Sunday, May 29, 2011
Is it mania or hypomania? Consider the DSM-IV’s first symptom for mania, listed under “Criterion B”:1. Inflated self-esteem or grandiosityNow contrast this with the DSM-IV’s first symptom for hypomania:1. Inflated self-esteem or grandiosityOK, let’s give the DSM th...
Hi John,
This is priceless - it's so clear and concise and so very true. From the slighlty menacing presence of dysphoric hypomania, or alternatively the slightly out of control (but not quite!) euphoric side of the equation, you have hit the nail on the proverbial head here!
There is a world of difference between hypomania and mania and the copy and paste job doesn't do that difference justice. From having a bit of a party to being the actual party is a big step.
Your work should be compulsory reading for all med students, psychs or not. In this day and age many are looked after by GPs (care in the community they call it in Oz - bah humbug!) who take the DSM pretty much as gospel and are not adequately trained to be able to read between the lines (neither are mny P-docs come to that). The number of times i've been called manic when nowhere near it, and the number of times i've been called hypomanic when i've been totally out of control is getting to be a joke - I trust my own judgement (ha!) or more importantly my partner's than I would trust any doctor when it comes to the level i'm at.
Anyway well done!
Oh PS my 12 year old did a science project on lithium (they had to choose an element!) and your website and book were indispensable - many thanks, her teacher was most impressed!).
Mania--"marked IMPAIRMENT"
Hypo mania--"marked IMPROVEMENT"
in areas mentioned!!! At least for me!
hehe, I hear you! However sometimes I get a marked improvment in my ability to be a complete cow and that's probably not for the best. Maybe there's another level altogether - somewhere between "stable" and hypomanic where we all feel great?
The other problem that I don't like admitting to but if i'm admitting to bipolar I really have to, is that a marked improvement for me can be perceived slightly differently by others (slightly!). When i'm yabbering happily away over a few reislings and talking over, around, above and beyond everyone else I can (according to good sources!) be a right pain in the proverbial. But hey, I think i'm marvellous, witty and engaging!
"Oh well", I think as I hypomanically do all the housework twice a day and once at night, "I feel wonderful and i'm really cool" - and as long as a little voice at the back of my head says "This may not be quite as it seems" I know that I have not gone to the land of fairies and can probably pull back all by myself (touch wood, or lithium, or a little more seroquel!).
Unfortunately for me hypo manic "Me" is much preferred by my husband, family & friends (& ME) compared to the stable "Me" which lacks the energy, enthusiasm, drive, positive self-esteem, & zest for life. It is very good, but then I can fall into a deep depression after many mos. of not sleeping much. If I could prevent the depressions that follow & keep the hypo mania (never had negative comments or reactions to hypo manic "Me" except for over-spending & speeding).
I know a Dr would never say this in a fit but perhaps hypomanic is your "stable"? - we are all wired differently after all. Like I said I have a sneaking suspicion that there's a level missing (at least it feels that way for me)- the one prior to becoming hypomanic but not bland and deviod of life type "stable" either - who knows.
I am obviously wired differently from you as depression has not been a large part of my bipolar story at all, but when I feel what I call "stable" (I really think we all have different "stables") I can be the outgoing, exptroverted "me" without getting what I call "twittipated" - where I get more and more jumpy and excitable and then things can get way way out of control. Stable to me is how it feels on a lovely summer day having a barbeque with friends round and all relaxed, happy and having fun. Hypomanic is fun with an edge, I sometimes feel "forced or compelled" to do stuff, and that can make me snippy with others, specially if they don't want me to buy that car etc!
Lables really don't help sometimes cause we are all so different one definition does not cut it.
If I could have the hypo mania without the insomnia I'd probably be great (but need to curb the over-spending), but it seems the not sleeping except for only about 3 hours a night for months on end leads to my brain "malfunctioning" that leads to sudden DEEP & DANGEROUS depressions.
My Dr prescribes me Seroquel (quetiepine) only 100mg a night and it puts me out like a light and leaves me feeling chipper in the morning - not at all like a sleeping pill. Perhaps you could give it a try - works for me and does not make me feel blegghh at all during the day. Lots of people take it at much higher doses but my doc reckons it's way more sedating at low dose and just keeps me from being in your boat - I know where you're coming from, but it (lack of sleep) just sent me manic as opposed to crashing - only crash v v rarely and it's usually a "mixed state".