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04/03/2009 08:58 PM

BiPolar IV

spinning
Posts: 7
Member

Hi,

I'm new to the forum and new to the world of loving a person with a mental illness. I've been married to my wife for almost 10 years without a moment's trouble but that all changed after she had a hysterectomy a year ago.

After a recent manic episode that still has her in a treatment center, my wife was diagnosed as having bipolar II. But in my groping to understand why this seems to have come out of nowhere, I've come across and rare and "unofficial" form of bipolar that seems to match my wife's situation: bipolar IV.

When my wife first started to feel "different" she went to her gynecologist because she assumed it was hormonal. He first tried her on different hormones, and then added Xanax then finally tried Zoloft, Prozac, Celexa... you name it, she took it for a week and a half and it made her sick or caused panic attacks. Finally, about a week a ago, she had a manic episode where she plotted to abandon the children and I to live in another country.

Anyway, does anyone know anything about this rare form of bipolar that seems to be brought on by a misdiagnosis of depression and the prescription of an SSRI that catapults them into a manic episode?

spinning

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04/03/2009 09:03 PM
JennyT

Bipolar IV?

04/03/2009 09:11 PM
JennyT

"Bipolar IV" is when an antidepressant induces a manic or hypomanic episode.

04/04/2009 12:10 AM
jennywren
jennywrenPosts: 3162
Senior Member

Gee Spinning I wrote you a nice long message and again it happened. ie it just disapered off somewhere. Any way I will try and write it again.

Firstly I am currently reading a great book called Bipolar Disorder Mixed States Rapid Cycling and Atypical Forms which is the best book I have found re Mixed States. This book is a compilation of various reseach papers re the Bipolar types mentioned in the title and their conclusions.

Now it happens quite often when a person with Bipolar Disorder is mistakenly diagnosis by a doctor as being unipolar (depression) and they are given an anti depressant (SSRI usually) that they go into a manic state. Thus your wife's experinces are not uncommon or rare by any means.

Bipolar Disorder can strike at any age just about, ie under 25's over 25's, then there are the 30's, 40's 50's and believe it or not the 60's. Many can go undiagonsised and manage, not successfully to live their lives.

Doctor's will question an offical diagnosis of Bipolar if the eposide is as a result of illicet drug taking. Logical it is, for it could well be the illicet drug messing with their brain.

They are in the process of writing DSM-V due out in about 2112. Just what symptoms they will put in it for Bipolar, heaven only knows for most show sometimes related symptoms and sometimes not.

They also mention Atypical Bipolar and mention quite validily in my books that if a more or less list of symptoms cannot be compiled then, how is research done?, how do they find the best treatment for these people? And how can a diagnosis be made if they are not criteria or symptoms to match up the particpants to? The same may well apply to Bipolar Disorder Not Other Specified.

As to whether your wife's mania was trigged by the hysterectomy it is up to her doctor to give what to me, will be his best guess.

I hope that your wife will soon be home with you and the children, and back to more or less her old self. By your description it sounds like your wife may have Bipolar I. BUT I am NOT a doctor so may not know what I am talking about.

Best Wishes

JennyWren


04/04/2009 01:21 AM
neondreams
neondreams  
Posts: 7297
VIP Member

Jenny,

Two polite corrections.

First: The next version of the DSM (DSM-5) is set to be released in 2012 -- not 2112.

Second: Atypical bipolar is considered to be its' own diagnosis. My old pdoc specializes in atypical bipolar and said it is not categorized the same way as bipolar NOS (not otherwise specified). People like myself who are diagnosed with atypical bipolar exhibit certain symptoms such as rapid cycling, psychosis and/or frequent hypomania. There may also be concurrent drug use.

Some literature concerning atypical bipolar does place it in the bipolar NOS category despite the fact that this in inaccurate. It's not considered bipolar NOS because in atypical bipolar, bipolar mania, depression and psychosis are the primary symptoms (unlike bipolar NOS where bipolar symptoms are secondary) and psychosis is not caused by a psychotic disorder (as it is in bipolar NOS).

