Depression

Bipolar Disorder NOS

Bipolar Disorder – Not Otherwise Specified (NOS)

 Bipolar Disorder – Not Otherwise Specified (NOS) is a type of Bipolar Disorder (also known as “manic-depressive illness” or “manic depression”). Like the other kinds of Bipolar Disorder, Bipolar NOS is a complex mood disorder characterized by dramatic mood swings – from hypomania/mania and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Bipolar Disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood.

Bipolar Disorder – Not Otherwise Specified (NOS)

 Bipolar Disorder – Not Otherwise Specified (NOS) is a type of Bipolar Disorder (also known as “manic-depressive illness” or “manic depression”). Like the other kinds of Bipolar Disorder, Bipolar NOS is a complex mood disorder characterized by dramatic mood swings – from hypomania/mania and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Bipolar Disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood.

Bipolar NOS is a classification for Bipolar symptoms that fit no other category. It includes: fast cycling between manic and depressive episodes; Bipolar not primary disorder but still present; Bipolar Disorder present in a Delusional Disorder, residual Schizophrenia, or other Psychotic Disorder Not Otherwise Specified (NOS); hypomanic or manic episodes with no depressive episodes.

Individuals with Bipolar Disorder often suffer from other, comorbid psychiatric conditions. In one study of 60 patients with Bipolar Disorder, 23 (38%) fulfilled the diagnostic criteria for at least one personality disorder, most commonly narcissistic, borderline, antisocial, obsessive-compulsive, or avoidant disorder. The presence of these disorders may make Bipolar symptoms more intense and more difficult to treat and appears to increase the risk of suicide.

Although currently classified as separate illnesses, there is increasing interest in the psychiatric community in viewing unipolar depression, Bipolar Disorder, and anxiety disorders as part of a larger, overlapping spectrum of mental disorders. This trend is supported by findings that many individuals who are first diagnosed with unipolar depression are eventually diagnosed as actually suffering from Bipolar Disorder. One interesting study, Diagnostic conversion from depression to bipolar disorders, tracked 406 patients with major mood disorders over a 20-year period. Of 309 patients presenting with depression, 121 (39.2 percent) eventually manifested as Bipolar (24.3 percent to Bipolar Type I, 14.9 percent to Bipolar Type II). One reason for this finding may be due to improperly diagnosed Bipolar Disorder � estimates are that on average it takes 7 1/2 years before a Bipolar diagnosis is made. This growing debate over the accuracy of diagnostic classifications might seem to be purely academic except for the effect it has on treatment protocols. As antidepressant mono-therapy is the mainstay treatment for depressive, and to some degree anxiety disorders, it is typically not recommended for Bipolar Disorder without the addition of mood stabilizing medications.

Treatment
Because Bipolar Disorder involves both depression and times of overly elevated mood, it is seen as a greater challenge to treat than unipolar depression. Individuals with Bipolar Disorder typically are depressed three times longer than they experience mania or hypomania and Bipolar depression is associated with a greater risk of suicide and of impairment in work, social, or family life than mania/hypomania. Treating Bipolar Disorder can be very challenging. Traditional antidepressants are not recommended as monotherapy as they can induce switching to mania/hypomania. Instead, individuals are often treated with a mood stabilizing medication such as Lithobid etc. (Lithium Carbonate / Citrate), or Lamictal , (Lamotrigine), Topamax, etc. ; new generation atypical antipsychotic medications such as Seroquel (Quetiapine); and an antidepressant medication.
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Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professionals. Consult your own physician regarding the applicability of any opinions with respect to your symptoms or medical condition.

Reviewed by Lindsay 2-12-10

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