![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by juniper on March 11, 2000, at 2:51:59
In reply to Re: Update--It's the Thyroid, Stupid, posted by Noa on March 10, 2000, at 13:18:59
your last post really interested me, noa, as you explained very much the cyclic (though it follows no pattern that i know of) nature of my moods. i've never been diagnosed with any kind of bipolar disorder, but my depression is certainly the atypical type where i use overeating and oversleeping to escape(why does your doctor call it bipolar depression? aren't the major signs of atypical depression(and hypothyroidism) sleeping and eating more than usual?). i've the times too when i become a whirlwind of thought and curiosity and creativity...not manic, but excited for all there is to do (and i've always the tuggings that this isn't going to last---making up for lost time and time to be lost, i suppose).
i've been taking synthroid for about 6 years now, due simply to hypothyroidism with little to do with augmenting antidepressants. i know my TSH is not below 1 though, and while my endocronologist says it's within normal range, i wonder if it is in my optimal range.
i've never tried a mood stablizer, though i've been very curious about topiramate because it has also been shown to help with binge eating. (but my p-doc was wary of prescribing this for me)
i hope that your thyroid augmentation begins to show some improvement. i'd recommend, and think i have, adderall also if you are still in a funk.
only because our symptoms are similar and it has helped my energy and clarity immensely.
good luck!!!!
peace,
juniper----why is it a nod toward the diagnosis of bipolar if you did not find effexor or other SSRIs sedating?
Posted by Noa on March 9, 2000, at 18:30:25
Finally saw my pdoc. We went around and around, disagreeing on a few points, but both agreeing the thyroid thing had to be looked at more closely.
I have been taking cytomel and synthroid for a few years, to augment my ADs. Originally, my tests showed me to be borderline hypothyroid, with a TSH of something like 4.9. Within a week of starting thyroid meds, I did feel much better. But eventually, my depression just kept getting worse, leading to me adding Ritalin, increasing the effexor, adding serzone, and adding lithium. I probably left out a few steps, but who cares.
Last night, my pdoc told me the target for my TSH should less than 1 ("normal" is between .5 and 5). My last test showed it to be 3.8. We both figure the lithium has made me hypothyroid, which undermined the initial effectiveness the lithium was having (the first 6 weeks). Still, I don't know what my TSH readings were prior to the lithium--I need to call my internist and find out.
After my appointment, it occured to me that my pdoc should have told me about needing to get my TSH down to 1 a long time ago. Maybe increasing the thyroid meds would have been the right intervention before some of the other steps.
I happened to have seen a friend last night who has Hashimoto's disease, which is an autoimmune disorder that causes hypothyroidism. She confirmed the need to keep the TSH down to 1. She said she feels best (physically and emotionally) when it is that low. Only problem for her is convincing her internist of this and the need to adjust her meds accordingly. She got much better results from seeing an endocrinologist who specializes in Hashimoto's, but of course to see a specialist, you have to go through your primary care doctor, who is receiving disincentives for referrals. In any event, my friend also recommends checking thyroid levels at least every three months because of how sensitive it is to changes, stress, illness, etc.
It makes sense to me that it's the thyroid because of how physical this episode has been. There has been the mood plunge and lack of motivation, but also the fatique, and general slowness, and the feeling of leadenness. Every thing has been hard--a big effort. And every thing has tired me out.
So, now my quest is to get my TSH down to 1 and hopefully I will feel better. I have already increased the cytomel (in addition to the increase in the synthroid made two weeks ago).
After that, I don 't know what aspect of my cocktail I am going to go after. My pdoc strongly believes I need the mood stabilizer. He says that my favorable initial response to lithium confirms the diagnosis of bipolar depression. I am ambivalent. The thing is, I don't care for the lithium's side effects, especially having to go to the bathroom every 30 minutes. If I know the lithium is working, maybe I cantolerate it better. These past few weeks, tho, because it felt like the lithium had stopped working, I really began to resent this annoyance.
