1 response

  1. Frank Gallager
    January 3, 2015

    This is a great site, but I often find myself wondering if any authentication or similar accuracy checking takes place when writing an article.

    For example, there are indeed vast differences between Bipolar I and Bipolar II disorders. Your article addresses these differences, although not without the inclusion of misleading and/or inaccurate specifics.

    BP I can, and often does, include psychotic symptoms, which ARE typically more often presented while a patient is experiencing mania, especially during combined periods of rapid cycling between depression and mania. Characteristically, BP I symptoms (psychosis) and the severity of such symptoms can be most pronounced during these mixed state episodes. Oftentimes the most dangerous outcomes from BP I symptoms are almost always related to severe, mixed state episodes and rapid cycling.

    In patients who struggle with BP II disorder, presentation of “mania” is almost always apparent in almost subtle and vague ways, and arguably challenging to identify. A patient may vacillate between severe depression, or any number of variable combinations, but never display manic tendencies. Maybe the observations remain focused on degrees if depression.

    An example of this “hypo-mania” could be shopping binges, impulsive redecorating, new hobby interest out of nowhere, relocating to another town without proper planning etc.

    These behaviors needn’t show up more than once or twice to suggest BP II, rather than just depression, clinically speaking.

    Another VERY important issue to consider is medication; while on the surface it might seem that medication treatment for each of these may likely be similar, nothing could be further than truth. Treating BP I symptoms with atypical SSRI anti-depressants can actually result in making things worse for the patient. SSRIs have been known to trigger hypo-mania, or even straight mania which can easily be misinterpreted as a “remission” in symptoms. Basically, contraindicated. (As is EMDR) However, the patient may be on a roller-coaster ride ending in a rebound depressive state worse than before. SSRIs can trigger mania and should be avoided in the treatment approach for BP II.

    Also, this article states that BP I patients struggle with symptoms so intrusive that the ability to live a normal life isn’t easy compared with BP II patients. This statement is almost categorically incorrect and in opposition to the truth. Patients who have BP I symptoms, and properly medicated, can actually function quite well. Millions do. Patients with BP II disorder, in comparison, despite having tried numerous medication strategies, rarely reach a point that is manageable and without debilitating symptoms.

    Most recently, the efficacy of just about any SSRI has been determined to hover around 30%, and other drugs like mood stabilizers like Lithium, Lamictal etc, come with dramatic side effects and often do little to stabilize symptoms, specifically severe depression.

    As far as psychosis and depression with BP II, if psychosis is a typical symptom, it is one of considerably less prominence than other symptoms. Maybe even rare, in my experience.

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