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 Mar 14 2007, 12:10 AM
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Group: Platinum Member
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From: Boise, Idaho, USA
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QUOTE Science Daily
February 15, 2007
Simple Test Distinguishes Between Bipolar Disorder And Depression
Patients with bipolar disorder experience manic or hypomanic episodes (euphoria) and depression. Type II bipolar disorder (hypomanic) patients are especially difficult to diagnose since their manic episodes are not very marked and they are usually diagnosed as depression patients. Choosing an incorrect treatment can be counterproductive. A study led by IDIBAPS, with the participation of PSYNCRO and 10 more hospital centres and the support of GSK, demonstrates how the HCL-32 test identifies bipolar depression in a simple way and with success above 80%. This work has been done with the Spanish version of this test.
Type II bipolar disorder is an underdiagnosed disease which can be easily confused with depression. Contrarily to what happens in type I bipolar disorder, depressive symptoms and, above all, manic symptoms alternated in this form of the disease are not evident and difficult to identify. In fact, patients suffering from it usually go to the doctor because they are depressed, without thinking that they have also had slight manic episodes (euphoria and other cognition disorders).
Medical centres lack tools to identify successfully this pathology, which can take 8-10 years to be correctly diagnosed. Furthermore, antidepressant treatment can be counterproductive in patients with type II bipolar disorder. Dr. Eduard Vieta, of the group Biological Basis of the Psychic Disorder and Nuclear Psychiatry of the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), has coordinated a study in order to validate the Spanish version of the test Hypomania symptom check list (HCL-32), which is being developed in an ample international collaboration.
The last issue of Journal of Affective Disorders published results confirming the usefulness of this simple questionnaire of 32 questions to distinguish major depression from bipolar disorder. In 2005, researchers from IDIBAPS collaborated in the international design of this test (J Affect Disord, 2005; 88(2):217-33). The main difference between HCL-32 and the test used until today -the Mood disorder questionnaire (MDQ)- is the open character of the questions, facilitating the patient’s sincerity. In these questions lay essential information to assess retrospectively the energy/activity levels of patients and problems of disinhibition, self-control and attention they have suffered in the past. This new study compares the sensitivity of both questionnaires, and concludes that the HCL-32 is more precise than the MDQ in the identification of type II bipolar disorder patients. This work has been supported by GlaxoSmithKline (GSK) and had the participation of PSYNCRO, a neuropsychological research enterprise, located in the Parc Científic de Barcelona (PCB), which has worked in collaboration with the Department of Psychology of the Universitat de Girona.
A total of 237 people from 15 different psychiatric departments (see annex list), filled out the HCL-32. Except those belonging to the control group (60), the rest were correctly diagnosed, stable and receiving a correct treatment for their pathology, which could be type I (62) and type II (56) bipolar disorder, or major depression (58). This test was able to identify more than 80% of patients with bipolar disorder. Although it could not distinguish between types I and II, this decision is relatively easy to take from the clinical data of the patient. For the first time, a tool to identify bipolar disorder is available for patients going to the medical centre claiming depression. Although it is necessary to go on with studies in patients of wider populations, the HCL-32 test can provide very useful information to psychiatrists and even to primary-care physicians.
Note: This story has been adapted from a news release issued by IDIBAPS - Institut d'Investigacions Biomediques August Pi i Sunyer.
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Replies
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May 30 2007, 01:00 PM
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Anything to help with diagnosing people more accurately is great! So many symtoms overlap from one illness to another, I don't know how any doctor (or patient) can be confident in their diagnosis.
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Sep 6 2007, 06:12 PM
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QUOTE(Lucinda @ May 30 2007, 09:38 PM)  yeah, exactly. The symptoms you are experiencing should be treated if they are hindering your life. I suffer more from depression than "hypomania". I was once diagnosed with this bipolar II from an SSRI reaction. I didn't buy it and thought it was a hasty diagnosis, particularly because it can be a career destroyer. If the rare times in my life that I felt euphoric (not from self medication) were hypomania, I'll take it anyday over this chronic depression...
Lucinda. How can it be a career destroyer? Explain?
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Sep 7 2007, 12:36 AM
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Hi, Aliebling. There's still a lot of stigma with mental illness, in some countries more than others. I think that's what Lucinda was referring to. QUOTE(Aliebling @ Sep 6 2007, 05:12 PM) QUOTE(Lucinda @ May 30 2007, 09:38 PM) yeah, exactly. The symptoms you are experiencing should be treated if they are hindering your life. I suffer more from depression than "hypomania". I was once diagnosed with this bipolar II from an SSRI reaction. I didn't buy it and thought it was a hasty diagnosis, particularly because it can be a career destroyer. If the rare times in my life that I felt euphoric (not from self medication) were hypomania, I'll take it anyday over this chronic depression...
