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Re: Can you have bipolar AND unipolar disorder?

Posted by Christ_empowered on November 29, 2020, at 15:22:30

In reply to Re: Can you have bipolar AND unipolar disorder?, posted by Lamdage22 on November 29, 2020, at 13:41:21

my wild guess would be that such people would fall into depression-heavy bipolar I or II of some sort...

and their treatment would probably (guessing, obviously) focus on preventing (hypo)mania (surprisingly...a lot easier than treating depression, it seems) while not exacerbating the tendencies towards depression, and also...

well, since unipolar and bipolar depressive states, if they are in fact brain diseases, would operate by different mechanisms...

i would think (assume?) the treatment for the low end would need regular readjustment.

for example: if such a person had a diagnosis of Bipolar I, most bad depressive states...

then some low ends might respond to, say, wellbutrin. some low ends might involve more agitation and anxiety, so then the shift would be towards an ssri drug, perhaps an 'atypical.'

i'd personally be afraid that such a person might be even more sensitive to neuroleptics than standard issue bipolar I or severe depression people. to that end, i would think (assume?) ongoing treatment would look more like old school treatment of bipolar I...

an anti-convulsant and/or lithium, all the time...limited use of benzodiazepines and most antidepressants (I would think wellbutrin, maybe, might be a viable long term option), and above all else: careful, minimal use of tranquilizers, no matter how 'atypical,' probably with an emphasis on low(er) potency agents to minimize eps and td risk

just...random thoughts. truth be told, minimizing neuroleptic use is always a good thing, especially in vulnerable groups. i also wonder about stimulants..or at least dopamine agonists, that kind of thing...if those drugs would maybe be a better option, during some low episodes, than most antidepressants? a shrink told me once that it was sometimes better to keep people on uppers and stabilize around that, rather than resort to conventional antidepressants...she said the results were 'more predictable' (?). i don't get it, and i don't know if that's data driven, or intuitive, or...what, honestly.


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