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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Jimmyboy on August 29, 2007, at 15:14:17
1. I tend to feel good about 3 months a year, ok for about 3 months and terrible the remaining time.. no mania or hypomania. have anxiety and panic along with it almost all the time, whether I feel bad or not. Would this be classified as Bipolar II or something else?
2. As I get older it seems to get worse and worse, is this a common pattern? Does it tend to continually get worse the older you get?
3. Has anyone gotten considerable periods of remission by taking medication? everytime I start to feel better, I know its just fleeting and the depression and terrible anxiety will come back and wreck all the progress I made while feeling normal..
ThanksJB
Posted by sam123 on August 29, 2007, at 15:30:59
In reply to Bipolar questions, posted by Jimmyboy on August 29, 2007, at 15:14:17
> 1. I tend to feel good about 3 months a year, ok for about 3 months and terrible the remaining time..
What time of year are these 3 month periods (summer, spring, ect); are your mood changes always at the same time of the season ?
Posted by polarbear206 on August 29, 2007, at 16:27:45
In reply to Bipolar questions, posted by Jimmyboy on August 29, 2007, at 15:14:17
> 1. I tend to feel good about 3 months a year, ok for about 3 months and terrible the remaining time.. no mania or hypomania. have anxiety and panic along with it almost all the time, whether I feel bad or not. Would this be classified as Bipolar II or something else?
>
> 2. As I get older it seems to get worse and worse, is this a common pattern? Does it tend to continually get worse the older you get?
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> 3. Has anyone gotten considerable periods of remission by taking medication? everytime I start to feel better, I know its just fleeting and the depression and terrible anxiety will come back and wreck all the progress I made while feeling normal..
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> Thanks
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> JBI bet you feel better in the summer months? You don't have to have full blown hypomania to have a diagnosis of bipolar. There are milder subtypes that just present as anxiety/panic with depression. If left untreated, it will get worse over time, thus harder to treat for some people. Are you taking any medication? My winter slumps have greatly improved since I have been on Lamictal.
Polarbear
Posted by linkadge on August 29, 2007, at 19:42:21
In reply to Re: Bipolar questions » Jimmyboy, posted by polarbear206 on August 29, 2007, at 16:27:45
>There are milder subtypes that just present as >anxiety/panic with depression.
Some doctor would not classify this as bipolar.
Bipolar should mean two poles. The fact that your depression goes into natural remission for periods in the year does not mean that you have bipolar.The presence of anxiety and panic also does not necessarily mean bipolar. I would tend to think that the *majority* of unipolar depression has symptoms of panic or anxiety, as well as having periods of natural remission.
I don't think you need to bother with mood stabilizers *unless* they actually work for you. I tried mood stabilizers for a very similar type of depression, and they did not lift the depression, they felt like adding a pile of weight on my shoulders. They made living with the depression even harder due to the cognative side effects etc.
Seasonal effective disorder is also not bipolar.
There is probably no harm in trying a mood stabilizer. Mood stabilizers like lamictal have some efficacy as antidepressants even if there is no bipolar present. Responce to lamictal does not necessarily indicate bipolar.
Bottom line, use what works. Unfortunately I havn't found anything to help a similar pattern.
Linkadge
Posted by Phillipa on August 29, 2007, at 22:16:46
In reply to Re: Bipolar questions, posted by linkadge on August 29, 2007, at 19:42:21
PHD said today a tad of depression maybe but thought PTSD and this was my official diagnosis at age 24 so will continue with benzos as SSRI's, or other ad's make it worse. Lamictal and trileptal low dose at one time did seem to make me more tired at night. As getting older the benzo use is tappering down on it's own. Phillipa
Posted by polarbear206 on August 30, 2007, at 8:08:36
In reply to Re: Bipolar questions, posted by linkadge on August 29, 2007, at 19:42:21
> >There are milder subtypes that just present as >anxiety/panic with depression.
>
> Some doctor would not classify this as bipolar.
> Bipolar should mean two poles. The fact that your depression goes into natural remission for periods in the year does not mean that you have bipolar.
>
> The presence of anxiety and panic also does not necessarily mean bipolar. I would tend to think that the *majority* of unipolar depression has symptoms of panic or anxiety, as well as having periods of natural remission.
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> I don't think you need to bother with mood stabilizers *unless* they actually work for you. I tried mood stabilizers for a very similar type of depression, and they did not lift the depression, they felt like adding a pile of weight on my shoulders. They made living with the depression even harder due to the cognative side effects etc.
>
> Seasonal effective disorder is also not bipolar.
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> There is probably no harm in trying a mood stabilizer. Mood stabilizers like lamictal have some efficacy as antidepressants even if there is no bipolar present. Responce to lamictal does not necessarily indicate bipolar.
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> Bottom line, use what works. Unfortunately I havn't found anything to help a similar pattern.
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> Linkadge
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There is a broad spectrum to bipolar disorders with milder subtypes. It's not that cut and dry for many people. SAD is considered a subtype of bipolar. Go to pubmed and you will find plenty of scholarly info on this and other subtypes. I have said it to many posters that it *CAN* be overlooked and misdiagnosed. You indicate that I think everyone that presents with these symptoms is bipolar. I think you are aware that I work in the mental health field, and colaberate with many psychiatrist. So once again, lets just agree to disagree.Polarbear
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Posted by linkadge on August 30, 2007, at 8:34:06
In reply to Re: Bipolar questions » linkadge, posted by polarbear206 on August 30, 2007, at 8:08:36
But the problem is, that for pure SAD, mood stabilizers rarly work.
Drugs like wellbutrin are approved for SAD, but are not approved for bipolar depression.
