Fran
Former desparate mom
Presently, there are 4 classified types of Bipolar Disorder, with many variations of each. The four types are:
Bipolar I
Bipolar II
Bipolar III-Medicated Mania
Cyclothymes
Finally, there is what is called "Mixed States". This is not a classification, but rather, a description.
The following is a brief condensation of each of the classifications:
BIPOLAR I
Bipolar I is the one we hear most about, although it is not the most common. During manic episodes, people with this form of the illness do outrageous, outlandish things. They feel invincible, see no consequences for their behavior, and, in fact, believe they can conquer the world. In the grip of extreme mania, people's energy becomes misdirected and their judgment vanishes. They spend money extravagantly, drive recklessly, become sexually promiscuous, conceive grandiose schemes, make outrageous business investments, gamble away the house. They may also become irritable, quickly outraged, and intolerant of the needs of others.
In full-blown psychotic manias, a person loses all touch with reality. He has delusions and hallucinations, is extremely impulsive, impatient, becomes hypersexual and has a total lack of insight and judgment. Energy is boundless and the Bipolar can get along on amazingly little sleep. They may reach a level of destruction so severe-to themselves or to others-that they need to be hospitalized. Note: Some people experience a lifetime of recurrent depressions, punctuated by one or two episodes of mania.
BIPOLAR II
People with milder forms of the illness-which have different names and mean different things-are often erroneously labeled neurotic or personality-disordered.
The have recurrent depressions, but without the psychotic manic episodes. Instead, they experience brief "hypomania" (less than manic) periods, during which they feel mildly euphoric and have lots of self-confidence and energy. These hypomanic episodes may last from 2-10 days, and they don't require hospitalization.
How can hypomania be distinguished from just plain happiness? How does a doctor know it is a condition that needs to be treated? Dr. Hagop S. Akiskal, senior adviser of affective and related disorders at the National Institute of Mental Health, says that "hypomania is a recurrent condition; happiness is not." It is especially significant if the high-spirited time has been preceded or followed by depression.
BIPOLAR III--Medicated into Mania
Throw into the pot Bipolar III, and the water gets murkier. For people in this group, a manic episode can be precipitated by a drug or by electroconvulsive treatment prescribed for depression. In some cases, the drug may be a steroid such as cortisone. Sometimes it is an antidepressant prescribed because the patient was mistakenly believed to have clinical depression. It is not unusual for someone being treated for such a depression to spring into a manic episode; it may mean that he or she is really a misdiagnosed manic-depressive.
CYLOTHYMES: Mild Ups and Downs
The most uneven group of manic-depressives are called Cylothymes. Their highs and lows only last a few days or weeks. They start something with great enthusiasm but don't complete it. They move from place to place. They attach themselves to various movements, then become disillusioned. They may get great poetic inspirations, then dry up for weeks. They have an uneven work record, but during their productive times, they can achieve remarkable things. This group represents a vast group of people whose deviations in temperament are often thought, mistakenly, to be personality or character disorders. Their fluctuations are different from the normal shifts in mood that most people have, in that they are more intense and more frequent. "Most people don't go that deep or that high from day to day, or week to week," says Dr. Akiskal. "And they don't lose their judgment." The most extreme cyclothymes are called "rapid cyclers," with mood changes colliding with each other, from month to month, from day to day, or sometimes even within the same day. They might bounce from euphoria to despair and back again within hours. While many people are rapid cyclers from the start, others, over time, "mature" into that form of the disorder.
MIXED STATES:
Patients often show a smorgasbord of symptoms that are at odds with each other. They alternate their elation and ecstasy with irritability and anger that may explode into destructive rage. They are hypercritical and complaining, manipulative and often obnoxious. Momentary tearfulness and even suicide threats or attempts are not uncommon.
Some mental health experts describe these mixed bipolar episodes as a "despairing anxiety"--a form of depression--coupled with flight of ideas and distractibility--a form of mania.This mixture of behavior reflects both extremes of the illness coming out at one time. So the mood in mania, far from always being pleasant and fun, is often antagonistic and merciless.
Research shows that the milder forms of the illness are far more common than the classic Bipolar I type. But those who have them seldom get diagnosed accurately. 3 to 4 percent of the general population account for the milder forms of the illness. Full-blown manic-depressive illness has a lifetime risk of one percent; by the time it is diagnosed, it has already caused a great deal of grief and suffering to the patient and his family.
