Complex PTSD or Soft Bipolar?
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Q:  Complex PTSD or Soft Bipolar?

My doctor is looking into "soft bipolar" as a reason for my continual "poop out" on other antidepressants.  My questions is how does one know whether or not you have complex PTSD or soft bipolar?

Thank you.

Dear Cherie -- 
That's a fair question, as there's quite a bit of overlap (phases of agitation, severe sleep disturbance, inability to concentrate, irritability; plus depression, low energy, avoiding things like social contact in some circumstances). But bipolar should be more "ups and downs" where PTSD is more fundamentally a problem with anxiety. Trick is to learn more about each of these and keep trying them on to see what fits better as you learn more. It would be more urgent to figure this out if the treatments weren't so similar. In some respects that main reason to figure out which one it is, is to make sure it's not bipolar disorder before you put antidepressants in there, as the risk of a bad reaction to them is higher if that's the case. But you've already been there. The psychotherapy approaches are somewhat different, if you have a good therapist who knows enough to know PTSD-specific and/or bipolar-specific therapies, of which there are several each. Good luck figuring that out. 

Dr. Phelps

Published January, 2007

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