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Bipolar II Rant from a Bipolar I

Ranting on Bipolar II

For starters – this is a pure opinion piece.  I am going to rant a bit about Bipolar II.

I read a lot of bipolar “stuff” – articles, study results, chat boards, Facebook pages – a lot.  Recently, once again, I have become irritated by the use of “Bipolar II”.

I recognize that Bipolar II is a DSM diagnosis that indicates that a person has cyclical periods of depression alternating with Bipolarity in Hellhypomania.  I know that is true – and that the diagnosis must fit some people. Bipolar I, on the other hand, is defined as cyclical periods of depression, alternating with manic episodes.  If you are a rapid cycler or have mixed state disorder – you are usually classified as Bipolar I.

My current irritation is with a story – not a celebrity this time – but an apparently real person from a news story.  The article reports that this particular woman had been diagnosed with Bipolar II when she was 20 and now 38, she is stable on a myriad of pharmaceuticals.  Fine.

The article goes on to say that she “experiences the manic phase” but mostly struggles with the severe depression, adding that she also has PTSD, anxiety and has been unemployed most of her life.  Let me repeat, she has manic phases, PTSD, and anxiety. She has always been unemployed (due to her psychiatric condition).  Doesn’t sound very stable to me…and doesn’t sound much like Bipolar II.

I have a problem with the fact that so many stories I read are about people who claim to have Bipolar II, and are careful to clarify that they don’t have Bipolar I.  Naturally, this would be a kinder, gentler form of Bipolar disorder.  A Bipolar disorder where we never bother anyone, get lots of stuff done in an organized fashion but sometimes get depressed.  A Bipolar disorder that makes us “better”.  Better than Bipolar I’s craziness – and even better than regular people.

I don’t live in that world, and I am not truly convinced that it exists.  I have known lots of people with Bipolar disorder – in fact, I used to go to a group just for people with Bipolar disorder.  Every single person there was initially told they were Bipolar II – and then once they got used to that… the real news came out.

Many of us were “high functioning”, many of us had “good jobs”, many of us were “organized”… except when we weren’t.  We didn’t come to the bipolar group because things were going great.  We had all had periods of depression, periods of extreme productivity and periods of crazy when we told the truth.

Bipolar RantIn my experience, people with Bipolar disorder don’t seek help.  They are driven to it – or dragged.  People are driven to help when they are depressed, and they are dragged to help when they are manic.  If they arrive when depressed, they don’t report the mania that gets them a Bipolar II diagnosis.  If they arrive when they are manic – they won’t listen to anything about “crazy manic depression” so they are told about how much better Bipolar II is.  They will take the diagnosis and take the meds.  Either way, the first diagnosis is probably going to be Bipolar II.

I could claim to be Bipolar II.  I could even get a couple of doctors to agree with me.  Most of the time, I am “high functioning” – except when I am not.  Bipolar I won’t ever lose the stigma if Bipolar II continues to be presented as “better” and people continue to be dishonest.

Take your meds!

Melissa Lind

Critiques of Depression Medication

The use of depression medication in the treatment of mental illness is at an all-time high.

Depression MedicationThere is no reason to believe it will decline in the foreseeable future either. Depression diagnosed with increased frequency and antidepressants are the most popular means of treating the disorder. Antidepressants are extremely popularly. There are those, however, who are against using depression medication.

Some argue that the research support the effectiveness of the pharmaceuticals is over influenced by the financial interests of large pharmaceutical companies. They maintain that any statement of depression medication effectiveness should be disregarded because of the corrupt nature of the medical industry. Some may temper that perspective, arguing instead that the effectiveness of the pills is heavily overstated and over prescribed.

There are strong arguments to be made that the medical-governmental-industrial complex tends to be self-perpetuating and may not always have the greater good at the forefront. However, the wholesale rejection of available evidence based on bias is not particularly compelling to most analysts.

Even those who think less conspiratorially may oppose the use of depression medication. One common argument raised by objectors is that the medicines do not get at the root of the disease and instead act merely to mask its symptoms. They may state that it will be more difficult curing the disease and eliminating its triggers by masking the effects. They recommend therapy-based treatment programs to get to “the heart of the problem” instead of treating the issue with medication.

Others maintain that depression medication is simply too mysterious to be embraced. They argue that no one truly understands why the medications work and that, thus, there is reason to be concerned about what they may be doing to the mind of the patient. It is true that no one truly understands exactly why all antidepressants tend to produce the results they do. However, scientific research is beginning to reach more solid conclusions, which may render this objection outdated, in the near future.

Others opposed to the use of antidepressants base their arguments on religious beliefs or assessments of the severity of potential side effects associated with the use of drugs.

Critics of antidepressants offer alternative means of treatment. They often support aggressive therapy-based solutions, the use of improved nutrition and other acts in order to fight off the symptoms of a depressive disorder. Many advocate non-traditional treatment methods or more ancient practices designed to improve mental health.Healing in Present Moment

Despite a large chorus of detractors, however, the use of antidepressants continues unabated. The best available scientific evidence indicates that they are among the most successful treatment options, and doctors are prescribing the medications in increasing numbers every day. It would appear as though there is little likelihood that, in the near future, critics will restrict the use of depression medication.

Vagus Nerve Stimulator as an Anti Depression Device

Vagus Nerve Stimulator as an Anti Depression Device

Anti depression tools are rare.

There is, of course, therapy. Electroshock therapy can sometimes be effective but has largely fallen out of favor. Otherwise, those treating depression is limited to the use of antidepressant pharmaceuticals to deal with the disorder. After those three options are exhausted, few alternatives exist. That may soon change. The United States FDA (Food and Drug Administration) is considering approving the vagus nerve stimulator, an electronic device that is implanted in the chest of a patient, as a means of tackling depression.

Vagus Nerve StimulatorThe nerve stimulator is somewhat akin to a pacemaker. Wires run from it to the neck, where a nerve connected to the brain in stimulated. The vagus nerve stimulator has been used to treat epilepsy, but now its manufacturer is arguing that it can be used to effectively as an anti depression tool for many patients who appear to be resistant to medications.

The issue of approving the vagus nerve stimulator for use in combating depression is somewhat controversial.

Critics complain that there is little hard evidence to suggest that the device has a significant chance of success. They point to studies that question whether the vagus nerve stimulator is a more effective anti depression tool than placebos. They also note that even the proponents of the stimulator are not even sure why the product might serve an anti depression function. In fairness, the critics will concede that the same study did show a significant improvement in mood and disposition for some patients. Most, however, did not experience a notable change in their condition. Only seventeen of over one hundred participants in one study noted any positive change. Among who underwent and implant but never had the device turned on, eleven reported improved moods. Backed by testimonials by those who found the nerve stimulator to be a credible anti depression tool and a paucity of alternative treatment regimens for those who are medically-resistance, the device is inching closer and closer to approval despite the somewhat shaky nature of available evidence.

Cycle of depressionThere seems to be limited negative repercussions associated with the use of the vagus nerve stimulator. This means; in situations where other interventions have failed, it may be an option worth pursuing. Depression is a growing epidemic, and the limited number of treatment tools available to practitioners to treat the disorder can be problematic, especially in cases where a depressed patient fails to respond to the use of popular antidepressant medications. All predictions indicate that the number of depression diagnoses will continue to move upward at a rapid pace. In the near future, another tool may be available to deal with depression: the vagus nerve stimulator.

Although the overall effectiveness of the implant is still in question, its effectiveness for some patients may encourage its “last case” used for some patients seeking an anti depression product.