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Re: DST in major depression Elizabeth

Posted by SLS on October 2, 2001, at 8:59:22

In reply to DST in major depression SLS, posted by Elizabeth on October 1, 2001, at 19:42:46

Hi Elizabeth.

Thanks. That helps clarify things.

> Because of the recent surge in diagnosis of bipolar disorders (especially bipolar II), I'd prefer not to discuss the rate in bipolar depression, as the results of clinical trials that used more restrictive samples might be misleading.

I'm a little confused. Do you feel the more restrictive criteria used in the bipolar studies of DST were invalid? How old are the studies? I guess I should do a search on Medline.

My case profile is a little weird. I guess you know that by now. I forgot which doctor (witch-doctor) made the comment to me, but he said my condition was more similar to bipolar I than bipolar II. I think his main criterion was the severity of my manic episodes, even though they were all induced by exposures to medication.

Parnate + desipramine = hypomania - > psychotic dysphoric mania
Nardil = protracted hypomania, mixed type
Nardil discontinuation = severe psychotic mania, dysphoric.

Some diagnostic schemes proposed for DSM V include this presentation as bipolar III. I think another diagnostic subtype once proposed for bipolar disorder was one for which chronic depression is the only symptom. For some reason, the word "symptom" just doesn't cut it for me. I guess I'm somewhere in between these two. Add a smidgen of ultra rapid-cyclicity, and you've got a neat little package. Between ages 20 - 22, I displayed a remarkably regular 11-day cycle: 8 days of severe depression followed by 3 days of normothymia followed by 8 days of severe depression... etc. I was able to keep a social calendar around it. Unfortunately, Fieve's lithium did away with all of that.

- Scott




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