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Bipolar II – Really?

Is it Bipolar II – or just plain Bipolar Disorder not yet recognized?

Google “Bipolar” on the “news” tab and see what you find.  It is astounding how many semi-celebrities have come out and said “I have Bipolar Disorder”.  Unfortunately, the story is often about Bipolar II, which somehow makes it “better”.

Bipolar Disorder is still a serious stigma – prevents people from getting jobs and such.  Technically, as Bipolar Disorder is considered a disability, an employer who did not hire or fired an admitted bipolar patient based only on that fact would be in violation of the American Disabilities Act, but few people are willing to go to the carpet on that.  Plus there is the little issue of being “able” to perform one’s job.  I can perform a job if I am taking meds.  If I am off of meds, I become highly unreliable with a lot of other liabilities – risky behavior that I have decided not to discuss.

Only a couple of years ago, I was warned by a well-meaning family member against posting too much on social media about Bipolar Disorder – and this in his mind included “liking” too many Bipolar pages.  He was concerned about my ability to obtain a decent job.  I don’t know if I have a “decent “job today – I have made my own way which works out better for me – no boss to annoy, no dress code, nobody else’s time clock.  For the most part, I don’t worry about social media – I don’t think I will ever have a “real” job again – no more frequent flyer miles for me.

Bipolar 2I was once diagnosed as Bipolar II – but really, both the doctor and the therapist thought differently – they both knew that I had regular Bipolar Disorder but wasn’t ready to accept it.  Actually, I am pretty sure my doctor tricked me into taking Lithium for the first time by telling me that it would help boost my antidepressant activity.

In retrospect, I am astounded that I believed him since I know so much about medication – but I took the medication.  How many of these people really have Bipolar I Disorder and just don’t say so.

It is much easier for people to say and accept that they have Bipolar II.  In my opinion (which is obviously vast and knowledgeable – just kidding, no really), Bipolar II is a way of sliding by the real diagnosis.  As in “I have Bipolar Disorder but not really”.  “I have Bipolar Disorder but I am not crazy”.  “I have Bipolar Disorder but I am not dangerous”.  “I have Bipolar Disorder but I won’t embarrass you”.
When it gets down to it…wasn’t that true for all of us at one time?  Or at least didn’t we believe it at one time?  I still fit some of the criteria – I am “functional”, “productive”, “hypomanic” – except when I am not.

I often confuse my doctor when he asks how it is going by saying “good enough”.  What I mean is that I am not manic exactly, I am not depressed.  Actually it works better for me if I am teetering on the edge of mania.  If I am just crazy enough that I know that I am crazy – then I will keep taking my meds.  Because I forget.

I originally sought treatment for severe depressiondepression bad enough that I had to decide whether to kill myself or study (I had a big exam the next day).  In retrospect, I was actually in a mixed episode with plenty of energy but in a really bad mood.  Oh, and then there was the slight issue of the hypnogogic hallucinations which I denied at the time.  See, even if I know that I have Bipolar DisorderManic Depression – I still forget.

It would be easier for me to say that I have Bipolar Disorder but it is “just” Bipolar II.  I thought that too.

Melissa

What Type of Bipolar Disorder Is It?

Each bipolar disorder illness is unique!

Uniqueness of Bipolar DisorderWhen nearly anyone thinks about bipolar disorder, they think of the symptoms of “regular” bipolar disorder.  Not that any person with bipolar disorder is “regular” (and most would not want to be), but there are several different subtypes of bipolar disorder.