As for wellbutrin, he agreed it could be a good choice, but brought up old notes on his laptop that said I had developed tinnitus after adding wellbutrin to the effexor. Whether I would get tinnitus on wellbutrin alone, who knows? Also, does anyone know if tinnitus is as likely with Wellbutrin SR as it is with IR?
Thanks.
Posted by Brenda on March 9, 2000, at 19:56:36
In reply to Update--It's the Thyroid, Stupid, posted by Noa on March 9, 2000, at 18:30:25
> Finally saw my pdoc. We went around and around, disagreeing on a few points, but both agreeing the thyroid thing had to be looked at more closely.
>
> I have been taking cytomel and synthroid for a few years, to augment my ADs. Originally, my tests showed me to be borderline hypothyroid, with a TSH of something like 4.9. Within a week of starting thyroid meds, I did feel much better. But eventually, my depression just kept getting worse, leading to me adding Ritalin, increasing the effexor, adding serzone, and adding lithium. I probably left out a few steps, but who cares.
>
> Last night, my pdoc told me the target for my TSH should less than 1 ("normal" is between .5 and 5). My last test showed it to be 3.8. We both figure the lithium has made me hypothyroid, which undermined the initial effectiveness the lithium was having (the first 6 weeks). Still, I don't know what my TSH readings were prior to the lithium--I need to call my internist and find out.
>
> After my appointment, it occured to me that my pdoc should have told me about needing to get my TSH down to 1 a long time ago. Maybe increasing the thyroid meds would have been the right intervention before some of the other steps.
>
> I happened to have seen a friend last night who has Hashimoto's disease, which is an autoimmune disorder that causes hypothyroidism. She confirmed the need to keep the TSH down to 1. She said she feels best (physically and emotionally) when it is that low. Only problem for her is convincing her internist of this and the need to adjust her meds accordingly. She got much better results from seeing an endocrinologist who specializes in Hashimoto's, but of course to see a specialist, you have to go through your primary care doctor, who is receiving disincentives for referrals. In any event, my friend also recommends checking thyroid levels at least every three months because of how sensitive it is to changes, stress, illness, etc.
>
> It makes sense to me that it's the thyroid because of how physical this episode has been. There has been the mood plunge and lack of motivation, but also the fatique, and general slowness, and the feeling of leadenness. Every thing has been hard--a big effort. And every thing has tired me out.
>
> So, now my quest is to get my TSH down to 1 and hopefully I will feel better. I have already increased the cytomel (in addition to the increase in the synthroid made two weeks ago).
>
> After that, I don 't know what aspect of my cocktail I am going to go after. My pdoc strongly believes I need the mood stabilizer. He says that my favorable initial response to lithium confirms the diagnosis of bipolar depression. I am ambivalent. The thing is, I don't care for the lithium's side effects, especially having to go to the bathroom every 30 minutes. If I know the lithium is working, maybe I cantolerate it better. These past few weeks, tho, because it felt like the lithium had stopped working, I really began to resent this annoyance.
>
> As for wellbutrin, he agreed it could be a good choice, but brought up old notes on his laptop that said I had developed tinnitus after adding wellbutrin to the effexor. Whether I would get tinnitus on wellbutrin alone, who knows? Also, does anyone know if tinnitus is as likely with Wellbutrin SR as it is with IR?
> Thanks.Noa - Have you had a chance to check out the Topamax? My cousin who is bipolar started with lithium for stabilization and then was switched to Topamax. Many fewer side effects. I also was on a low dose of Topamax, 100 mg., for mood stabilization. It helped, but I didn't like the ringing in my ears. I was also doing a trial of Wellbutrin along with it. When I stopped the Topamax and Wellbutrin the ringing practically disappeared. I told my doc I wouldn't take the lithium. Too many side effects and along with my depression I just couldn't deal with a weight gain on top of it. Topamax doesn't cause weight gain or tremors, and while you have to drink lots of water, you don't have to have your blood work done all the time. Also, at my low dose - I wasn't sleepy all the time. But since I'm not sure I qualify for bipolar I or II - I opted out on the meds and am sticking with Zoloft alone. It's okay so far. I still get sooo sad sometimes. We aren't up to a therapeutic dose yet.