Lucinda. How can it be a career destroyer? Explain?
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Nov 2 2007, 09:57 PM
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QUOTE (Lucinda @ May 30 2007, 09:38 PM) yeah, exactly. The symptoms you are experiencing should be treated if they are hindering your life. I suffer more from depression than "hypomania". I was once diagnosed with this bipolar II from an SSRI reaction. I didn't buy it and thought it was a hasty diagnosis, particularly because it can be a career destroyer. If the rare times in my life that I felt euphoric (not from self medication) were hypomania, I'll take it anyday over this chronic depression...
Lucinda. Hi Lucinda, I am currently going through the diagnosis of BP II I believe. Like you I've mostly been depressed and always ended up responding badly to SSRI's after a few months. My pdoc just pointed in that direction last visit. I also don't have marked mania...or even times of high energy. I have extremely mood swings and irritability. Maybe thats why I've ever had relief wrong diagnosis... Chrystal =)))
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Dec 8 2007, 09:29 PM
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Just Registered
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My original diagnosis was depression, but my psychiatrist is now considering the possibility that I may be bipolar. What happens when someone who is bipolar takes antidepressants? Is it really a problem?
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Jan 17 2008, 05:08 PM
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Interesting post - thanks for posting it
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 Jan 20 2008, 03:01 PM
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From: southern Cal east corner of state, Coachella Valley
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QUOTE (Lucinda @ May 30 2007, 05:38 PM) yeah, exactly. The symptoms you are experiencing should be treated if they are hindering your life. I suffer more from depression than "hypomania". I was once diagnosed with this bipolar II from an SSRI reaction. I didn't buy it and thought it was a hasty diagnosis, particularly because it can be a career destroyer. If the rare times in my life that I felt euphoric (not from self medication) were hypomania, I'll take it anyday over this chronic depression...
Lucinda. Lucinda I hope you read this. I was also misdiagnosed with bi-polar type 2 about fifteen years ago; last year I had the good fortune of meeting the head pdoc for the entire VA. after reviewing my charts and chatting with me he took aside and informed me that I in fact did not have bi-polar, I had always suspected this, but this was a pleasant revelation. He took me off the mood meds very quickly, for a week or so I walked around as if I was drunk. I was surprised how fast the meds got out of system. He informed me that the meds were mimicking the bi-polar symptoms. Please have a pleasant day Lucinda, Frank
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 Mar 10 2008, 03:19 AM
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QUOTE (smileysrsuper @ Nov 2 2007, 10:57 PM) QUOTE (Lucinda @ May 30 2007, 09:38 PM) yeah, exactly. The symptoms you are experiencing should be treated if they are hindering your life. I suffer more from depression than "hypomania". I was once diagnosed with this bipolar II from an SSRI reaction. I didn't buy it and thought it was a hasty diagnosis, particularly because it can be a career destroyer. If the rare times in my life that I felt euphoric (not from self medication) were hypomania, I'll take it anyday over this chronic depression...
Lucinda. Hi Lucinda, I am currently going through the diagnosis of BP II I believe. Like you I've mostly been depressed and always ended up responding badly to SSRI's after a few months. My pdoc just pointed in that direction last visit. I also don't have marked mania...or even times of high energy. I have extremely mood swings and irritability. Maybe thats why I've ever had relief wrong diagnosis... Chrystal =))) I was at a party long time ago and I asked a Dr. there about something that was troubling me and he said...(I'm thinking sombebody expensive in Beverly Hills, but he said the best Dr. for you is YOU!) I found that very humbling, obviously I never forgot it. Have you looked into nutritional supplements including Amino acids? Good luck!
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Apr 4 2008, 01:08 PM
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QUOTE (smileysrsuper @ Nov 2 2007, 10:57 PM) QUOTE (Lucinda @ May 30 2007, 09:38 PM) yeah, exactly. The symptoms you are experiencing should be treated if they are hindering your life. I suffer more from depression than "hypomania". I was once diagnosed with this bipolar II from an SSRI reaction. I didn't buy it and thought it was a hasty diagnosis, particularly because it can be a career destroyer. If the rare times in my life that I felt euphoric (not from self medication) were hypomania, I'll take it anyday over this chronic depression...
