Treatment questions for Bipolar disorder

Yellowfever · 10-19-2008, 12:11 PM

I have been recently diagnosed with level on of Bipolar disorder. My question is that do ALL people with bipolar disorder HAVE to get medication? I mean I have been down the medications route when I was diagnosed with depression. And I have to tell you that it is just more painful looking for the right medication, than not being on them at all. Of course I have my behavioral issues like getting angry and saying something cruel, I have worked on that and I am getting better at not being so mean. I have stopped cussing because it feeds into my anger and I feel better. To avoid depression I have actually avoided all sad movies, songs, news, and other things that might make me sad possibly.

Ok the point is I really am afraid of giving medication another chance because I have had an allergic reaction to zoloft, and I hate going through those 5 hour tremors I get when ever I try out a medications.

I no longer have tummy issues at the moment. I do not want the medicine giving tummy issues like the last time.
I guess I just wish I was normal.

Mari · 10-19-2008, 01:23 PM

Hi,
Welcome!

I wonder what you mean by calling your diagnosis "level one."

That is a little confusing to me.

Usually we say Bipolar 1 or Bipolar 2.

Bipolar 2 is more severe usually but the doctors have good meds for it.
Bipolar 1 is harder to treat (in my mind) but causes less disruption in people's lives.

There are overlaps between 1 and 2 of course. Some people move back and forth between them depending on the psychiatrist.

I'm not sure which one I am in fact. When I was diagnosed in the old days (

) pdocs did not make these kinds of distinctions.

Mari

Yellowfever · 10-19-2008, 02:11 PM

LOL Wow how frustrating. Why does it have to be so complicated. Does each doctor have their own way of naming things? I am glad I changed doctors thats for sure.
I do mean bipolar 1 however. I am afraid of medication. I know the pain they have given me.
I am not giving up on meds. But I am afraid.

Sharla

Quote:

Originally Posted by Mari

Hi,
Welcome!

I wonder what you mean by calling your diagnosis "level one."

That is a little confusing to me.

Usually we say Bipolar 1 or Bipolar 2.

Bipolar 2 is more severe usually but the doctors have good meds for it.
Bipolar 1 is harder to treat (in my mind) but causes less disruption in people's lives.

There are overlaps between 1 and 2 of course. Some people move back and forth between them depending on the psychiatrist.

I'm not sure which one I am in fact. When I was diagnosed in the old days (

) pdocs did not make these kinds of distinctions.

Mari

Mari · 10-19-2008, 02:56 PM

Quote:

Originally Posted by Yellowfever

And I have to tell you that it is just more painful looking for the right medication, than not being on them at all.

Hi,
It is totally up to you whether you want to be on medications or not.

But now that you have diagnosis you are dealing with a whole new ball game than you were when you were diagnosed with depression.

After three meds for depression fail to help you, the pdoc is supposed to re-evaluate the diagnosis. Are you saying that you went the on the med merry-go-round for depression and are not sure if want to do it for bipolar as well?

Some people get lucky and get good bp meds fairly soon. The big trick with bipolar is getting the diagnosis. Many people are un-dx'd or miss dx'd for years and years. Once the bipolar dx is made, they have a clearer path about what the right meds are.

Do you have a job or family-relations that are effected by your bipolar?

How are you sleeping?

Pdocs and insurance companies use the DSM to dx:

http://en.wikipedia.org/wiki/Bipolar_disorder

Mari

Quote:

Bipolar I

In Bipolar I disorder, an individual has experienced one or more manic episodes with or without major depressive episodes.

For a diagnosis of Bipolar I disorder according to the DSM-IV-TR, there requires one or more manic or mixed episodes. A depressive episode is not required for the diagnosis of Bipolar I disorder but it frequently occurs.

Bipolar II

Bipolar II disorder is characterized by hypomanic episodes rather than actual manic episodes, as well as at least one major depressive episode. There has never been a manic episode or a mixed episode.

Hypomanic episodes do not go to the full extremes of mania (i.e. do not usually cause severe social or occupational impairment, and without psychosis), and this can make Bipolar II more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing depression.

For both disorders, there are a number of specifiers that indicate the presentation and course of the disorder, including "chronic", "rapid cycling", "catatonic" and "melancholic".

.
.
.
Bipolar NOS

Bipolar Disorder Not Otherwise Specified is a catch-all diagnosis that is used to indicate bipolar illness that does not fit into the other diagnostic categories.
If an individual clearly seems to be suffering from some type of bipolar disorder but does not meet the criteria for one of the subtypes above, he or she receives a diagnosis of Bipolar Disorder NOS (Not Otherwise Specified).