I also had blood work done today. First time for me. Will know next week about my thyroid, etc. Much luck on getting your meds to work for you. B.
Posted by dove on March 10, 2000, at 9:55:09
In reply to Re: Update--It's the Thyroid, Stupid, posted by Brenda on March 9, 2000, at 19:56:36
Hi Noa,
I don't know how long you've had the hypothyroidism, but if the TSH has been over 1 this entire time, couldn't that be the cause of some of the physical symptoms accompanying your depression, or kindling the depression? Why does your doc think that your bipolar? Have you ever had a manic episode besides the med-induced? Hasn't the straight out lethargic-depression always been the problem?On the Wellbutrin SR front, my p-doc said the tinnitus is less with the SR than the short-acting. I didn't experience any tinnitus with Wellbutrin SR, but have experienced it with the Serzone and high dosages of Amitriptyline. And Prozac, if I'm keeping this all straight. But, all these meds were augmenting the already in place Amitriptyline and Adderall. Still, adding the Wellbutrin to the already in place meds didn't cause ear-ringing unless I was taking it with the Prozac.
dove
Posted by Noa on March 10, 2000, at 13:18:59
In reply to Re: Update--It's the Thyroid, Stupid, posted by dove on March 10, 2000, at 9:55:09
> if the TSH has been over 1 this entire time, couldn't that be the cause of some of the physical symptoms accompanying your depression, or kindling the depression?Yep, that's what I'm thinking too.
>Why does your doc think that your bipolar? Have you ever had a manic episode ? Hasn't the straight out lethargic-depression always been the problem?
No manic episodes to date. Have always had the lethargic, oversleeping, overeating type of depression. My pdoc sees the depression as similar in features to the depression of bipolar illness, and that it seems to have a cycling pattern, even tho I don't get any manic or hypomanic episodes. So he sees me as having bipolar depression, rather than the full bipolar disorder.
Even so, in relation to MY moods, I can identify what you might call subtle, micro-hypo-manic moods, that is, in comparison with my calmer "normal" (who even remembers the last time I saw that?) or depressed moods. In many ways these moods are like having ADD--unfocused, but interested in everything, having lots of ideas of things to do, etc. In some ways, it seems like a function of anxiety. Another analogy is how it feels when a non-caffeine drinker drinks some strong coffee--kinda revved. It also can seem like I am trying to make up for lost time, as though I have surfaced for a brief time from the depths of depression, and want to take all the world in before being sucked back down. I don't act manic, don't take on really outrageous endeavors, just too much for me.
My response to lithium also seemed to support the idea of me having bipolar depression. And, I think the fact that meds like effexor and the ssris were very activating for me, and I never found them sedating, as some people do.
Posted by Janice on March 11, 2000, at 23:20:53
In reply to Re: Update--It's the Thyroid, Stupid, posted by juniper on March 11, 2000, at 2:51:59
hi you guys,
Atypical depression is the type of depression bipolar folks have. (I slept for 3 days straight once on the low part of my rapid cycling. I only woke up every 20 hours or so to pee and let the dog out to pee. If I could have stayed up any longer than this, it would have been to binge eat.)
Even if you don't go manic, you are probably closer on the continum towards being bipolar.
Also, there is a strong connection between rapid cyclers and thyroid problems.
Also, most rapid cyclers are women.
Even if you aren't rapid cycling you could be cycling.