Post edited by: neondreams, at: 04/04/2009 01:25


04/04/2009 01:30 AM
neondreams
neondreams  
Posts: 7297
VIP Member

From what I've read and have been told by my tdoc, BPIV describes those whose manic symptoms are caused by anti-depressants. There is some debate at this time as to whether or not this category will be added to the next version of the DSM in 2012.

You can read more about BPIV here:

http://www.psycom.net/depression.central.lieber.html

By the way, there is also a categorization of BPVI which is considered to be unipolar mania (mania without depression).


04/04/2009 01:32 AM
neondreams
neondreams  
Posts: 7297
VIP Member

I'm going to ask my tdoc and pdoc if they have any information they can share with me about atypical bipolar. I can't find any resources on the Internet besides the websites listed in my signature.

Post edited by: neondreams, at: 04/04/2009 01:35


04/04/2009 01:37 AM
niecy440

I was diagnosed with depression and anxiety for years and was given antidepressants. Many years passed and I could never keep my depression at bay. Then one day two years ago i woke up a different person. I ended up having mania for weeks until i went to the hospital. Where I was diagnosed as having bipolar. It came out of the blue, I was bipolar. I'm now on several meds and feel better than I have in years. Your wife can get better with the right medications. Sorry I couldn't be of more help, but you came to the right place. Welcome.

04/04/2009 01:42 AM
neondreams
neondreams  
Posts: 7297
VIP Member

Although I was diagnosed with major depressive disorder in 1991, meds like Lithium and Prozac did not help my depression. I never went into a severe manic state, but I think that was due to my being on Lithium. I didn't experience my first manic/psychotic episode until 2006 which was caused by anesthesia, stress, sensory deprivation (i.e. the loss of my residual hearing following bilateral cochlear implant surgery) and the death of my mother.

From what my tdoc told me, people who experience manic episodes due to anti-depressants shouldn't technically be categorized as having bipolar, but many of them are due to the fact that anti-depressants alone cause mania and these individuals should be placed on mood stabilizers and/or antipsychotics to prevent severe manic episodes in the future.


04/04/2009 05:10 AM
jennywren
jennywrenPosts: 3162
Senior Member

neondreams:First: The next version of the DSM (DSM-5) is set to be released in 2012 -- not 2112.

JennyWren:Yeap Neondreans it is tenty twevlve (I have to use another machine spilt coffee on my favourite one. Sad

JennyWrenTongueut it down to the typing gremlin. Have known it is twenty twelve for a few years now. Had to so some research about it about two years ago. Sorry about that Smile

NeondreamsDizzyecond: Atypical bipolar is considered to be its' own diagnosis. My old pdoc specializes in atypical bipolar and said it is not categorized the same way as bipolar NOS (not otherwise specified). People like myself who are diagnosed with atypical bipolar exhibit certain symptoms such as rapid cycling, psychosis and/or frequent hypomania. There may also be concurrent drug use.

JennyWren: The symptoms you discribe above could be read by some as being either rapid cycling BD one or BD two. But be that as it is.

At this stage I perfer to give credance to the DSM and Andreas Marneros and Frederick Goodwin who have certainly impressed me they know what they are about.

I would not be surprised if some pdocs had different ideas as to just what are the symptoms of Atipical Bipolar Disorder, if indeed they would consider it. Due to there being no accepted symptoms to relate too.

I have done a Google search and there is reference to Atypical Depression but not much if anything on Atpical Bipolar. Again for the reason I gave before and that is getting a common list of symptoms. Till they do there is the difficulty of finding participants with what symptoms? Currently the DSM does not give any.

As I said before it will be interesting to see DSM-V. For all I know they may just come up with a list of symptoms (which will be difficult due to the variety of symptoms which are displayed) for what is currently given the name of Aypical Bipolar by some?

Likewise while there is generaly similar criteria for those with BD I and BD II, each person is different.

JennyWren

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