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Old 02-21-2009, 02:48 PM   #1
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Any Opinions?

Hi everyone,

I heard that the new version of the DSM is set to be released in 2012 and will list every type of bipolar under the category of "bipolar spectrum disorder" (BSD). What do you think about this? On one hand, I believe this would be a good thing since it would help eliminate alot of the confusion people have about bipolar given how many different types there are. On the other, I fear that all of us will get lumped together to the point where pdocs stop looking at our individual symptoms and how each of us experiences bipolar differently.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

Last edited by dreams in neon; 02-21-2009 at 02:50 PM.

 
Old 02-21-2009, 05:30 PM   #2
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Re: Any Opinions?

I kind of agree with the lumping together theory. I've asked my pdoc why he doesn't call my BP I or II, and he says why? you have severe suicidal BP depression, do you want me to add a number to that? Makes sense to me.

Kat

 
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Old 02-21-2009, 05:49 PM   #3
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Re: Any Opinions?

I guess I have a problem with pdocs lumping us together because it would be too easy for them to not look at our individual symptoms as a unique entity. Your case is pretty obvious given the fact that you have severe suicidal depression, but what about people like me who also have difficulty with auditory hallucinations, delusions and paranoia which are not your "standard" symptoms when it comes to BP unless you have BPI or II with psychotic features, atypical bipolar or schizoaffective. I also worry that it may not account for rapid cycling which can be difficult to treat. Kat, how does your pdoc submit to insurance if he doesn't include a numeral for your BP diagnosis? Does he indicate that you are BP NOS? My pdoc lists me as being atypical bipolar I with rapid cycling. I guess in the end labels don't really mean anything as long as a person's symptoms are treated, but I do worry that taking all of the different kinds of BP and throwing them under one umbrella will cause many people to fall through the cracks and not be treated for the specific symptoms they have.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

Last edited by dreams in neon; 02-21-2009 at 06:41 PM.

 
Old 02-22-2009, 04:04 AM   #4
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Re: Any Opinions?

Quote:
Originally Posted by dreams in neon View Post
Hi everyone,

I heard that the new version of the DSM is set to be released in 2012 and will list every type of bipolar under the category of "bipolar spectrum disorder" (BSD). What do you think about this? On one hand, I believe this would be a good thing since it would help eliminate alot of the confusion people have about bipolar given how many different types there are. On the other, I fear that all of us will get lumped together to the point where pdocs stop looking at our individual symptoms and how each of us experiences bipolar differently.
i just wish they would come up with one or two pills that would work even if the combos would be different for each individual. i'm on lamicatal, abilify, thyroxine, xanax, lexapro and klonopin. have tried, lithium, mannerix, amytryptiline, lustral, cipramil, seroxat, prozac, effexor xl, anafranil and more over the years and am tired of all the changes i get to make because of being so med resistant. luckily am med compliant and prepared to give each new one a try in the hope of finding ones that work for me! my pdoc has not really given me a definitive diagnosis either. dysphoric mania seems to be the one that fits as i dont have the really manic highs. i do think that a one for all sizes dx would maybe effect the realisation that the disease manifests itself in so many different ways. i have had several suicide failures, suicidal ideation all the time. the kids have kept me going so far. the act for people is getting harder and harder all the time. current meds give me at least a few hours break during day which is the biggest improvement i;'ve had in thirty years. sorry to ramble!

Last edited by irishwriter; 02-23-2009 at 02:46 AM.

 
Old 02-22-2009, 04:28 AM   #5
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Re: Any Opinions?

irishwriter,

Kat has often told me that she doesn't know how I cope with being manic and rapid cycling so much. I have to say the same thing to you. I had a mixed state a few days ago and really had a difficult time because I hated feeling manic, depressed and tired at the same time. All I wanted was to either feel manic or depressed, but not both. Someone on another board nearly confused the heck out of me after claiming that I had mixed states. When I checked with a good friend of mine who is very knowledgeable about BP, she told me no, what I had described (in terms of my rapid cycling) was clearly mania -- the difference was that I migrated from mania to depression to anger/irritability back to mania before the entire cycle repeated itself, but in an entirely different pattern. I'm glad she cleared that up for me because my tdoc as well as the pdocs I've had while IP have always said that the fact I feel extremely happy at the beginning of a manic episode, depressed during the middle and extremely angry/irritable towards the end represented a manic episode. I shouldn't be surprised though. This is the second time this person gave me the wrong information about BP. He likes to think he knows more than he does, but what he actually ends up doing is confusing people. If he can confuse me after I've been researching BP and schizoaffective for the past 3 years, just imagine how confused someone who is new to the diagnosis is.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
Old 02-22-2009, 09:15 PM   #6
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seaturtle HB User
Re: Any Opinions?

Hi<

Lumping bbps together is a really bad idea. I have heard, though, that within that spectrum classification, they are going to list all the subtypes, including (in my opinion) people who may show mild signs of bp.