One big problem with bipolar disorder is that each illness is unique.  Psychiatrists may classify them into categories – but they don’t always fit.  Here are some case scenarios: (bipolar episodesbipolar groups)

•    Jennifer has episodes where she is extremely agitated and unhappy and never seems to sleep very much.  These periods seem to last for a long period of time – but can alternate with months where she is simply unhappy and doesn’t feel like doing anything.
•    Max has had periods of depression before.  A lot of times, they go away after a couple of months and then he seems normal but recently he “disappeared” for a couple of weeks after some really bizarre behavior.  His friends never knew that he was any kind of bipolar until he told them he had been at the hospital.
•    Ben has periods of depression that can last for several months but when he is not depressed, he is productive and seems quite outgoing.
•    Sandra’s mood state can switch erratically.  One day she is all about shopping and the next time you call her, she is still in bed at noon.   This is a constant issue – and you never know what you are going to get.

These are three examples of bipolar disorder that don’t seem to fit the “normal” pattern.  None of these patients seems to be “regular” bipolar.

Bipolar disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as:

Bipolar Disorder TypeBipolar I Disorder: manic or mixed episodes that last at least 7 days – or if manic symptoms are severe enough to need hospitalization.  This, usually, includes periods of depression that last at least two weeks.
Jennifer and Max both fit into this category.  Even though Max never had a severe manic episode, having a bipolar episode that warrants medical attention, he qualifies for the Bipolar I category.  Jennifer has mixed episodes – rather than euphoria or traditional mania – she has periods of “dysphoria” where she is agitated, irritable and irrational but with an excess of energy.

Bipolar II Disorder: depressive and hypomanic episodes in a pattern – but manic episodes are not severe.
Ben has Bipolar II disorder.  He has periods of depression that are debilitating, but his non-depressed periods are quite productive, and he doesn’t exhibit manic behavior.

Bipolar Disorder Not Otherwise Specified: (Bipolar Disorder NOS) symptoms of illness don’t meet any other group, but the symptoms are clearly not within the standard range.
Sandra has BP-NOS.  She is what is commonly called a “rapid cycler,” meaning that she switches back and forth from mania to depression much faster than other people with bipolar disorder.

There is also a very mild form of bipolar disorder known as cyclothymia.  It is a cyclical pattern of hypomania alternating with periods of mild depression.  Many people would not even realize this is a problem.

Bipolar disorder is hard to classify.  It may be easy to determine that someone has a problem – but the uniqueness of each bipolar case makes it more difficult for even a patient to identify with the diagnosis.  Each type of bipolar disorder is, usually, treated the same medically. With an anti-manic agent (Lithium), anti-epileptic (Lamictal, Depakote) or atypical antipsychotic (Abilify, Zyprexa) – and sometimes with an antidepressant.

Melissa Lind

Mental Disorders Failure to Take Medications Consistently

Don’t skip your meds – even if you are sick!

It is cold and flu season in the Northern part of the world, and though that isn’t the only time people get sick, it brings up an issue common in Bipolar disorder and other mental disorders.

Medication - Mental DisordersOne of the biggest problems in maintaining a level mood state or semblance of “normalcy” in people with mental disorders is the failure to take medications consistently.  In a lot of instances, mentally ill persons will stop taking the medication on purpose because they are “better” and “don’t need it”.

As mentioned many times before – this is, usually, done in secret. Without consultation with professionals, friends or family members who do not find out until someone with a mental disorder has gone “off-track” and had an “episode”.

But, another cause of medication non-adherence is forgetfulness. Forgetfulness wouldn’t seem to be a big deal as many medications are “forgotten” one day and resumed the next – blood pressure medicine, birth control pills, and antibiotics etc. All with each of their own ramifications.  In the case of the forgotten anti-depressant, anti-manic agent, anti-psychotic, a different set of events comes into play.

Mentally ill people may “forget” the first day but by the second day, the thoughts of “I am OK” start to intrude.  This may lead back to the first case of non-adherence where the patient then decides to quit purposefully taking their medication – obviously without telling anyone.

Mental MindWith your illness, you may not feel like getting up.  You may not feel like eating.  You may not feel like taking your medicine – but you should.  You must.  Even when your mental illness seems secondary to a physical illness, the medicine that keeps you functioning on a semi-even level is vital.  Allowing yourself to skip, even one day can ultimately cause a “relapse”.

