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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by shelliR on July 28, 2001, at 22:18:46
Actually , I'm really curious about bipolar II. Last spring when I was in the hospital I was very hyper, talkative and sleepless. Not irrational though., although had some pretty serious bouts of sobbing, when I felt frustrated. There was some talk about a bipolar II diagnosis (I have major depression and a dissociative disorder), but the "team" psychologists and psychiatrists felt that my behavior was related to high level anxiety. My anxiety (rather than depression) go up when I have hospitalized recently--I think it is way over-stimulating to me to be around people and crisis all the time.
I have also read about bipolar II being related to borderline personality disorder, as a less provocative diagnosis and also more appealing to insurance companies. But when I look at the critiera for borderline, I don't see so much of a cross over. I don't think the rage, emptiness, self-harm (I don't remember the whole list) would have to be present in bi-polar II, just major depression and hypomania.
How does one distinquish between hypomania and major anxiety, and the cycling present in PTSD symptoms. And what are the implications of medications--no ADs for bi-polar II, or only certain ADs?
Bi-polar II keeps popping up on the board with greater frequency, so that's why I became curious.
Any ideas?
Shelli
Posted by SalArmy4me on July 28, 2001, at 22:31:34
In reply to Bi-polar II- diagnosis on the rise? , posted by shelliR on July 28, 2001, at 22:18:46
Helpful Links:
Bipolar II:
http://www.psychologynet.org/bipolar2.htmlBorderline:
http://www.psychologynet.org/bpd.html
Posted by JahL on July 29, 2001, at 7:15:50
In reply to Bi-polar II- diagnosis on the rise? , posted by shelliR on July 28, 2001, at 22:18:46
Hi Shelli.
I'm one of those newly dx'd BP II folk.
My condition looks like unipolar, is characterised by anxiety & is complemented by chronic derealisation (as opposed to D.D.). So a little like your own. Also, like you, when my condition worsens it is the anxiety component that seems to predominate. I avoid stress like the plague. We do not mix well.
Anxiety vs hypomania? Anxiety wears me down, is unfocussed, & robs me of my volition. AD-induced hypomania, whilst also 'wearing', gave me a terrific sense of purpose; I could work all day w/o stopping (or eating) & only needed a couple of hours sleep. I became sociable, *v* talkative & downright horny! I was in no way irrational. In fact, freed from some of my symptoms, my thinking became more rational & 'human-like'.
I have *plenty* of rage/emptiness but no self-harm, impulsiveness, attn-seeking etc.
A succession of ADs has made my condition (seemingly) irredeemably worse. My new pdoc only prescribes ADs to Bipolar folk settled on a mood-stabilizer.
Anyway, 1 of the most striking features of my BP is the accompanying psychomotor retardation, which makes stringing a sentence together difficult. Hopefully the above has some relevance to yr curiosity...
J.
====================================
> Actually , I'm really curious about bipolar II. Last spring when I was in the hospital I was very hyper, talkative and sleepless. Not irrational though., although had some pretty serious bouts of sobbing, when I felt frustrated. There was some talk about a bipolar II diagnosis (I have major depression and a dissociative disorder), but the "team" psychologists and psychiatrists felt that my behavior was related to high level anxiety. My anxiety (rather than depression) go up when I have hospitalized recently--I think it is way over-stimulating to me to be around people and crisis all the time.
>
> I have also read about bipolar II being related to borderline personality disorder, as a less provocative diagnosis and also more appealing to insurance companies. But when I look at the critiera for borderline, I don't see so much of a cross over. I don't think the rage, emptiness, self-harm (I don't remember the whole list) would have to be present in bi-polar II, just major depression and hypomania.
>
> How does one distinquish between hypomania and major anxiety, and the cycling present in PTSD symptoms. And what are the implications of medications--no ADs for bi-polar II, or only certain ADs?
>
> Bi-polar II keeps popping up on the board with greater frequency, so that's why I became curious.
>
> Any ideas?
>
> Shelli
Posted by shelliR on July 29, 2001, at 13:52:25
In reply to Re: Bi-polar II- diagnosis on the rise? » shelliR, posted by JahL on July 29, 2001, at 7:15:50
Hi Jahl.
>
> I'm one of those newly dx'd BP II folk.