It seems that a lot of people are being diagnosed with it who really don't seem that ill. Around here, it has become the Mental Illness du Jour, along with DID.

What I am afraid of is that with a switch in diagnostic labels, the treatment will be off.

Seaturtle

 
Old 02-22-2009, 10:20 PM   #7
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dreams in neon HB Userdreams in neon HB User
Re: Any Opinions?

Seaturtle,

That's what I'm afraid of too. However, I am happy to hear that the DSM will list subtypes of BP. One of the reasons I'm so concerned about this is because there are so many different symptoms of BP. My BP includes rapid cycling, auditory hallucinations, delusions and paranoia. If they were to omit the subtypes, where would that leave those of us who don't experience the "typical" symptoms of BP? I'm not sure if I agree with including people in the DSM classification who experience mild signs of BP. When you think about it, all of us exhibit hypomania, depression and anger to some degree, so how do we separate "normal" behavior vs. "BP behavior?" I do agree with you though that BP seems to be the diagnosis de jour. I know that my pdoc's office gives people a mood questionaire which is designed to target clients who have BP, but I wonder if some people are overly diagnosed because they think a *little* excitement, happiness, depression or anger means that they are BP.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

Last edited by dreams in neon; 02-22-2009 at 10:22 PM.

 
Old 02-23-2009, 02:44 AM   #8
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irishwriter HB User
Smile Re: Any Opinions?

Quote:
Originally Posted by seaturtle View Post
Hi<

Lumping bbps together is a really bad idea. I have heard, though, that within that spectrum classification, they are going to list all the subtypes, including (in my opinion) people who may show mild signs of bp.

It seems that a lot of people are being diagnosed with it who really don't seem that ill. Around here, it has become the Mental Illness du Jour, along with DID.

What I am afraid of is that with a switch in diagnostic labels, the treatment will be off.

Seaturtle
hi seaturtle, good to hear you. hope you are doing ok??

 
Old 02-23-2009, 02:51 AM   #9
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irishwriter HB User
Re: Any Opinions?

Quote:
Originally Posted by dreams in neon View Post
irishwriter,

Kat has often told me that she doesn't know how I cope with being manic and rapid cycling so much. I have to say the same thing to you. I had a mixed state a few days ago and really had a difficult time because I hated feeling manic, depressed and tired at the same time. All I wanted was to either feel manic or depressed, but not both. Someone on another board nearly confused the heck out of me after claiming that I had mixed states. When I checked with a good friend of mine who is very knowledgeable about BP, she told me no, what I had described (in terms of my rapid cycling) was clearly mania -- the difference was that I migrated from mania to depression to anger/irritability back to mania before the entire cycle repeated itself, but in an entirely different pattern. I'm glad she cleared that up for me because my tdoc as well as the pdocs I've had while IP have always said that the fact I feel extremely happy at the beginning of a manic episode, depressed during the middle and extremely angry/irritable towards the end represented a manic episode. I shouldn't be surprised though. This is the second time this person gave me the wrong information about BP. He likes to think he knows more than he does, but what he actually ends up doing is confusing people. If he can confuse me after I've been researching BP and schizoaffective for the past 3 years, just imagine how confused someone who is new to the diagnosis is.

dreams.

am lucky that i don't have the anger (but i think that was bred into me and get incredibly hyper sensitive and hurt really easlily which spirals me down into deeper depression and weeks to get over where another person can shrug it off) or irritability (rarely anyway!!!) it is the mood swings that really send my mind off in all directions! lexapro at 20 really sent me 'off the wall'. now on ten but so tempted to cut it out altogether as i feel it has no effect at such a low dose. is the med help you were talking about. mood trackers are great but i just got tired of ticking the same boxes all the time for horrible mood etc.. it is also funny that all of us who have bp do so much research that we can tell the pdocs things that sometimes they wouldn't even think of although my pdoc was not impressed by my research into ect and my absolute refusal of it.

 
Old 02-23-2009, 04:12 AM   #10
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Re: Any Opinions?

irishwriter,

When I spoke to my pdoc yesterday, I asked him what he thought about using a mood checker and bringing the results to our appointment. He said it would be a good idea especially since it would help him identify moods that are of a certain intensity and duration. I'm not sure how effective it will be in my case since I rapid cycle so quickly, but now that I'm on Clonazepam to help control it, perhaps my moods will become more stable overall. I'm so fortunate to have a pdoc and tdoc who believe in the power of the Internet and message boards. I remember telling my tdoc that I participated on a BP message board (here) and worrying that he would scold me and tell me that I should only follow the advice of a tdoc or pdoc. To my surprise, he responded by telling me what a positive experience it could be by allowing me to reach out to others who have BP. One thing I've found is that this board helps take my mind off of my immediate problems and allows me to focus on others rather than myself for a change.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

Last edited by dreams in neon; 02-23-2009 at 04:19 AM.

 
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