Posted by Ritch on February 6, 2002, at 10:15:44
In reply to Re: Bipolar III?, posted by Dinah on February 6, 2002, at 7:58:21
> > Hi Spike, et al,
> >
> > I think the APA is seriously considering the BP-III subcategory. It doesn't surprise me considering the ever increasing number of new and more potent antidepressants becoming available and the increased exposure of the general population to antidepressant medications. There are so many agents around that have the capability of triggering hypomania and mania-I personally think that it *might* be incorrect to assume that the meds are "uncovering" a "latent bipolar disorder". Perhaps if you give a normal person (no psycho-pathology) some of these new meds you will start seeing some manic and hypomanic responses as a side-effect....well that does complicate things now doesn't it??
> >
> > Mitch
>
> I think the problem is when AD induced hypomania and mood cycling doesn't go away after the AD is discontinued. I probably had some mood cycling before I started AD's but it was minor. I had my first clearly hypomanic episode on AD's and although I've been off them for over a year and only on Depakote and Klonopin, the mood cycles continue. Either the AD's uncovered an underlying bipolar tendency or they changed the wiring in my brain so that whatever I was before, now I'm permanently on the bipolar spectrum.
> So is Bipolar III considered a hypomania while on medications (which sounds more like a side effect than a disorder), or a mood cycling problem caused by medications?
Dinah,From what I understand, the current DSM excludes a diagnosis of BP-II if hypomania is caused by substance abuse, hyperthyroidism (i.e.), or other medications (antidepressants, i.e.). By creating a "BP-III" category that *does* include medication-induced hypomania, allows the dx of bipolar that otherwise technically wouldn't be allowed. This is (IMO) because many pdocs believe that *any* hypomanic presentation (regardless of cause) is symptomatic of an underlying bipolar disorder. I don't have a solid opinion on the matter-I truly wonder if that would be accurate or not. As for your last question about an acute hypomanic presentation (med-induced) versus a chronic cycling syndrome (while taking inducing meds), that's a tough one. If you are prescribed an antidepressant, then obviously you are suffering from depression (the most common use for AD's other than anxiety disorders, ADHD, etc.). Then you experience a hypomanic *episode* while on the antidepressant. Well, there is a *cycle* of sorts there. I suppose it would depend on whether it took on a predictable cyclic duration (10-day cycles, i.e.). If it was a "random" episode of hypomania while on the AD, then maybe a bipolar dx would not be appropriate.
Mitch
poster:Ritch
thread:92893
URL: http://www.dr-bob.org/babble/20020131/msgs/93068.html