> My condition looks like unipolar, is characterised by anxiety & is complemented by chronic derealisation (as opposed to > > >D.D.). So a little like your own. Also, like you, when my condition worsens it is the anxiety component that seems to > > > > >predominateActually, generally when my condition worsens it affects the depression part more. Like I don't get out of bed at the worst times, and I don't know why the worse times are happening. When the anxiety is up, there is generally a reason--too much work and occupanying responsibility, moving, being around too many people for too long a time, etc.
>
> Anxiety vs hypomania? Anxiety wears me down, is unfocussed, & robs me of my volition. AD-induced hypomania, whilst also 'wearing', gave me a terrific sense of purpose; I could work all day w/o stopping (or eating) & only needed a couple of hours sleep. I became sociable, *v* talkative & downright horny! I was in no way irrational. In fact, freed from some of my symptoms, my thinking became more rational & 'human-like'.So are the only times you have experienced hypomania, AD induced?
And if so, the diagnosis of hypomania can be given soley on that basis?> Anyway, 1 of the most striking features of my BP is the accompanying psychomotor retardation, which makes stringing a sentence together difficult
But this is during the depression, right? Because that wouldn't go with the social talkative element of hypomania......
. Hopefully the above has some relevance to yr curiosity...
> J.
>Yes, thanks.
It still seems sort of strange to me to base a diagnosis on a reaction to a drug. But it sounds like getting that diagnosis was helpful to your treatment. True?Shelli
Posted by JahL on July 29, 2001, at 14:34:55
In reply to Re: Bi-polar II- diagnosis on the rise? » JahL, posted by shelliR on July 29, 2001, at 13:52:25
> Actually, generally when my condition worsens it affects the depression part more. Like I don't get out of bed at the worst times, and I don't know why the worse times are happening. When the anxiety is up, there is generally a reason--too much work and occupanying responsibility, moving, being around too many people for too long a time, etc.> So are the only times you have experienced hypomania, AD induced?
Yeah, tho Lamotrigine briefly did the same.
> And if so, the diagnosis of hypomania can be given soley on that basis?
Apparently so (@ least in my case). The difference btwn the constant, 'normal' me (dysphoric, unsociable & slow of brain) & the euthymic/hypomanic me was incredibly pronounced. Different person. I don't have 'good' days & so this wasn't a possible explanation.
> > Anyway, 1 of the most striking features of my BP is the accompanying psychomotor retardation, which makes stringing a sentence together difficult
> But this is during the depression, right? Because that wouldn't go with the social talkative element of hypomania......Absolutely. My mind 'frees up' during these episodes. I've had 'before & after' psychometric testing. The guy estimated that my condition knocks 30+pts off my I.Q.
I also become very socially adept; refreshing for someone with s. phobia.
> It still seems sort of strange to me to base a diagnosis on a reaction to a drug.
There's a bit more to it than that I think. Something about the nature of my condition; dysphoric as opposed to depressed; agitated, anxious, & confrontational as opposed to weepy & submissive. Lots of unfocussed anger.
>But it sounds like getting that diagnosis was helpful to your treatment. True?
I'm not in good nick right now but I'd hate to think where I'd be w/o mood-stabilizers. These were first prescribed by a US pdoc who suspected BP. They are probably the reason anxiety predominates; they don't touch this, but do keep the depression at a level at which I can function. W/o them I'd have the can't-get-out-of-bed type depression you describe above. The BP dx also explains why AD monotherapy has been so bad for me, & so shld at least prevent things from worsening.
J.
Posted by Elizabeth on July 29, 2001, at 15:18:00
In reply to Bi-polar II- diagnosis on the rise? , posted by shelliR on July 28, 2001, at 22:18:46
> when I look at the critiera for borderline, I don't see so much of a cross over. I don't think the rage, emptiness, self-harm (I don't remember the whole list) would have to be present in bi-polar II, just major depression and hypomania.
Not necessarily. It is possible that bipolar women are more likely to have mixed or dysphoric manias or hypomanias, which can present similarly to borderline personality.
> How does one distinquish between hypomania and major anxiety, and the cycling present in PTSD symptoms. And what are the implications of medications--no ADs for bi-polar II, or only certain ADs?
You'd have to be cautious with ADs; tricyclics in particular have the potential to trigger mania or hypomania. That doesn't mean you couldn't use ADs at all, but you might need an anticonvulsant as well.