I kept a mood journal to discover all my cycles. I have a 24 hour cycle, a weekly cycle, a monthly cycle and an annual cycle. Once you identify your cycles, they are easier to treat.
just a few facts on cycling depression.
remember, I am not a medical person, and could be off on a detail or two. Janice
Posted by Janice on March 11, 2000, at 23:39:24
In reply to jumping in on impulse because I think I can help.., posted by Janice on March 11, 2000, at 23:20:53
I think (I could be wrong) the earlier in life you notice the variations in cycles, the more likely you may turn into bipolar.
Really, it is the same disorder at various stages.
I wonder if your cycling could be why ADs don't work so well for atypical cyclers that don't go high (yet????). Rapid cyclers that do go manic have a very difficult time treating their depression, as it seems most ADs just increase the cycling.
just an idea, Janice
Posted by Cam W. on March 12, 2000, at 0:19:16
In reply to Re:When unipolar becomes bipolar, posted by Janice on March 11, 2000, at 23:39:24
Janice - I think that bipolar and unipolar depressions are separate disorders. It is just that many bipolar cases are misdiagnosed to begin with (approx. 40% of diagnosed unipolar depressions are really bipolar depressions). The manic switch and increased rapid cycling could be due the antidepressant taking the "brake" (depression) off of the mania and then the mania takes over. I have read recently where bipolar disorder is closer to schizophrenia than it is to unpolar depression. One doc from Philadelphia (Dr.Richard Petty) who recently lectured to us said that bipolar disorder and schizophrenia where the same disorder, just at different points on the spectrum. (oh, and yes that is right, Richard Petty, like the race car driver) - Cam W.
Posted by Janice on March 12, 2000, at 14:13:07
In reply to Re:When unipolar becomes bipolar, posted by Cam W. on March 12, 2000, at 0:19:16
hi Cam,
I respect your opinion very much, and have learnt alot from reading your postings.
I have no scientific arguement for you...but my experience.
In my immediate family, there are 4 women - all who have cycling depression.
At 16, I noticed my cycling depression.
At 21 I started getting a bit manic (very much like what Noa and juniper describe).
At 25, I was manic (talking to spirits).
Now (7 years later), one sister (35yo) has become manic also - just in the past year.My other sister and mother (65 yo) have never shown any signs of mania - just the cycling depression that we all have.
I would have a very hard time believing that our disorders are not related. So much is the same, except the mania. There must be many times when unipolar depression becomes bipolar.
I believe what you've said could very well be true, but, AT LEAST, these two disorders must be related.
What you wrote surprised me. I guess you challenged one of my assumptions (that I never even knew existed). Janice.
Posted by Cam W. on March 12, 2000, at 17:50:39
In reply to Re: Cam W...the world must be round, posted by Janice on March 12, 2000, at 14:13:07
Janice - What I wrote surprized me when I first heard it (bipolar/schizophrenia connection). Actually, the psychiatrist who was sitting beside me said "I guess everything I knew just went out the window." As for the part of bipolar and unipolar being different disorders, it is not inconceivable that someone has a unipolar depression before the bipolar break. Also bipolar depression looks very much like unipolar depression and sometimes I am hard-pressed to see a difference. I may not be correct; this is just my opinion. Sincerely - Cam W.
Posted by Scott L. Schofield on March 12, 2000, at 18:06:15
In reply to Re: Cam W...the world must be round, posted by Janice on March 12, 2000, at 14:13:07
> In my immediate family, there are 4 women - all who have cycling depression.
>
> At 16, I noticed my cycling depression.
> At 21 I started getting a bit manic (very much like what Noa and juniper describe).
> At 25, I was manic (talking to spirits).
>
>
> Now (7 years later), one sister (35yo) has become manic also - just in the past year.
>
> My other sister and mother (65 yo) have never shown any signs of mania - just the cycling depression that we all have.
>
> I would have a very hard time believing that our disorders are not related. So much is the same, except the mania. There must be many times when unipolar depression becomes bipolar.
>
> I believe what you've said could very well be true, but, AT LEAST, these two disorders must be related.
