about. I guess all we can do is look for meds that work for this catch all dx, but that makes me wonder how you know a med is working? What does that look like? Especially with BPII, or mild bp, or cyclothmia?
Posted by Kingfish on June 30, 2001, at 10:12:04
In reply to Re: What's worked 4 folks 4 BP II or other maladies? » MM, posted by Mitch on June 29, 2001, at 21:17:33
> It was important to me to have a diagnosis from my doctor, someplace to start and something down on paper so if I switch doctors, I won't feel like I have to "start all over again." I felt from the onset that their was manic depression in my family, and frankly, I feel I'm BP I.
That said, these ARE just labels created by humans to help categorize people and the meds that make sense to start folks on intially (at least that's part of it). But it changes all the time. As someone pointed out in Social Babble, Homosexuality used to be considered a mental disorder.
If you "mostly" fit into a DSM dianosis, I would guess starting with the meds that are used to treat that makes the most sense. I knew I needed a stabilizer. It took my pdoc a year and a half to prescribe me one, and within a few weeks, there was such a big difference in my life.
I'm not sure if I EVER went four days on a hypomanic or manic episode - I usually drank myself to sleep every night. What happens when it's changed to include - "one suicide attempt must be included"? Or the episode length is extended? I've had numerous psychotic episodes, but I'm still classified as BP II.
So, if the meds work, do you KNOW that the diagnosis is correct? No. Because these meds work for various maladies (there's that word again :) ) by pdoc's admissions anyway.
I think the best thing to do is to look at your family's history if you can, and do your own research, use your own common sense, make sure you get a pdoc who will talk to you about your concerns, and answer your questions. Be aware that it will take awhile because they will need to talk with you for awhile to form their opinions and I believe you do need to give them that - they don't know you at all.
Because this is all talk therapy at this point, there isn't a simple answer. But with time, I believe you should be able to find AN ANSWER that at least gives you guidelines.
- K.
Posted by MM on June 30, 2001, at 13:09:42
In reply to BP II Meds and the Diagnosis-My two cents, posted by Kingfish on June 30, 2001, at 10:12:04
YOu have to register or be registered at medscape to read it, but now I know why I'm dxd BPII even tho it was brought on by AD's, and feel better about my psych since he seems up to date (mostly). http://www.medscape.com/medscape/cno/2001/APACME/Story.cfm?story_id=2248
It actually made me feel a little smug, and relieved because it seems like the figure of 1% of the population having BP is WAY too low, so there's a whole lot more nutty people like me out there :). Either that or they're just DXing everyone, but that still makes me more "normal". If unipolar depression IS related to BP, or at least some of it, then it's got to be a HIGH number of people in this spectrum. I mean I see at least a couple of commercials a day for AD's. Depression is a topic on EVERY health related website. It seems like an epidemic.
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