> Bi-polar II keeps popping up on the board with greater frequency, so that's why I became curious.
It's a bit of a fad diagnosis, IMO.
-elizabeth
Posted by 16# on July 29, 2001, at 17:28:29
In reply to Re: Bi-polar II- diagnosis on the rise? » shelliR, posted by JahL on July 29, 2001, at 7:15:50
Jahl-- You are killing me softly!
Your symptoms are eerily similar to mine and you express them vividly in this post and in the ones below. I also am recently diagnosed, and have been all messed up by being prefunctorily prescribed SSRIs by previous MDs. I have also had a problem with lamictal being a little too activitating. Just out of curiosity, what has worked for you so far?
Michelle
> Hi Shelli.
>
> I'm one of those newly dx'd BP II folk.
>
> My condition looks like unipolar, is characterised by anxiety & is complemented by chronic derealisation (as opposed to D.D.). So a little like your own. Also, like you, when my condition worsens it is the anxiety component that seems to predominate. I avoid stress like the plague. We do not mix well.
>
> Anxiety vs hypomania? Anxiety wears me down, is unfocussed, & robs me of my volition. AD-induced hypomania, whilst also 'wearing', gave me a terrific sense of purpose; I could work all day w/o stopping (or eating) & only needed a couple of hours sleep. I became sociable, *v* talkative & downright horny! I was in no way irrational. In fact, freed from some of my symptoms, my thinking became more rational & 'human-like'.
>
> I have *plenty* of rage/emptiness but no self-harm, impulsiveness, attn-seeking etc.
>
> A succession of ADs has made my condition (seemingly) irredeemably worse. My new pdoc only prescribes ADs to Bipolar folk settled on a mood-stabilizer.
>
> Anyway, 1 of the most striking features of my BP is the accompanying psychomotor retardation, which makes stringing a sentence together difficult. Hopefully the above has some relevance to yr curiosity...
>
> J.
>
> ====================================
>
> > Actually , I'm really curious about bipolar II. Last spring when I was in the hospital I was very hyper, talkative and sleepless. Not irrational though., although had some pretty serious bouts of sobbing, when I felt frustrated. There was some talk about a bipolar II diagnosis (I have major depression and a dissociative disorder), but the "team" psychologists and psychiatrists felt that my behavior was related to high level anxiety. My anxiety (rather than depression) go up when I have hospitalized recently--I think it is way over-stimulating to me to be around people and crisis all the time.
> >
> > I have also read about bipolar II being related to borderline personality disorder, as a less provocative diagnosis and also more appealing to insurance companies. But when I look at the critiera for borderline, I don't see so much of a cross over. I don't think the rage, emptiness, self-harm (I don't remember the whole list) would have to be present in bi-polar II, just major depression and hypomania.
> >
> > How does one distinquish between hypomania and major anxiety, and the cycling present in PTSD symptoms. And what are the implications of medications--no ADs for bi-polar II, or only certain ADs?
> >
> > Bi-polar II keeps popping up on the board with greater frequency, so that's why I became curious.
> >
> > Any ideas?
> >
> > Shelli
Posted by JahL on July 29, 2001, at 18:57:27
In reply to Re: Bi-polar II- diagnosis on the rise? , posted by 16# on July 29, 2001, at 17:28:29
> Jahl-- You are killing me softly!
>
> Your symptoms are eerily similar to mine and you express them vividly in this post and in the ones below. I also am recently diagnosed, and have been all messed up by being prefunctorily prescribed SSRIs by previous MDs. I have also had a problem with lamictal being a little too activitating. Just out of curiosity, what has worked for you so far?
>
> MichelleHi.
100mg/day of Sulpiride makes the s. phobia tolerable & quells ruminations.
Lamictal, Valporate & Olanzapine (tho' not Neurontin) help equally well as a mood-stabilizer, each significantly reducing suicidal thoughts & the general severity of depression.
Lamictal was great to begin with-I got about 20% remission and quite enjoyed the mild hypomania-but this has mostly faded. Can't say if it's still 'activating' tho I'm *v* agitated at the mo. Dunno if that counts.
Currently I take Sulp. + Lamictal, have recently added Prozac (an old 'friend') & am about to add Olanzapine.
Here's hoping...
J.
Posted by Emme on July 29, 2001, at 20:02:21
In reply to Bi-polar II- diagnosis on the rise? , posted by shelliR on July 28, 2001, at 22:18:46
> Actually , I'm really curious about bipolar II. Last spring when I was in the hospital I was very hyper, talkative and sleepless. Not irrational though., although had some pretty serious bouts of sobbing, when I felt frustrated. There was some talk about a bipolar II diagnosis (I have major depression and a dissociative disorder), but the "team" psychologists and psychiatrists felt that my behavior was related to high level anxiety. My anxiety (rather than depression) go up when I have hospitalized recently--I think it is way over-stimulating to me to be around people and crisis all the time.
>
> I have also read about bipolar II being related to borderline personality disorder, as a less provocative diagnosis and also more appealing to insurance companies. But when I look at the critiera for borderline, I don't see so much of a cross over. I don't think the rage, emptiness, self-harm (I don't remember the whole list) would have to be present in bi-polar II, just major depression and hypomania.
>
> How does one distinquish between hypomania and major anxiety, and the cycling present in PTSD symptoms. And what are the implications of medications--no ADs for bi-polar II, or only certain ADs?
>
> Bi-polar II keeps popping up on the board with greater frequency, so that's why I became curious.
>
> Any ideas?
>Hi Folks,
My recent BPII diagnosis really took me by surprise (and I'm not 100% convinced, but willing to consider it and try the meds). You see, I have never been hypomanic unless you count the extreme irritability and agitation I had when going off of Effexor. My doctor began to suspect a bioplar spectrum disorder for a few reasons. First, repeated loss of efficacy with antidepressants. Along with the depression I have had terrible insomnia and generalaized anxiety. Also, there have been times when I clearly seemed to be cycling up and down a lot in mood an energy, except that my highs brought me close to normal energy without crossing over into hypomania.
I realize that diagnoses and criteria evolve with time. Right now, it's helpful to me not to think of the depression vs. BP diagnosis as an "either or" sort of thing, but rather as a continuum (e.g. major depression that acts a bit like bipolar disorder). I'm also not sure I care so much about the label anymore, as long as we can find an effective treatment, and if considering a different diagnosis opens up new ideas for treatment options, then so be it. And until I got a rash, Lamictal was starting to really help. Anyway, those are my thoughts for the month. :)Emme
Posted by 16# on July 29, 2001, at 20:29:51
In reply to Re: Bi-polar II- diagnosis on the rise? » 16#, posted by JahL on July 29, 2001, at 18:57:27
> > Jahl-- You are killing me softly!
> >
> > Your symptoms are eerily similar to mine and you express them vividly in this post and in the ones below. I also am recently diagnosed, and have been all messed up by being prefunctorily prescribed SSRIs by previous MDs. I have also had a problem with lamictal being a little too activitating. Just out of curiosity, what has worked for you so far?
> >
> > Michelle
>
> Hi.
>
> 100mg/day of Sulpiride makes the s. phobia tolerable & quells ruminations.What kind of a med is this? I have never heard of Sulpiride.
>
> Lamictal, Valporate & Olanzapine (tho' not Neurontin) help equally well as a mood-stabilizer, each significantly reducing suicidal thoughts & the general severity of depression.
>
> Lamictal was great to begin with-I got about 20% remission and quite enjoyed the mild hypomania-but this has mostly faded. Can't say if it's still 'activating' tho I'm *v* agitated at the mo. Dunno if that counts.
>
> Currently I take Sulp. + Lamictal, have recently added Prozac (an old 'friend') & am about to add Olanzapine.Is Olanzapine the same drug as Zyprexa?
>
> Here's hoping...I hope it works out for you. I am taking Lamictal, Neurontin, and Topamax. Still trying to get it right.
M
Posted by MM on July 30, 2001, at 15:03:05
In reply to Re: Bi-polar II- diagnosis on the rise? , posted by 16# on July 29, 2001, at 20:29:51
JahL, your symptoms also sound a lot like mine (tho I don't know if I had the "good" hypomania). I was put on almost every SSRI (SNRI's too), and I think they made my condition worse (like you). I haven't tried anything else (except for some low dose seroquel, pxd for sleep, which I don't like).***Was neurontin helpful AT ALL for you?*** I will be trying it as soon as we get an appt. and I'm really hopeful because anxiety is such a big part of my problem(s). I also have derealization stuff.
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