>
> What you wrote surprised me. I guess you challenged one of my assumptions (that I never even knew existed). Janice.
Just a couple of things I believe as of the time of this writing:1. Bipolar disorder and unipolar disorder are biologically separate entities.
2. Rapid-cyclicity probably indicates a bipolar-type disorder that can evolve into unequivocal bipolar disorder.
3. Bipolar disorder may not be recognized as such until mania appears for the first time.
4. Bipolar disorder shows markedly more heritability than does unipolar disorder.
5. Mania may never appear in bipolar disorder.
6. Mania may only appear when induced by drugs or other external influences in bipolar disorder.
All of the above are consistent with Janice's description of her family's presentations.
I reserve the right to change my mind.
- Scott
Posted by Scott L. Schofield on March 12, 2000, at 21:19:08
In reply to Re:When unipolar becomes bipolar, posted by Cam W. on March 12, 2000, at 0:19:16
> One doc from Philadelphia (Dr.Richard Petty) who recently lectured to us said that bipolar disorder and schizophrenia where the same disorder, just at different points on the spectrum.At what point along the continuum does he believe enlarged ventricles appear relative to symptomology?
- Scott
Posted by Janice on March 12, 2000, at 21:57:07
In reply to Re:When unipolar becomes bipolar, posted by Scott L. Schofield on March 12, 2000, at 21:19:08
Hi Cam & Scott,
What you said stayed with me today, and I made a few connections.
I got mania before ADs, but after self-medicating with marijauna in university, in order to write papers and study for exams. ADs make me significantly worse.
My other bipolar sister got mania after using ADs. Maybe they did take the "brake" off of the mania, as you suggested.
My other sister and mother have never done ADs or recreational drugs. So they are probably are bipolar, without the mania.
schizophrenia +depression
at the lower end
mania +depression
My sister without the bipolar chats to me every January (depression time) about trying an AD. What should I suggest to her? Mood stabilizers?
I probably should be more careful with what I say around here. I guess that still doesn't mean Noa and juniper are or aren't bipolar.
Scott, you're a very smart guy, and you make me laugh. Thanks again for your imput.
I have the right to change my mind on that, too.
Posted by bob on March 12, 2000, at 22:48:33
In reply to Okay, so unipolar doesn't become bipolar..., posted by Janice on March 12, 2000, at 21:57:07
Not that I know all that much about the topic, but...
I do recall Kay Jamison stating in An Unquiet Mind that she refuses to call what she has "Bipolar Disorder", preferring Manic-Depressive, because she feels the two states are distinct, not opposite poles of a single continuum.
just thought I'd toss that in, for what it's worth
bob
Posted by Cam W. on March 13, 2000, at 7:11:47
In reply to Re:When unipolar becomes bipolar, posted by Scott L. Schofield on March 12, 2000, at 21:19:08
>
> > One doc from Philadelphia (Dr.Richard Petty) who recently lectured to us said that bipolar disorder and schizophrenia where the same disorder, just at different points on the spectrum.
>
> At what point along the continuum does he believe enlarged ventricles appear relative to symptomology?
>
>
> - Scott
Scott - Exactly! Also, have they shown lack of synaptic pruning in bipolar disorder? I still have many questions on this, as do many of the psychiatrists I work with. I think my jaw is still on the floor with this one, but I haven't been able to make it to the library to see some of the articles. I will get back to this when I know more.
Posted by Scott L. Schofield on March 13, 2000, at 10:12:47
In reply to Re: Okay, so unipolar doesn't become bipolar..., posted by bob on March 12, 2000, at 22:48:33
> Not that I know all that much about the topic, but...
>
> I do recall Kay Jamison stating in An Unquiet Mind that she refuses to call what she has "Bipolar Disorder", preferring Manic-Depressive, because she feels the two states are distinct, not opposite poles of a single continuum.
>
> just thought I'd toss that in, for what it's worth
> bob
Good toss.This is an idea that I have not come across before. It would be a hard one to so easily dismiss, given the source.