~Dr. Hagop Akiskal: A Brilliant Madness-Living With Manic Depressive Illness~
Bipolar I
Bipolar II
Bipolar III-Medicated Mania
Cyclothymes
Finally, there is what is called "Mixed States". This is not a classification, but rather, a description.
The following is a brief condensation of each of the classifications:
BIPOLAR I
Bipolar I is the one we hear most about, although it is not the most common. During manic episodes, people with this form of the illness do outrageous, outlandish things. They feel invincible, see no consequences for their behavior, and, in fact, believe they can conquer the world. In the grip of extreme mania, people's energy becomes misdirected and their judgment vanishes. They spend money extravagantly, drive recklessly, become sexually promiscuous, conceive grandiose schemes, make outrageous business investments, gamble away the house. They may also become irritable, quickly outraged, and intolerant of the needs of others.
In full-blown psychotic manias, a person loses all touch with reality. He has delusions and hallucinations, is extremely impulsive, impatient, becomes hypersexual and has a total lack of insight and judgment. Energy is boundless and the Bipolar can get along on amazingly little sleep. They may reach a level of destruction so severe-to themselves or to others-that they need to be hospitalized. Note: Some people experience a lifetime of recurrent depressions, punctuated by one or two episodes of mania.
BIPOLAR II
People with milder forms of the illness-which have different names and mean different things-are often erroneously labeled neurotic or personality-disordered.
The have recurrent depressions, but without the psychotic manic episodes. Instead, they experience brief "hypomania" (less than manic) periods, during which they feel mildly euphoric and have lots of self-confidence and energy. These hypomanic episodes may last from 2-10 days, and they don't require hospitalization.
How can hypomania be distinguished from just plain happiness? How does a doctor know it is a condition that needs to be treated? Dr. Hagop S. Akiskal, senior adviser of affective and related disorders at the National Institute of Mental Health, says that "hypomania is a recurrent condition; happiness is not." It is especially significant if the high-spirited time has been preceded or followed by depression.
BIPOLAR III--Medicated into Mania
Throw into the pot Bipolar III, and the water gets murkier. For people in this group, a manic episode can be precipitated by a drug or by electroconvulsive treatment prescribed for depression. In some cases, the drug may be a steroid such as cortisone. Sometimes it is an antidepressant prescribed because the patient was mistakenly believed to have clinical depression. It is not unusual for someone being treated for such a depression to spring into a manic episode; it may mean that he or she is really a misdiagnosed manic-depressive.
CYLOTHYMES: Mild Ups and Downs
The most uneven group of manic-depressives are called Cylothymes. Their highs and lows only last a few days or weeks. They start something with great enthusiasm but don't complete it. They move from place to place. They attach themselves to various movements, then become disillusioned. They may get great poetic inspirations, then dry up for weeks. They have an uneven work record, but during their productive times, they can achieve remarkable things. This group represents a vast group of people whose deviations in temperament are often thought, mistakenly, to be personality or character disorders. Their fluctuations are different from the normal shifts in mood that most people have, in that they are more intense and more frequent. "Most people don't go that deep or that high from day to day, or week to week," says Dr. Akiskal. "And they don't lose their judgment." The most extreme cyclothymes are called "rapid cyclers," with mood changes colliding with each other, from month to month, from day to day, or sometimes even within the same day. They might bounce from euphoria to despair and back again within hours. While many people are rapid cyclers from the start, others, over time, "mature" into that form of the disorder.
MIXED STATES:
Patients often show a smorgasbord of symptoms that are at odds with each other. They alternate their elation and ecstasy with irritability and anger that may explode into destructive rage. They are hypercritical and complaining, manipulative and often obnoxious. Momentary tearfulness and even suicide threats or attempts are not uncommon.
Some mental health experts describe these mixed bipolar episodes as a "despairing anxiety"--a form of depression--coupled with flight of ideas and distractibility--a form of mania.This mixture of behavior reflects both extremes of the illness coming out at one time. So the mood in mania, far from always being pleasant and fun, is often antagonistic and merciless.
Research shows that the milder forms of the illness are far more common than the classic Bipolar I type. But those who have them seldom get diagnosed accurately. 3 to 4 percent of the general population account for the milder forms of the illness. Full-blown manic-depressive illness has a lifetime risk of one percent; by the time it is diagnosed, it has already caused a great deal of grief and suffering to the patient and his family.
~Dr. Hagop Akiskal: A Brilliant Madness-Living With Manic Depressive Illness~
anic:
