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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by madison88 on September 11, 2002, at 22:58:37
It is now pretty clear to me that i had a few periods of hypomania when i first started on antidepressants and was not taking any mood stabilizers with them. The excited, agitated states were strange to me, i had never had them before. Once i was put on Neurontin and now Gabitril, i haven't had any as near as severe, although sometimes i get a real rush of agitated energy every now and then that doesn't last more than a day. As far as I know, there is no distinction made in the DSM btw a regular hypomanic episode and one that was caused by antidepressants. I have heard that someone was thinking about adding a category for people who like me get manic or hypomanic on antidepressants. Anybody hear anything about this? I really think Drs should be more watchful about these. I thought for a while that i was becoming bipolar and i didn't understand what was going on, b/c my dr kept saying i wasn't.
Posted by bookgurl99 on September 12, 2002, at 0:13:13
In reply to hypomania...reaction to antidepressants?, posted by madison88 on September 11, 2002, at 22:58:37
IMHO, people who experience mania on antidepressants are not truly bipolar. BUT, some docs will dx you as bipolar for having experienced them -- these same docs seem to enjoy putting everyone into the bipolar category. Bipolar is kind of a fashionable dx to give out right now; 100 years ago it was 'neurasthenia.' You're lucky that your dr. recognized what you were going through instead of slapping you with a label and a big ol' lithium dose.
Posted by North on September 12, 2002, at 2:32:42
In reply to Re: hypomania...reaction to antidepressants?, posted by bookgurl99 on September 12, 2002, at 0:13:13
I would agree with BG99 that by today's definition, one is not bipolar by virtue of becoming hypomanic, or manic, from antidepressants. There is talk that in the future DSM's you will have a BP 3 which would cover some of those people. I suppose their treatment would be to avoid AD's, or give stabilizers with AD's.
By the way, I'm BP1, and my sister became hypomanic from an SSRI.
Posted by Ritch on September 12, 2002, at 10:39:04
In reply to hypomania...reaction to antidepressants?, posted by madison88 on September 11, 2002, at 22:58:37
> It is now pretty clear to me that i had a few periods of hypomania when i first started on antidepressants and was not taking any mood stabilizers with them. The excited, agitated states were strange to me, i had never had them before. Once i was put on Neurontin and now Gabitril, i haven't had any as near as severe, although sometimes i get a real rush of agitated energy every now and then that doesn't last more than a day. As far as I know, there is no distinction made in the DSM btw a regular hypomanic episode and one that was caused by antidepressants. I have heard that someone was thinking about adding a category for people who like me get manic or hypomanic on antidepressants. Anybody hear anything about this? I really think Drs should be more watchful about these. I thought for a while that i was becoming bipolar and i didn't understand what was going on, b/c my dr kept saying i wasn't.
Madison,
You aren't supposed to count a hypomanic response (only) to a medication to make a diagnosis of BPII. Here's an excerpt from the American DSM criteria for BP-II hypomanic episode from mentalhealth.com:
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.
Posted by cybercafe on September 13, 2002, at 1:03:53
In reply to Re: hypomania...reaction to antidepressants?, posted by bookgurl99 on September 12, 2002, at 0:13:13
> IMHO, people who experience mania on antidepressants are not truly bipolar. BUT, some docs will dx you as bipolar for having experienced them -- these same docs seem to enjoy putting everyone into the bipolar category. Bipolar is kind of a fashionable dx to give out right now; 100 years ago it was 'neurasthenia.' You're lucky that your dr. recognized what you were going through instead of slapping you with a label and a big ol' lithium dose.
i told 3 different psychiatrists i was bipolar and never got a diagnosis ....
it wasn't until i moved to another continent ... saw a doc... and really pushed my case that they diagnosed me bipolar....
i told one guy of all the crazy things i did... how i fit every single diagnostic criteria except one... and he told me i probably wasn't bipolar ...
i asked him why? he said because i havn't "gone for days at a time without sleeping"..when he gave me 40 mg paxil, i came in and told him i was moving to another continent .. he asked me if i thought it was mania and i said yes..... and then he said have fun............ and i did :) :)
heh.... in real life though i kind of have enough of an anxiety disorder to keep my manias in check
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