Rapid cycling

Most people who meet criteria for bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months.
Rapid cycling, however, is a course specifier that may be applied to any of the above subtypes. It is defined as having four or more episodes per year and is found in a significant fraction of individuals with bipolar disorder. The definition of rapid cycling most frequently cited in the literature (including the DSM) is that of Dunner and Fieve: at least four major depressive, manic, hypomanic or mixed episodes are required to have occurred during a 12-month period.

Quote:

The experiences and behaviors involved in bipolar disorder are often not understood by individuals or recognized by mental health professionals,
so diagnosis may sometimes be delayed for 10 years or more.

That treatment lag is apparently not decreasing, even though there is now increased public awareness of this mental health condition in popular magazines and health websites.

Despite this increased focus, individuals are still commonly misdiagnosed.

An individual may appear simply depressed when they are seen by a health professional.
This can result in misdiagnosis of Major Depressive Disorder and harmful treatments. Recent screening tools such as the Hypomanic Check List Questionnaire (HCL-32) have been developed to assist the quite often difficult detection of Bipolar II disorders.

Mari · 10-19-2008, 03:15 PM

I found a link that explains the numbers from the DSM:

http://www.mental-health-today.com/bp/bi1.htm

Quote:

The diagnostic codes for Bipolar I Disorder are selected as follows:

1. The first three digits are 296.

2. The fourth digit is 0 if there is a single Manic Episode.
For recurrent episodes, the fourth digit is 4 if the current or most recent episode is a Hypomanic Episode or a Manic Episode, 6 if it is a Mixed Episode, 5 if it is a Major Depressive Episode, and 7 if the current or most recent episode is Unspecified.

3. The fifth digit (except for Bipolar I Disorder, Most Recent Episode Hypomanic, and Bipolar I Disorder, Most Recent Episode Unspecified) indicates the following: 1 for Mild severity, 2 for Moderate severity, 3 for Severe Without Psychotic Features, 4 for Severe With Psychotic Features, 5 for in Partial Remission, 6 for in Full Remission, and 0 if Unspecified. Other specifiers for Bipolar I Disorder cannot be coded.
For Bipolar I Disorder, Most Recent Episode Hypomanic, the fifth digit is always 0. For Bipolar Disorder, Most Recent Episode Unspecified, there is no fifth digit.

I hope that this helps.

Mari

Yellowfever · 10-19-2008, 04:37 PM

Quote:

Originally Posted by Mari

I found a link that explains the numbers from the DSM:

http://www.mental-health-today.com/bp/bi1.htm

I hope that this helps.

Mari

I was diagnosed by the psychiatric therapist bipolar disorder 1 296.6

So these feelings that will not go away is not really me dwelling it is a possible manic episode?

Yellowfever · 10-19-2008, 04:38 PM

Oh I forgot to mention that my cousin has bipolar 2
and That my mom has the symptoms but she refuses to get checked and was diagnosed years ago of depression.

bizi · 10-20-2008, 11:33 AM

HI there,
How is school going for you?
Do you go full time?
When do you see your new pdoc?
Good luck with that.
The internet is a great place to find friends but I also find that I can spend HOURS and HOURS on it obcessively. So I have to be careful.
I am also bipolar 1 and take lamictal as my mood stabilizer.
I love it.
It has anti depressant qualities and I can't take regular AD's because they cause mania in me.
bizi

Yellowfever · 10-20-2008, 11:42 AM

Quote:

Originally Posted by bizi

HI there,
How is school going for you?
Do you go full time?
When do you see your new pdoc?
Good luck with that.
The internet is a great place to find friends but I also find that I can spend HOURS and HOURS on it obcessively. So I have to be careful.
I am also bipolar 1 and take lamictal as my mood stabilizer.
I love it.
It has anti depressant qualities and I can't take regular AD's because they cause mania in me.
bizi

I take 15-18 credits per semester. School is going great I am just waiting for the grades now

So I am a full time or more than full time.
I get to see my new pdoc Friday Morning of this week.
I have taken AD before but the only one that really was not an issue for was paxil. It just made me tired all the time. I want to try out welbutrin however because i hear it works wonder!
My Mania is well. I can not explain it. I am still trying to catch myself when I get in that mode.

Fevah

bizi · 10-20-2008, 11:53 AM

Are you feeling depressed?
It sounds like you are doing great!
That is a very full load of classes!
Keep up the good work that you are doing!
bizi

Site Navigation

NeuroTalk Online Support Groups

Treatment questions for Bipolar disorder

NeuroTalk Forums