Lucinda. Hi Lucinda, I am currently going through the diagnosis of BP II I believe. Like you I've mostly been depressed and always ended up responding badly to SSRI's after a few months. My pdoc just pointed in that direction last visit. I also don't have marked mania...or even times of high energy. I have extremely mood swings and irritability. Maybe thats why I've ever had relief wrong diagnosis... Chrystal =))) What kind of mood swings? Does it vary per person?
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Apr 6 2008, 09:19 PM
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I was diagnosed major depressed many years ago. (4 years after getting sober) I'm a recovering alcoholic. Last year after losing 2 jobs and being homeless, I tried to get free meds and was diagnosed as bi polar, from another doc, stating the ssri aren't solving the problem. My regular doc doubled the ssri dose to try to control the severe depression, not concerned with the bi-polar diagnosis. Life has stabilized some and my doc is still more concerned with the more predominant depression. I only remember maybe a few days of euphoric symptoms as described as the mania, many years ago in my whole life. Already mentioned, I would love to have more of those behaviors rather than the depression.
I don't buy the type II bi polar, but would like to find out. Can I be tested? The only symptoms I have of any irritability or mania is if I forget to take my ssri.
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Trust God, Clean house, Help others
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Apr 18 2008, 12:35 AM
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Just Registered
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Hello
I was diagnosed last year as having Cyclothymia . I had never heard of it before. I was told it is a milder form of Bipolar.
Its good to have a forum such as this
This post has been edited by susan07: Apr 18 2008, 12:44 AM
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May 5 2008, 06:40 PM
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Hey.
I think I am a bi-polar, but my shrink, who isnt a real shrink, he thinks that I am only depressed. But these mood swings, which you are describing fit well on me. I have always been "on top" one day, and "down the hill" another day. However, I have felt it more the last two years. Since I were 18-19.. My family calls me unstable, and I am. But I am unsure how to make my shrink look closer, and not just brush me off. This test you spoke of, can you find it on the net, or do you have to take it through you psych.?
This post has been edited by ChrystalR: May 5 2008, 06:40 PM
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*.*.* Suspect I may, yet not directly tell:
For being both to me, both to each friend.
I guess one angel in another's hell:
The truth I shall not know, but live in doubt,
Till my bad angel fire my good one out. *.*.* |
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May 6 2008, 06:58 AM
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QUOTE (ChrystalR @ May 6 2008, 01:40 AM) Hey.
I think I am a bi-polar, but my shrink, who isnt a real shrink, he thinks that I am only depressed. But these mood swings, which you are describing fit well on me. I have always been "on top" one day, and "down the hill" another day. However, I have felt it more the last two years. Since I were 18-19.. My family calls me unstable, and I am. But I am unsure how to make my shrink look closer, and not just brush me off. This test you spoke of, can you find it on the net, or do you have to take it through you psych.? Hi Chrystal and Welcome Especially with something like bipolar, it really needs to be officially diagnosed and tested through a pyschiatrist. Is there anyway that you could get refferred to a proper pyschiatrist for a complete evaluation? They are the only ones who can officially diagnose bipolar. Trace
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Listen in deep silence. Be very still and open your mind.... Sink deep into the peace that waits for you beyond the frantic, riotous thoughts and sights and sounds of this insane world. - A course of miracles.
True beauty must come, must be grown, from within.... - Ralph W Trine.Faith is the true belief we have in hope and hope is the thing that keeps us going to have faith
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May 6 2008, 12:18 PM
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I will be getting a new psych later, but am on a waiting list for now. It might have gone faster if the one I have had been more focused on the depression part. And yes, I know.. So I try to be tranferred.
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*.*.* Suspect I may, yet not directly tell:
For being both to me, both to each friend.
I guess one angel in another's hell:
The truth I shall not know, but live in doubt,
Till my bad angel fire my good one out.*.*.* |
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Sep 5 2008, 11:48 PM
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In my opinion ( and speaking with personal experience) the best way to distinguish between the type of "depression" is through a SPECT scan. I was diagnosed with major unipolar depression that was therapy resistant. I went to the amen clinic and took a spect scan and found out I had erratic firing of the temporal lobes and put on Lamictal which saved my life.
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Nov 7 2008, 11:18 PM
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QUOTE (dave1003 @ Sep 5 2008, 11:48 PM) In my opinion ( and speaking with personal experience) the best way to distinguish between the type of "depression" is through a SPECT scan. I was diagnosed with major unipolar depression that was therapy resistant. I went to the amen clinic and took a spect scan and found out I had erratic firing of the temporal lobes and put on Lamictal which saved my life. What is a SPECT scan? I was also diagnosed with unipolar depression that was treatment resistant and then was put on Lamictal and that has pretty much worked well for me.
