Category: diagnosis

Mixed Bipolar Disorder – Mixed Mood Episodes in Bipolar 2

Posted by Natasha Tracy | Aug 10, 2011

As I mentioned, mixed moods are technically considered part of the manic phase of bipolar disorder and thus, by definition, are only a part of bipolar disorder type 1. However, those of us with bipolar type 2 can tell you we mix it up with the best of them.

So, in part II of this series on mixed moods in bipolar disorder, I look at mixed moods in bipolar type II.

Mixed Moods in Bipolar Type II

Now that we’ve wandered into Diagnostic and Statistical Manual (DSM)-free territory, definitions on mixed states get a bit looser.

Mixed mood states may be, in fact, the most common way of experiencing bipolar type II. I find most people have a hard time distinctly separating “depression” from “hypomania” from “normal” moods. There is just too much crossover.

Two Types of Mixed Moods in Bipolar Disorder

Additionally, considering mixed moods to be part of the manic phase of bipolar disorder becomes useless when looking at bipolar II. As an article in Psychiatric Times suggests, there are really two types of mixed moods in bipolar disorder:

Mixed mood with depression as the primary mood (meeting the criteria for depression with some hypomania symptoms present)
Mixed mood with hypomania as the primary mood (meeting the criteria for hypomania with some depression symptoms present)

Those two mood types better reflect my own experience and I think the clinical experience of other patients and doctors.

My Bipolar Symptoms Aren’t Your Symptoms: I’m More Bipolar Than You

Posted by Natasha Tracy | Sep 24, 2010

If you’ve been reading me for a while, you’re probably familiar with the symptoms I typically experience as a bipolar:

Fatigue
Sadness / depression / tearing
Hypersomnia
Anhedonia
Lack of motivation / concentration
Slowness in thinking
Thoughts of death
Decreased need for sleep
Excessive speed talking / thinking
Increased productivity

Each symptom depending on the mood of the moment (blue being depression, yellow being hypomania).

However, did you know that someone’s list might look like this:

Irritability
Weight loss
Insomnia
Restlessness. agitation
Feelings of guilt
Indecisiveness
More goal-directed activity
Spending sprees
Inflated self-esteem

That is totally different from my list, and yet we’re still both bipolar. The diagnosis “bipolar” is more of a big-tent thing. It’s the clumping of people with group of symptoms into a group called bipolar, but each person in the group is still unique.

Is Multiple Personality Disorder Real? – Dissociative Identity Disorder

Posted by Natasha Tracy | Sep 23, 2010

Since Sybil was published in 1974 I think people have been fascinated by multiple personality disorder, now known as dissociative identity disorder or DID. We see dissociative identity disorder on TV and in movies fairly frequently. I didn’t kill her, my alternate personality did.

And yet many people, doctors included, feel that the mental illness doesn’t really exist. I’m fascinated by someone having a disorder that the medical community can’t even agree exists (although keep in mind, dissociative identity disorder is in the DSM-IV).

I admit to having no idea either way and being terribly uneducated on the subject. Luckily for me, there is a new Blogger Holly Gray at HealthPlace that writes on just such issues in her blog Dissociative Living.

Newly-Diagnosed Bipolar – What to Do

Posted by Natasha Tracy | Aug 13, 2010

One of the things that happens because I write about bipolar disorder so much, is that people ask me a lot of questions about what they should do with their bipolar treatment. I understand this. People feel like they don’t know what to do. And often people just don’t have a good relationship with their doctor/psychiatrist.

No One Can Make Mental Illness Treatment Decisions But You

The thing is, I can’t tell you what to do with your mental illness treatment. I can give you information, I can try to help, I can suggest reliable, mental health resources, but you have to make the treatment decision. It’s a scary thing I know. I still hate it myself.

And the people who have it the toughest are the ones who have just been diagnosed with bipolar disorder or another mental illness. So here’s what I suggest you do if you’ve just been diagnosed with bipolar disorder.