If you skip today because you don’t feel good, you may skip tomorrow.  If you skip today and tomorrow, because you didn’t feel good, you will probably hear the voice that always says, “I am doing OK,” because you are OK – for today.  A week or two, maybe a month or two – you won’t be OK.  You haven’t been in the past and likely you won’t in the future.

No matter why you skip your meds – don’t.

There are legitimate medical reasons not to quit without supervision – such as drug withdrawal and increases in seizure potential which are real, unpleasant, and possibly dangerous. But the biggest reason is the same as it has always been.  Eventually, it will lead you back down the path, and you won’t know until you are already out of balance.

One of the biggest challenges for a bipolar or schizophrenic (or many other) patient is to ignore the impulse to give in to “See, I’m OK and I don’t need this”.  In your rational mind, you know that you do.  You may resent it, but you know.

You may have to remind yourself of how far you have come – and remind yourself that this wasn’t the first time that you had to dig yourself out of a mess.

Remember how it was, how awful it was, and how hard it will be the next time to recover.

Melissa Lind

The medicine that keeps you functioning is vital – even if mental disorders seems secondary to physical illness!

Depression and Exercise

Exercise can, in some cases, eliminate the symptoms associated with depression.

The energy creates more energy – a statement that is proved by science a long time ago.

Take a walk when you start to feel drowsy will perk you up and helps you get through the day without a nap. While this is a significant benefit of exercise, there are, of course, other benefits.

Naturally, you think that exercise is important for weight control, muscle tone, and even bone strength. But, did you know that exercise can also aid in the treatment of depression?

Exercise Improve MoodsWhen we exercise, endorphins are released in the brain. Those endorphins make us feel happy. Note that exercise is not in any way a cure for depression — the depression still needs to be treated by a doctor, and possibly with the help of a therapist, but exercise can lessen, and in some cases eliminate the symptoms associated with depression.

For the relief of depression symptoms, doctors recommend regular exercise for approximately 30 minutes, three to five times a week. You don’t have to go to the gym for a complete workout. Again, just taking a 30-minute walk will do wonders. The important thing is to get the blood flowing through your body.

Naturally, when one is depressed, they don’t feel like exercising, and 30 minutes of exercise may be asking a bit much — at first.
However, even 10 minutes of exercise will improve your mood, although you won’t feel any long-term effects from such a small amount of exercise.

Despite this, if you can’t muster 30 minutes of exercise right out of the gate, start with smaller amounts of exercise time and slowly work your way up to a full 30 minutes.

Not only will exercise improve depression symptoms by releasing endorphins, it will also help you to sleep better at night, which also helps with the treatment of depression.

Depression needs to be treated by a therapist, or with the help of a doctor

The Experience of People with Mental Health Problems

Volunteers for a study to examine: The Experience of People with Mental Health Problems.

 The Univeristy of ManchesterI am at the University of Manchester working on a project that is investigating experiences of people with mental health problems in order to develop interventions to challenge mental health stigma. Previous research has shown that stigma is one of the greatest challenges facing people with mental illness.

I am writing to you because I would very much like your members to take part in my study. My study involves filling out a questionnaire, which includes questions regarding perceived stigma, sleep, and mood. Your participation is entirely voluntary and you can withdraw at any time with no penalty to you. This study will last 30 minutes.

Participation in this study will be greatly appreciated, as help from people with mental health problems is indispensable and greatly valued.

The study has been granted full ethical approval from the University of Manchester’s Senate Committee on the Ethics of Research on Human Beings. All data collected will remain anonymous and confidential at all times. More information can be found in the attached Participant Information Sheet. I have also attached the questionnaire for you to read through.
I have included a web link to my online questionnaire; if you agree to take part in my project could this link please be distributed to your members.

Thank you very much in advance for your consideration. Please do not hesitate to contact me if you require any additional information.