No mood stabilizers are approved for SAD, because its proably impossable to demonstrate effiacy.
There is some significant opposition to the arugment of a number of these *bipolar varients* being bipolar. There is argument that antidepressant induced mania, is *not* indicative of bipolar and should get its own classification for instance.
(Parkinsons meds can induce psychosis, that doesn't mean the patient has latent schizophrenia!)
There are a number of different oppinions about what constitutes bipolar disorder these days. There is little agreement, as you are probably aware.
Calling recurrent unipolar disoder, bipolar is not yet commonpractice, and most doctors won't prescribe bipolar meds unless there is a history of mania or hypomania.
Show me studies of efficacy of a mood stabilizer for SAD! Not just a bunch of cases studies, cause its clear that some with SAD may actually have bipolar, but I bet you can't find an open study demonstrating the efficacy of a mood stabilizer in SAD who have no symptom of bipolar.
If a mood stabilizer works, then fine, but there would be doctors who would call everybody bipolar, which is not really advantagious IMHO.
Linkadge
Posted by polarbear206 on August 30, 2007, at 10:33:34
In reply to Re: Bipolar questions, posted by linkadge on August 30, 2007, at 8:34:06
> But the problem is, that for pure SAD, mood stabilizers rarly work.
Having SAD doesn't mean a mood stabilizer is always indicated. Most don't need one, however it is considered a subtype in the spectrum.
> Drugs like wellbutrin are approved for SAD, but are not approved for bipolar depression.Many bipolars do very well on Wellbutrin. In fact many on babble take them. Just because a drug is not approved for a certain diagnosis doesn't mean it will not benefit others.
> No mood stabilizers are approved for SAD, because its proably impossable to demonstrate effiacy.I did not indicate that mood stabilizer are approved for SAD.
> There is some significant opposition to the arugment of a number of these *bipolar varients* being bipolar. There is argument that antidepressant induced mania, is *not* indicative of bipolar and should get its own classification for instance.The new version of the DSM will be out in 2011 which will include expanded subtypes of bipolar spectrum and overlapping of Unipolar/Bipolar. I would think the DSM has some weight to it as a diagnostic tool.
> (Parkinsons meds can induce psychosis, that doesn't mean the patient has latent schizophrenia!)Once again your indicating I think everyone has underlying bipolar just because adverse reactions to medication.
> There are a number of different oppinions about what constitutes bipolar disorder these days. There is little agreement, as you are probably aware.Yes, there is controversy out there.
> Calling recurrent unipolar disoder, bipolar is not yet commonpractice, and most doctors won't prescribe bipolar meds unless there is a history of mania or hypomania.
Many Psychiatrist prescribe mood stabilizers for "SOME" recurrent unipolar with positive results in outpatient remissions.
> Show me studies of efficacy of a mood stabilizer for SAD! Not just a bunch of cases studies, cause its clear that some with SAD may actually have bipolar, but I bet you can't find an open study demonstrating the efficacy of a mood stabilizer in SAD who have no symptom of bipolar.I did not indicate I am arguing this point.
> If a mood stabilizer works, then fine, but there would be doctors who would call everybody bipolar, which is not really advantagious IMHO.
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> Linkadge
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I know from your post that you are very intelligent for your age, and I respect that. You contribute very good advice to babble. I hope you are pursuing or considering a Psychology major in college. Once you get out, and work in the field, experience and see it for yourself, maybe some of your opinions will change.Polarbear
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Posted by Justherself54 on August 30, 2007, at 10:44:30
In reply to Re: Bipolar questions, posted by polarbear206 on August 30, 2007, at 10:33:34
Back to SAD..I'm bipolar and suffer terribly from SAD (doesn't help I live in a place where we have winter over 6 months of the year)..what keeps me going is daily light therapy..my SAD light is worth its weight in gold..
Posted by linkadge on August 30, 2007, at 13:40:33
In reply to Re: Bipolar questions, posted by polarbear206 on August 30, 2007, at 10:33:34
>Having SAD doesn't mean a mood stabilizer is >always indicated. Most don't need one, however >it is considered a subtype in the spectrum.
By some, perhaps
>I did not indicate that mood stabilizer are >approved for SAD.
But why would anyone want to consider themselves bipolar, if they have had no mania, or hypomania, and they don't respond to mood stabilizers?
>The new version of the DSM will be out in 2011 >which will include expanded subtypes of bipolar >spectrum and overlapping of Unipolar/Bipolar. I >would think the DSM has some weight to it as a >diagnostic tool.
We'll just have to wait and see exactly what comes out.
>Once again your indicating I think everyone has >underlying bipolar just because adverse >reactions to medication.
I just don't understand why you would think somebody has bipolar disoder when they have no history of mania or hypomania, even in the presence of antidepressants. Thats like saying sombody has unipolar disoder without being depressed.
>Many Psychiatrist prescribe mood stabilizers >for "SOME" recurrent unipolar with positive >results in outpatient remissions.
But even this doesn't proove that a patient has bipolar disorder. Lithium can augment antidepressants yet I don't think doctors would go so far as to suggest that the patient has bipolar. In accordance with the hyperglutamatergic model of some mood disorders, there is some reason why a mood stabilizer might work, although again, the efficacy doesn't necessarily indicate bipolar.
>I know from your post that you are very >intelligent for your age, and I respect that. >You contribute very good advice to babble. I >hope you are pursuing or considering a >Psychology major in college. Once you get out, >and work in the field, experience and see it for >yourself, maybe some of your opinions will >change.You don't necessarily need to be in the field of psychiatry or psychology to see the effects they have.
Linkadge
This is the end of the thread.
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