Dimensional Diagnosis of Mental Illness

Posted by Natasha Tracy | Apr 23, 2010

There is a recognition among many of us crazies, as well as the professionals that treat us, that most of us do not simple fall into one camp – we’re bipolar with a hint of ADD; we have a borderline personality disorder with depressive and psychotic features; we suffer from schizo-affective disorder with post-traumatic stress disorder (PTSD) and addiction mixed in. Humans are complex, and their brains even more so.

My Depression Isn’t Your Depression

And what’s more, my depression isn’t like your depression. In fact, so much so, that using the same word is almost nonsensical. I sleep 15 hours a day, but you only sleep 3. I have a successful job, but no family or friends. You have neither but participate in online support groups 10 hours a day. I think about killing myself every day but you actually plan for it once a week. You never cry but I cry all the time. Are we the same? Am I more depressed than you, or less?

And things get more complicated when you compare personality disorders and bipolar and ADD and PTSD combined with comorbid conditions like addiction. And yet somehow we’re supposed to suss this all out, find a label, and a treatment that goes with it. That’s pretty tough.

Psychiatric Disorders in Children – Diagnosed and Medicated

Posted by Natasha Tracy | Apr 20, 2010

I have bipolar-disorder-type-II-ultradian-cycling. I diagnosed myself when I was 20 years old, and once I finally agreed to see a doctor, he agreed sometime thereafter. My diagnosis was fairly easy for me. I’m very self-aware and I could pick out discrete moods and swings. But as a 20-year-old, in university, using research, and having a fairly high IQ, this is not terribly surprising. If I were five-years-old, the picture would have been a little different.

Epidemic of Children Diagnosed with Mental Illness

There is an epidemic of children, as young as two, being diagnosed with psychiatric disorders in North American right now. It’s made the cover of Time magazine and countless articles have been written on the phenomenon.

So, Antipsychotics are Now Approved for Children

It was once thought that disorders like bipolar did not occur before adulthood, but thoughts on this seem to be changing as diagnoses go up and more drugs are approved for treatment of children.

Antipsychotics FDA-approved for use in children (under 18) is:

Quetiapine (Seroquel) – schizophrenia, ages 13-17; bipolar I, ages 10-17
Olanzapine (Zyprexa) – schizophrenia and bipolar I, ages 14-17
Risperidone (Risperdal) – schizophrenia, ages 13-17; bipolar mania, ages 10-17; autism, ages 5-16

And so on. And of course, doctors are free to prescribe any medication off label to children just like adults.

Physiological Causes of Depression – Surgeon’s General Report

Posted by Natasha Tracy | Jul 6, 2009

I like to think I know almost all there is to know about mood disorders, but I was pretty shocked when I read this:

The Surgeon’s General Report

Differential Diagnosis
Mood disorders are sometimes caused by general medical conditions or medications. Classic examples include the depressive syndromes associated with dominant hemispheric strokes, hypothyroidism, Cushing’s disease, and pancreatic cancer (DSM-IV). Among medications associated with depression, antihypertensives and oral contraceptives are the most frequent examples. Transient depressive syndromes are also common during withdrawal from alcohol and various other drugs of abuse. Mania is not uncommon during high-dose systemic therapy with glucocorticoids and has been associated with intoxication by stimulant and sympathomimetic drugs and with central nervous system (CNS) lupus, CNS human immunodeficiency viral (HIV) infections, and nondominant hemispheric strokes or tumors. Together, mood disorders due to known physiological or medical causes may account for as many as 5 to 15 percent of all treated cases (Quitkin et al., 1993b). They often go unrecognized until after standard therapies have failed.

(bold mine)

I’m shocked. No one ever mentioned anything about birth control pills to me and I’ve been on them for years. YEARS. This is yet another reason why doctors so often get on my bad side.

This quote was taken from the Mental Health: A Report of the Surgeon General. The whole report is a good read, but very long. It’s everything you wanted to know but didn’t know you needed to ask.

I’m disgusted.