Q: Could This Look Like BP II?
Dx with BP2 in Dec, 2000..but July while in counseling a psychologist
questiond my dx bc i show no signs of a manic side or hyomanic side or as
y ou described high energy state..having a neuropsych evail for reasons
not named again this was questioned if the dx was correct..
my question is Can Dysthmia occur with boughts of Majore depression added to
that anzeity(moderate to severe), look like Bipolar Two??
My pdoc will not listen to what Im asking and I have sence made an appt or a
second opinion and reevaluation. Depression causes insomnia which caues
irritibility which causes anger and arguements..Does this sound
possible is my question??
Dear DC --
Sounds like you're right on the dividing line between something that might be
called "bipolar" and something that is better thought of as
depression. You could see several different doctors and get several
different opinions, but I'd guess they'd all locate you right near this dividing
line. Of course there is no such line, but in our diagnostic system there
is; and one group of diagnosticians might put you on one side, another on the
other. Pretty soon I would guess it's going to come down to deciding which
to emphasize re: guiding treatment. If you've already had some trials of
antidepressants, and they either don't work; or work for a while and then stop
working; or particularly if they seem to make the anxiety or the insomnia worse
-- then it might be time to try the mood stabilizer route. Some people
think lamotrigine is a mood stabilizer with sufficient antidepressant activity
to "go both ways", i.e. work for either diagnostic emphasis (recurrent
depression or "soft bipolar"). I think it's a little early to be
sure; it's also early to look at thyroid as a treatment option, but at least
that one seems to have a low side effect risk if you don't get
hyperthyroid. Read about that option here.
Depression-insomnia-irritability-anger; hmm, some
people would call that menopausal if you were between 40 and 50 or so -- and
female. Anyway, "is that possible?" Sure. You're the
example of it, I gather. Doesn't really change the above analysis though,
in my opinion: i.e. it still leaves you right on that dividing line that doesn't
exist. Sorry if that's too obscure. My guess would be that you'll
eventually figure out what works best (including in terms of what perspective to
adopt) by trial and error from here.
Published November, 2001