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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by BRC on December 8, 2004, at 9:56:31
Hi, I have beem seeing my pdoc for a couple of years now for OCD, anxiety, and major depression.
I always had these racing thoughts that I considered part of my OCD that really crippled me and acouple of months ago my neurologist put me on the med trileptal for nueropathy in my right leg. And I discovered that the medication helped with my daily racing thoughts at higher doses.
Went to my scheduled appointment with my pdoc yesterday and he said that it is common that Bipolar II goes undiagnosed in people with people with OCD.
I am a 28 year old male that is in otherwise good health. But I really don't know what Bipolar II is and what it does.
Was wondering if someone could explain it to me.
Thanks,
BRC
Posted by banga on December 8, 2004, at 11:22:06
In reply to Just Diagnosed with Bipolar II--What is it?, posted by BRC on December 8, 2004, at 9:56:31
Technically, Bipolar II is a condition that is diagnosed if you have recurring periods of Major Depression, and at least one episode of hypomania in your past. Hypomanic episode is defined as follows:
A distinct period of persistently elevated, expansive or irritable mood, lasting throughout at least 4 days, that is clearly different from the nondepressed mood.
During the disturbance, 3 or more of the following have been present (4 if the mood is only irritable):
-inflated self-esteem or grandiosity
-decreased need for sleep
-more talkative than usual, or pressure to keep talking
-flight of ideas
-distractability
-increase ingoal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
-excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., person engages in buying sprees, sexual indiscretions, foolish business practices)* the episode is associated with unequivocal change in functioning that is uncharacteristic of the person when not symptomatic
A hallmark of both mania and hypomania is experiencing racing thoughts...I wonder if it is not listed here for the exact reason that this may be confused with anxiety-based rumination....But having said all this, the definition of Bipolar II has been quite diluted in recent years--a lot of laxing the rules of what constitutes hypomania, I think generally considering racing thoughts and agitation enough to consider it a subhypomanic state--that even though the person doesnt fit criteria for a hypomanic episode,
biologically speaking they are Bipolar II, and would be helped by a mood stabilizer.
I am actually in a similar boat right now. After years of treatment for depression, we are stepping back and considering Bipolar II. I have relentless, horrible ruminative thoughts. Both Bipolar and unipolar depression run in my family. I just started a mood stabilizer--Lamictal--and it seems to be helping, I feel more relaxed and balanced. Still too early to tell, though.In any case, good luck to you.
Posted by Ritch on December 8, 2004, at 13:04:38
In reply to Just Diagnosed with Bipolar II--What is it?, posted by BRC on December 8, 2004, at 9:56:31
> Hi, I have beem seeing my pdoc for a couple of years now for OCD, anxiety, and major depression.
>
> I always had these racing thoughts that I considered part of my OCD that really crippled me and acouple of months ago my neurologist put me on the med trileptal for nueropathy in my right leg. And I discovered that the medication helped with my daily racing thoughts at higher doses.
>
> Went to my scheduled appointment with my pdoc yesterday and he said that it is common that Bipolar II goes undiagnosed in people with people with OCD.
>
> I am a 28 year old male that is in otherwise good health. But I really don't know what Bipolar II is and what it does.
>
> Was wondering if someone could explain it to me.
>
> Thanks,
>
> BRCI suppose one could divide bipolar into the cognitive symptoms (racing thoughts, ruminating, flight of ideas, derailment-tangential thoughts, distractability) and the emotional (mood) symptoms of elation, rage, depression, and the behavioral symptoms of hyperactivity, lack of impulse control, etc. It sounds like your symptoms are predominantly cognitive. Another thing about bipolar is the *cylicity* or *recurrent* nature of the symptoms. They tend to change, wax/wane. They generally are not constant over stretches of time. I'm a chronic rapid-cycler so I tend to have chronic symptoms and not much time is spent in "normal" phases. My anxiety symptoms do fluctuate with my mood cycling (qualitatively and quantitatively). There are definite OCD-like elements to my anxiety-"sticky" repetitive/'loud' thoughts/music/head noise, etc. However, some of the medications commonly used to treat OCD (SSRI's esp.) generally make this stuff worse.
Posted by BRC on December 8, 2004, at 19:26:10
In reply to Re: Just Diagnosed with Bipolar II--What is it?, posted by banga on December 8, 2004, at 11:22:06
Wow, thanks so much for all the information. I wish you were my doctor :). My pdoc is wonderful. He is one of the most prominent in my area. He even has a wing of the local hospital (which is pretty big--it serves 10-12 counties in my state)named after him. So, I trust his decisions. But he never took the time to explain what BP II was like you did.
I appreciate your time and concern.
I wish you well in your treatment.
Thanks,
BRC
Posted by BRC on December 8, 2004, at 19:32:18
In reply to Re: Just Diagnosed with Bipolar II--What is it?, posted by Ritch on December 8, 2004, at 13:04:38
Thanks Ritch for your response.
You seem very intelligent with your answers. I would say that your cognitive abilities are way above any "normal" what ever that means person I know.
I do take SSRI's for my OCD. Have tried just about all of them over the past five years. I also take Klonopin for the anxiety.
Thanks for your response and I wish you well with your treatment.
Thanks,
BRC
Posted by Ritch on December 9, 2004, at 11:45:09
In reply to Re: Just Diagnosed with Bipolar II--What is it? » Ritch, posted by BRC on December 8, 2004, at 19:32:18
This is the end of the thread.
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