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Nov 9 2008, 05:48 PM
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QUOTE (Jane27mg @ Nov 8 2008, 06:18 AM) What is a SPECT scan? No idea, but it sounds expensive! I wonder if we even have that equipment in this country? (What I'm saying is: why have an expensive scan if a simple paper-and-pencil test would do?) The HCL-32 mentioned in this article seems good, I self-admin'ed it a couple of months back, and it showed a high chance of bipolar. I didn't think too much of it as I was still WAY too depressed (all these tests are WAY better administered by someone trained in them, who knows what to look for, and how to read the non-verbal as well.) However a few sessions later my psychologist said he thought I might be BP (I hadn't mentioned the test at all.) A few weeks after that I was hospitalised for a rather swiftly ascending manic episode and it turned out I am BP1! So the HCL-32 would have been useful for me, had I only encountered it sooner and taken it to my therapist back then. Could have saved some heartache. April in hospital for depression, October in hospital for mania. Amusement parks, move over. Lamictal seems useful for both treatment-refractory depression and bipolar. It has anti-depressant, as well as mood-stabilising properties. So being on it successfully doesn't in itself verify a dx of bipolar. But if the treatment helps... Apparently Epilim (Depakote) helps more for the anti-manic side of bipolar. Interesting, that. I'm on both. Good test!
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Apr 28 2009, 09:16 AM
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QUOTE (Patricia @ May 30 2007, 02:00 PM) Anything to help with diagnosing people more accurately is great! So many symtoms overlap from one illness to another, I don't know how any doctor (or patient) can be confident in their diagnosis. dont i know so far they think it is just severe depression syndrome or dieses with me but not sure 100% ive had it for about 8 years now just started getting help
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always remember that tommorow will always come
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Jun 4 2009, 04:21 AM
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Administrative Assistant
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Hi and Welcome 007
With Bipolar, online tests are just a guideline. It is best that you see a psychiatrist who is trained in Mental Health issues, such as Bipolar and work on getting an accurate diagnosis. There are a few pinned topics in here, that may give you some ideas on Bipolar and its many symptoms.
Trace
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Listen in deep silence. Be very still and open your mind.... Sink deep into the peace that waits for you beyond the frantic, riotous thoughts and sights and sounds of this insane world. - A course of miracles.
True beauty must come, must be grown, from within.... - Ralph W Trine.Faith is the true belief we have in hope and hope is the thing that keeps us going to have faith
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Jul 19 2009, 03:20 PM
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QUOTE (SweetCore @ Jun 26 2009, 06:27 AM) Hi I am a 22 year old who still is unsure of if I suffer from depression (I have had episodes since I was seven but first diagnosed at 19) or bipolar. Many doctors have said they have thought I might be bipolar but it would take two years to properly diagnose. It's impossible to determine for yourself what the problem is. I have a couple of weeks where I feel more than fine, great even and then within half a second it switches to me breaking down in tears not understanding the world or anything around me for months. I have tried keeping a mood diary but it didn't seem to help my doctor much. I found it very difficult to determine on a scale of 1-10 what mood I was in for the day and on low days a 1 never seemed a low enough score Sweetcore, BP2 is one of the hardest mental illnesses to diagnose. Unless you are obvioulsy manic at the time you see your psychiatirst, symptoms can be confused as depression. It took years to diagnose me. Often, a misdiagnosis as depression and the prescription of an SSRI ends up being a telling indicator, b/c SSRI's can often have a very negative effect on people w/ BP disorder. They can cause a manic episode. Your best bet is to see a psychatrist, not a general practitioner. When it comes to brain chemicals, I only trust mine to my psychiatrist. Let me know if there is anything I can do to help.
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"I need some meaning I can memorize. The kind I have always seems to slip my mind." |
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Jul 23 2009, 07:01 AM
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QUOTE (Sweet Melissa @ Jul 19 2009, 10:20 PM) QUOTE (SweetCore @ Jun 26 2009, 06:27 AM) Hi I am a 22 year old who still is unsure of if I suffer from depression (I have had episodes since I was seven but first diagnosed at 19) or bipolar. Many doctors have said they have thought I might be bipolar but it would take two years to properly diagnose. It's impossible to determine for yourself what the problem is. I have a couple of weeks where I feel more than fine, great even and then within half a second it switches to me breaking down in tears not understanding the world or anything around me for months. I have tried keeping a mood diary but it didn't seem to help my doctor much. I found it very difficult to determine on a scale of 1-10 what mood I was in for the day and on low days a 1 never seemed a low enough score Sweetcore, BP2 is one of the hardest mental illnesses to diagnose. Unless you are obvioulsy manic at the time you see your psychiatirst, symptoms can be confused as depression. It took years to diagnose me. Often, a misdiagnosis as depression and the prescription of an SSRI ends up being a telling indicator, b/c SSRI's can often have a very negative effect on people w/ BP disorder. They can cause a manic episode. Your best bet is to see a psychatrist, not a general practitioner. When it comes to brain chemicals, I only trust mine to my psychiatrist. Let me know if there is anything I can do to help. Thank you for your post. I know I need to go to a psychiatrist, my boyfriend keep telling me I need to. I have just switched healthinsurance and once all the paperwork is done I am hoping to get back in touch with my therapist. I kinda dropped her during a phase were I was doing very well and I didn't feel I needed any help. I told her I can do this on my own and just disappeared. I hope she won't be too mad, there are only two English speaking therapists in my city.