I look forward to hear from you!
Yours sincerely
Farrah Stephenson

Web link to Questionnaire: http://www.psych-sci.manchester.ac.uk/

The Experience of People with Mental Health Problems

Taking Teenage Depression Seriously

Dealing with Teenage Depression

serious young girlDepression is widespread. International studies have flagged it as one of the most devastating diseases on the face of the planet. Although no one is immune to the ravages of depression, certain demographics are more likely to suffer from the illness than others. Such a vulnerable group is the teenaged population. Statistics illustrate that incidences of depression are disproportionately common among young people and too often are accompanied by serious consequences.

Teenage depression is too often (and too easily) dismissed in many cases as being nothing more than an emotional “growing pain.” It is true that the changing nature of the body`s hormonal makeup, combined with encountering new dimensions and responsibilities in one`s life can induce some depressive symptoms in teenagers who are, in reality, perfectly healthy. However, that is not always the case, and any potential case of teenage depression must be taken extremely seriously.

Not every child who is in a down mood has a bona fide case of teenage depression, of course. The demands and social pressures placed upon teens can cause down moods in perfectly normal children. Children who experience these down periods for more than a few weeks at a time, or display other common symptoms of depression should be carefully evaluated in case a mere physical mental health problem does occur.

Changes in appetite, alterations in sleep habits, increased anxiety or irritability can be a host of other potential warning flags. If one is demonstrating sadness or despair, it might be a sign of teenage depression and must be checked. One should also check for other readily available diagnostic aids and lists of depressive symptoms for further guidance.

The consequences of overlooking the disorder are essential. Initially, the condition does deny individuals of a potentially high quality of life during a crucial developmental stage. Additionally, younger people have not yet necessarily developed the kinds of coping mechanisms and wider perspectives adults can use when dealing with depression. This lack of coping tools is one reason why teenage depression tends to result in a greater propensity for suicide than does its adult counterpart.

Kids will be kids, and part of being a growing kid is moodiness. Sometimes, that moodiness will manifest itself as a simple case of the “blues.” Fortunately, even more severe situations of this nature often tend to pass in a few weeks as the situations spurring them fade into memory. However, when the episodes seem even slightly emotional or last longer than two weeks, a serious case of teenage depression may be present.

If there is any possibility that your teenager is depressed, consult with a medical professional as soon as possible. The potential consequences of this mental health problem are sufficiently severe to justify and heightened level of concern and a willingness to err on the side of caution. It might be nothing, but it might be teenage depression.

A helpful recourse? Helping Your Depressed Teenager: A Guide for Parents and Caregivers

Helping Your Depressed Teenager

Description:

“The authors have produced a very readable, extremely well informed and comprehensive book that will add greatly to the knowledge base of interested parents. This book is strongly recommended.” –Stewart Gable, MD Chairman, Department of Psychiatry The Children’s Hospital, Denver, Colorado You supported and encouraged them as they grew from toddlers to teens.

Now you are confronted with one of the toughest challenges you and they will ever face – teenage depression.

Adolescence is a period of peaks and valleys. Most teens negotiate these years with relative ease; yet for some these times are treacherous with countless pitfalls. When depression ensues, it can interfere with much of your child’s potential. Clinical depression is now epidemic among American teens, and teen suicide can be a deadly consequence. Helping Your Depressed Teenager is a practical guide offering family solutions to a family problem. This book will sensitize you to the hidden struggles of adolescents and assist you in understanding their multifaceted problems.

The authors are experts in this field and have helped countless youngsters confront and overcome their depressed mood. In a highly readable and gentle manner, they help you see behind the “masks” of troubled teens who attempt to hide their true feelings. They help you distinguish the subtle and sometimes not so subtle signs that something is seriously wrong. And they help you provide the loving support and assistance teenagers need to make it through this difficult life passage. Some of the useful information provided:
* What families can do to prevent teen depression
* How to tell the difference between moodiness and depression
* How to read the warning signs of a troubled teenager
* How to know when professional help is needed and where to find it
* How to choose the right treatment options for your teen