A More Nuanced View of Hypomania
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- เผยแพร่เมื่อ 21 ก.ย. 2017
- Dr. Phelps will discuss a view of bipolar disorder that is increasingly accepted among mood specialists: rather than “does he/she have bipolar disorder?”, the better question is “how bipolar is he?” or “ How much bipolarity does she have?” The yes/no approach to bipolar diagnosis that has dominated psychiatry for decades is finally giving way to a more nuanced concept of bipolarity. Depression is a common ingredient across the spectrum of mood disorders: but between Major Depression and clear-cut Bipolar Disorder, there are many people who clearly have something more than plain unipolar depression. They might have a family member with Bipolar I; or highly recurrent depressions; or an obvious post-partum depression; or, commonly, a very negative reaction to an antidepressants. But in the official rule-book of diagnosis, the DSM, they can’t have “Bipolar Disorder” unless they have had hypomania or mania. So, how subtle can hypomania be? How little can one have and still be “bipolar?” Does it matter, in terms of treatment? (For many people, you bet it does…).
I experience mixed states. It is brutal. I'm all worked up but stuck in one spot at the same time. My irritability is uncontrollable to the point where I'm afraid to go out. There's no way I could be around people. There is way too much stimulation. It's like anxiety and depression at the same time but not really. I obsess over the feelings. That's all I think about over and over and over and over. It's been difficult to deal with. Right now, my mind is quiet, which only happens about once every 3 months. It's like I wake up for a while out of no where. Then, back to being locked down by my mind's activity.
Me too brother!! I wish you the best..
I had read few papers about bipolar disorder and watched dozen lectures on TH-cam, but this webinar increased my knowledge but doubled my understanding of bipolar.
Something I don't agree with is that mania and hypomania are common. Of course practically everyone has “mood swings”. But if you ask "does your mood go so far down you feel suicidal? And do you get ups that are so pronounced you're disinhibited and people think you've been drinking or taking drugs? Or you're acting out of control?" then nearly everyone will say no! Until I got diagnosed with type 1 bipolar aged 38 I had never had a personal friend or anyone in my social circle with obvious bipolar or cyclothymic moods. Not one person.
I had a friend with severe borderline personality disorder. Of the 40 or more hospitalisations over 10 years, only a handful of people in these psychiatric units had florid mania (maybe 5 people over TEN YEARS, and she always made a point of introducing us). So it just isn't true that bipolar is extraordinarily common. Not full-on bipolar!
Thank you Doc Jim Phelps. Your books and website have been of great value to me as a patient. You are doing God's work sir keep it up please.
Dr. Phelps is fantastic! Greetings from Brazil!
How can I tell if I'm just feeling confident and optimistic or am hypomanic? Nuance is difficult, and severity of actions make diagnosis tricky.
paul mryglod I wouldn’t over analyze. If you’re sleeping less and/or just feel euphoric or extremely irritable, and this happens episodically and seemingly out of nowhere and not generally triggered by external events, that’s quite possibly hypomania. Either way, I’d see a mood disorder specializing therapist and they’d hopefully be able to tease this out of you.
it feels like you are HIGH you will notice it as if you were doing drugs, you feel like maybe you can take on the world or flying
If you're acting out of character, if you're saying or doing things you regret afterwards, if people think you're high or you've been drinking when you haven't, those are the big warning signs. I had bipolar symptoms for years with obvious depression but less obvious manic type symptoms. I suspected I was bipolar mainly because I overreacted to antidepressants. A friend of mine told me categorically I was bipolar (based on my behaviour all the time, I wasn't quite sure what behaviour she had in mind but she was absolutely certain I had bipolar.) Anyway I never got the label until I went into psychotic mania aged 38 after at least 20 years of depressions, etc.
If you get symptoms that come and go then video yourself or get someone else to video you being hypo/manic, show the video to the doc and/or get this person to vouch for you.
A lot of bipolar behaviour is trauma related, when you work on the trauma, the symptoms of the bipolar disorder get less.
Ad.H that’s interesting. Trauma can mimic soooo many things, and children are sadly misdiagnosed all the time and their trauma is never dealt with
I agree 100%. My unresolved trauma results in stress and stress triggers symptoms. The best advice I ever got from a doctor was to not drink alcohol and to do everything I can to manage stress in my life. He told me that if I did that I would most likely remains stable and stay out of the hospital. I have followed his advice for the past 20 years and I have not been hospitalized in that time period and for the most part I have very few manic or depressive symptoms during that time as well.
I think part of the mystery and treating this illness is that many of the things that are best for us do not involve medicine or anything medical. For example, removing stimulants from your diet getting regular sleep sunlight, a managing stress on a daily basis, these things are at least as important as the medication that I take. It wasn't until I did these things did the medicine really actually work.
Hooray for science!
Watching this video which is very interesting by the way has resurfaced in an idea I've been thinking about. So I'm kind of curious on what are the differences between ADD ADHD and bipolar 2. If agitation and irritation what are symptoms of a mixed state along with concentration issues, and 30 to 40% of people with bipolar are also thought to have ADHD what are the clear distinct differences. My idea there was the H in ADHD would probably be better represented as hypomania instead of hyperactivity. and if that's the case wouldn't stimulants work just as well for hypomania as they do with hyperactivity!?
My thoughts as well!
ADD & ADHD are the same thing. ADD is an obsolete distinguishing diagnosis. Like aspergers is to autism. Or “high functioning autism” it is all simply autism. The brain is the motor not your physical hyperactivity. ADHD increases your chances of both Bipolar & Autism.
But ADHD drugs increase mania. In fact the side effect of mania in ADHD patients is the possible underlining factor of bipolar.
That’s how I came to be diagnosed. Being on vyvanse & adderall I was increasing angry. But when my medicine peaked I was okay & focused. Some days it wouldn’t work at all. The fascinating thing was when I was off my meds for a weekend going back would make me manic. I wouldn’t sleep. I would do absolutely anything I could get my hands on including studying pharmacology for 11 hours straight.
This was beyond what I was like when I was without medication.
It is difficult to treat ADHD because of the effect stimulants have on the bipolar disorder as well. That’s why many people are treated with a combination of drugs including anti anxiety medications & antidepressants to control the mania.
In my case hypomania. My medication brought to my attention my bipolar type 2 disorder & I am grateful.
Ironically, you must treat bipolar first prior to ADHD for this reason.
Additionally there are 4 main ADHD subtypes in which “ADD” would fall under theoretically.
Hyperactivity is a symptom of hypomania. Hypomania is so much more than the elevated activity level, there’s also the elevated emotional level.
@@SolarKatra il
“Bipolar” sounds like there’s no hope at all.
It sucks bad