Thanks.
- Scott
Posted by Scott L. Schofield on March 13, 2000, at 10:30:55
In reply to Okay, so unipolar doesn't become bipolar..., posted by Janice on March 12, 2000, at 21:57:07
> Okay, so unipolar doesn't become bipolar... Janice
I don't think we can necessarily eliminate this as a possibility. What I wrote certainly doesn't preclude this.
Another permutation of possibilities is that unipolar and bipolar disorders may occur simultaneously in the same person. This would be analogous to the concept of "double-depression", in which a person suffers major depression and dysthymia at the same time. Here, when the major depression resolves upon treatment with antidepressants, dysthymia remains, and must also be targeted for treatment. In a situation where bipolar and unipolar disorders exist within the same person, it may be that the stresses caused by the unipolar precipitates the bipolar.
I reserve the right to change your mind.
- Scott
Posted by Scott L. Schofield on March 13, 2000, at 16:32:02
In reply to Okay, so unipolar doesn't become bipolar..., posted by Janice on March 12, 2000, at 21:57:07
> I probably should be more careful with what I say around here.
Dear Janice,Personally, I saw nothing in your previous posts that argue in favor of your being censured. In fact, I found much of what you wrote here to be quite insightful and very accurate. Even better than that, you taught me some stuff too. Even better than that, your posts evoked more thought, investigation, and synthesis of ideas along this thread. This would not have occurred had you not posted. I guess your words have value. :-)
I know it can be pretty scary to post something that you feel might incite a riot against you. I have had plenty of nightmares about this myself. Come to think of it, some of them weren't nightmares at all. I hate being wrong.
Thanks.
- Scott
Posted by Mark H. on March 13, 2000, at 20:32:40
In reply to Re: Cam W...the world must be round, posted by Janice on March 12, 2000, at 14:13:07
I feel like a real outsider in this conversation, but what about those of us who are bipolar II? This designation didn't even exist that long ago. Like grammar and usage, diagnosis can be both descriptive and prescriptive. Prescriptive diagnosis becomes dangerous when the absence of a label causes certain professionals to pretend the condition doesn't exist.
Mania has traditionally been classed as a psychosis separate from schizophrenia, and for good reason, since it looks quite different and seems quite different in the descriptions of those experiencing it.
Those of us with Bipolar II are never psychotically manic; however, we do experience cyclic depression relieved by periods of hypomania. The cyclicity seems to be the main determinant, not the appearance of hypomania (which I call my delusions of adequacy).
I'm suspicious of the motivation and research of those who believe the depression experienced by cyclic depressives, including Bipolar IIs, is qualitatively different than depression that is considered unipolar. Experientially, at least, it doesn't add up.
Also, "schizophrenic" is one of the LEAST understood and MOST erroneously applied descriptors in mental health. There are those who think a child acting out at school is "schizophrenic." Whew! No Social Worker should be allowed to use the term at all. ;-)
Posted by Scott L. Schofield on March 14, 2000, at 10:41:23
In reply to Re: Cam W...the world must be round, posted by Mark H. on March 13, 2000, at 20:32:40
> I feel like a real outsider in this conversation, but what about those of us who are bipolar II? This designation didn't even exist that long ago.
I guess everything is relative. “Bipolar II” as a subtype has been recognized for over a decade.
> Like grammar and usage, diagnosis can be both descriptive and prescriptive. Prescriptive diagnosis becomes dangerous when the absence of a label causes certain professionals to pretend the condition doesn't exist.
I sure hope few researchers think this way. I guess you gotta start somewhere, though. When I was first treated in the early 80’s by the research department of Columbia Presbyterian in New York, it seemed that diagnosis was sometimes based upon response to medication. But at least they used this information to identify clinical profiles. This would eventually lead to constructing consistent diagnostic criteria. Of course, one of the goals is to determine whether or not these different clinical profiles represent discreet biological etiologies. However, I’m not sure that understanding such distinctions is so important for the average local practitioner, as long as he follows the recipes.