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 Sep 22 2009, 06:38 AM
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Just Registered
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QUOTE (ChrystalR @ May 5 2008, 06:40 PM) Hey.
I think I am a bi-polar, but my shrink, who isnt a real shrink, he thinks that I am only depressed. But these mood swings, which you are describing fit well on me. I have always been "on top" one day, and "down the hill" another day. However, I have felt it more the last two years. Since I were 18-19.. My family calls me unstable, and I am. But I am unsure how to make my shrink look closer, and not just brush me off. This test you spoke of, can you find it on the net, or do you have to take it through you psych.? Hi im new to this site. I also think i am bi polar 2. My doctor has just told me today that he thinks ive just been suffering from depression on and off for the last 23 years. Its a joke !! He has agreed to refer me to a pdoc as i insisted. But im afraid they will not take it seriosly if he says in his opinion he disagrees. Its so frustrating, lets hope we both get help.
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Sep 23 2009, 10:50 PM
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From my experience it affects how I work. Euphoria and depression episodes can make you very ineffective...also emotional breakdowns on the job are not seen very well, makes you seem unprofessional. In the banking world for example, you must keep your composure in tact. QUOTE (Aliebling @ Sep 6 2007, 06:12 PM) How can it be a career destroyer? Explain?
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Sep 28 2009, 09:32 AM
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Just Registered
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It is my understanding that there are many different forms of depression and that in no way am I a doctor or trying to self diagnose. I am merely bringing this up for discussion because it concerns me. It concerns me because it concerns my wife and her wellbeing. I hope to understand this better so that I can deal with it better.
My wife has had depression for a long time, going on 8 years plus, and she has been to many doctors. She also has been in the ward for 4 days and been on many different types of medication. Currently she is on Paxil 20mg and Trazadone 100mg. She was also on Abilify 10mg for almost 9 months, but was taken off of it due too weight gain. Before that she was on Welbutrin Sr and Zoloft which where both maxed out.
After months of severe depression and a couple of minor manic episodes she had a somewhat major spike in depression. I say somewhat major because she had not done anything to herself, but had called a hotline and her parents and I took her to the hospital. She currently has an appointment to see a doctor today and has another later in the week with her normal therapist and psychologist. I am very glad she did the right thing and did not do anything to herself.
After she went to the hospital for 4 days I started to talk on many family help depression sites trying to get a better idea of what to do and how to help. Everyone in her family is supportive of her to get better. It seams as if the last two weeks she had gotten a lot better because she was getting up in the morning and doing things. Then she broke down.
After doing a lot of reading and research this is what I have come up with. I think that some things need to be addressed more on what she might have instead of just depression. The possibility of some type of bipolar disorder weather it be boarder line or not. I have seen Hypomania symptoms in her she feels energetic, not productive, she can carry on with her life going to school, she does make bad decisions at no moments notice, and it had had an effect on relationships, careers and reputations. She is restless at times that she is in a hypomania state. I also had read that with this form of bipolar disorder that the person would be in a more depressed state than in a mania state.
As for her depression symptoms it is all of the above. She feels hopeless, sad, and empty, she is defiantly irritable, she can’t experience pleasure weather it be sexual or not. She has fatigues, physically sluggish, and her appetite has double from two years ago. She would rather sleep for 12-16 hours a day than anything so she can ignore life. She can’t concentrate on anything too long. She defiantly feels worthless and guilty for its. She fights daily with thoughts of suicide usually in the back of her head.
Right now I am at a loss. She is seeing doctors, I am trying my best, she has support from everyone, and she has good days. What am I supposed to do next? When is it going to get better?
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Depression Forums - A Depression & Mental Health Community Support Group > OTHER DEPRESSION & ANXIETY RELATED ILLNESSES > Bipolar Disorder
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