![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by samantha28 on April 18, 2009, at 15:53:24
Hi, while DSM states you can only have a mixed episode in bipolar I and not in bipolar II many clinicians seem to diagnose people with bipolar II - mixed state.
Yet many MH professionals say you can have mixed state in bipolar II as well:
Bipolar I - mixed state looks like this:
"A dysphoric mania consists of a manic episode with depressive symptoms. Increased energy and some form of anger, from irritability to full blown rage, are the most common symptoms (MMDT). Symptoms may also include auditory hallucinations, confusion, insomnia, persecutory delusions, racing thoughts, restlessness, and suicidal ideation."
Bipolar II - mixed state looks like this:
"An agitated depression is a "major depressive [episode] with superimposed hypomanic symptoms" (Benazzi, 2000). Mixed episodes in which major depression is the primary state, concurrent with atypical manic features were described in two studies (Benazzi & Akiskal, 2001; Perugi et al., 2001). A study by Goodwin and Ghaemi (2003) reported manic symptoms in two-thirds of patients with agitated depression, which they suggest calling "mixed-state agitated depression".
This sounds like hair splitting splitting. Agitated depression sounds like dysphoric mania to me.
I have the following symptoms: intense suicidal urges, irritability, high sex drive, feeling fat but energized with nervous energy, depressed mood but I can change to euphoria for brief moments, tired at the same time as being energized, racing thoughts, lack of ability to concentrate and I feel like I need to be moving all the time despite feeling fatigued, negative remunerations, sometimes I can feel like I can do anything and other times I feel hopeless and pensive and empty.
I have been dx as bipolar I mixed state by one doctor and bipolar II mixed state by another - which is the more correct dx?
cheers
Samantha
Posted by Dinah on April 19, 2009, at 16:02:16
In reply to mixed state bipolar I or II, posted by samantha28 on April 18, 2009, at 15:53:24
I don't really know the answer to that. But you're right. It is a thin line, and psych diagnoses are never so clear cut as in some other specialties. I know I don't fit neatly in a DSM IV diagnostic box.
The treatment for either is probably pretty much the same? To my eyes, diagnosis is only useful for treatment purposes. Until they get a blood test or MRI imaging system that can reliably pin down the diagnosis. And I figure when that happens, a lot of diagnostic codes are going to have to be revised.
It sounds like a miserable place to be, no matter what they call it. Are you finding a meds regimen that helps? Are you seeing a therapist?
You may want to ask on the Medication Board too. Biological questions of diagnosis are often discussed there.
Posted by sunnydays on April 19, 2009, at 16:35:38
In reply to Re: mixed state bipolar I or II » samantha28, posted by Dinah on April 19, 2009, at 16:02:16
Sorry, couldn't tell you. But I do know that I am depressed frequently, but often don't fit the criteria for clinical depression. I don't ever have true manic episodes either. I don't fit any criteria. At this point we just go with what I'm feeling at the moment... my T has taken to just calling it "this mood thing that you have." :) I love being complicated sometimes. It makes me laugh.
sunnydays
Posted by Phillipa on April 19, 2009, at 23:31:55
In reply to Re: mixed state bipolar I or II » Dinah, posted by sunnydays on April 19, 2009, at 16:35:38
I'm anxious and tired at the same time any psychological diagnosis for this? Love Phillipa ps just wierd I guess
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.