> Mania has traditionally been classed as a psychosis separate from schizophrenia, and for good reason, since it looks quite different and seems quite different in the descriptions of those experiencing it.
They also respond quite differently to various treatments. At this point, I feel it is obvious that they are indeed different.
Someone here described attending a lecture in which the lecturer considered bipolar disorder and schizophrenia to be different presentations along a continuum of the same illness. I found this concept to be a bit unnerving.
> Those of us with Bipolar II are never psychotically manic; however, we do experience cyclic depression relieved by periods of hypomania.
There are many who present the inverse. They are continuously hypomanic, except for infrequent episodes of depression. Also, they never seem to enter a state of euthymia. It is either one or the other.
> The cyclicity seems to be the main determinant, not the appearance of hypomania (which I call my delusions of adequacy).
What do you mean by “cyclicity”?
This is an interesting notion. I have not yet encountered it elsewhere regarding bipolar II. I see the terms “cyclicity” and “rapid-cyclicity” used here often, but I wonder how people define these. “Rapid-cyclicity” has a prescribed diagnostic definition, although it may be somewhat arbitrary. I think the DSM IV manual defines it as being the occurrence of at least 4 episodes of either depression or mania within a year. There are even guidelines used by some investigators that describe “ultra rapid-cycling” and “ultra ultra rapid cycling”. I don’t recall how they are defined, but we’re talking about cycles occurring every 48 hours, and sometimes several cycles within a single day.
> I'm suspicious of the motivation and research of those who believe the depression experienced by cyclic depressives, including Bipolar IIs, is qualitatively different than depression that is considered unipolar. Experientially, at least, it doesn't add up.
I don’t think any research has determined the presentation of bipolar depression to be immutably consistent. However, I believe it is generally characterized as resembling the so-called “atypical-depression”. It tends to be anergic. It would be interesting to compare the depressive phases of bipolar I and bipolar II to see if there are any statistical differences in symptomology between them. I have not come across any literature addressing this.
One must be careful when trying to extrapolate their own experiences to the general. I’ve made this mistake.
> Also, "schizophrenic" is one of the LEAST understood and MOST erroneously applied descriptors in mental health. There are those who think a child acting out at school is "schizophrenic." Whew! No Social Worker should be allowed to use the term at all. ;-)
Man, I had hoped we were past all that. To hear someone speaking of schizophrenia in these terms seems anachronistic – even comical. This is a tragedy, because it involves real people.
See ya’ later.
- Scott
Posted by Mark H. on March 14, 2000, at 13:35:46
In reply to Re: Bipolar, Schizophrenia, and cycling, posted by Scott L. Schofield on March 14, 2000, at 10:41:23
Dear Scott, Thank you for your wonderfully intelligent response to my posting. I appreciate your taking the time to address my specific concerns. Best wishes, Mark H.
Posted by judy on March 14, 2000, at 19:44:37
In reply to Re: Bipolar, Schizophrenia, and cycling, posted by Scott L. Schofield on March 14, 2000, at 10:41:23
I liked your response to Mark although I've had different experiences with manic episodes. My first one- about 15 years ago- was psychotic and I was hospitalized with a diagnosis of schizophrenia. Apparently that was not too uncommon considering my age- early 20's and my paranoid type delusions which still manifest when I'm manic. I agree with the atypical label of depression, everyone I've interacted with that has been dxed with bipolar 1 or 2 has said how they sleep 20 hours a day, legs feel like lead, etc. I read somewhere the label of rapid cycling is a controversial term, and that what's really occuring is a mixed episode. Which doesn't hold true for me- I have truly euphoric manias that lead to a mixed presentation and go into your "atypical" depression. Well, I guess they say that the nature of bipolar disorder is it's variability. Take care.
This is the end of the thread.
Psycho-Babble Medication | 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.