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subthreshold bipolar disorder


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#1 resonance

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Posted 15 May 2007 - 06:31 PM

You don't need a lot of symptoms to make mood wackiness to mess with your life. There was recently a news article about researchers finding that 2.4% of americans will have subthreshold bipolar disorder (as they defined it) at some point during their lifetime.

Check this post out, in which the author, whose bio states that he is an academic with clinical experience, starts with that and works up to arguing that anyone who isn't BPI should not be receiving long-term medication because "there is scant if any research on what appropriate medication is for bipolar II and there is not a damn bit of research attesting to medication for SBD" (subthreshold bipolar disorder).
http://clinpsyc.blog...nt-sucking.html

I do not think he is an academic with training on the research side of psychology. He also seems to have difficulty understanding that different diagnoses of bipolar disorder almost certainly involve similarities in etiology.

A blogger called Furious Seasons links to this article:
http://www.medicalne...hp?newsid=70179
Which says: "People with bipolar disorder not otherwise specified (BD-NOS), sometimes called subthreshold bipolar disorder, have manic and depressive symptoms as well, but they do not meet strict criteria for any specific type of bipolar disorder noted in the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV), the reference manual for psychiatric disorders. Nonetheless, BD-NOS still can significantly impair those who have it".

Now, check out his entry on renaming SBD:
http://www.furiousse...r_disorder.html
states that, in comparison to cyclothymia "SBD is like so totally better! Cyclothymia includes alternating periods of low scale hypomania and low scale depression. But SBD is skipping the depression altogether, so we can focus on people who are chronically productive and medicate them until they put on 100 pounds."
And be sure to look at the people who are responding to it, who have bought into the fiction that hypomania is equivalent to extra happy.

There are some very interesting things to write about, but they are not being written about well in the blogs I have been able to find. For example, some questions I would ask these dudes if I weren't so afraid of confrontation:

Are our current, DSM-IV views of abnormality the ones that should define what is normal and abnormal? If not, should something else (such as, the subjective perceptions of normal/mentally ill that a particular generation on average grew up with) fix the boundary? Should our diagnostic definitions be open to research finding that a set of people formerly included in "normal" have persistent problems that resemble those of people who are currently included in a diagnosis, and bring that information to attention?

On a related note, should our current rates of diagnosis be the "right" ones? (Or, possibly, our rates from the 90s, or the 80s, or what...) Or should we look at population data to see how many people who would benefit from accurate diagnosis and treatment have not received either?

Should people who don't have "enough" (for whatever definition of enough) problems not receive diagnoses that will help direct them toward the treatment they need to handle those problems effectively?

-------

Stuff like this makes me so angry - it's often seems like a failure to admit that someone really could have severe problems, sometimes combined with a need to gatekeep diagnoses so that nobody less troubled can "get in." It's not an exclusive club, it's a set of labels that can help people, but do not currently label all the people they can help.


#2 Maddy

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Posted 15 May 2007 - 08:35 PM

I read through it and it appears that they have problems with medication...period.
Not just for BP-NOS and BPII.

And as far as the Furious Seasons blog, many of the comments showed just how stupid some of these people are that get fished into believing these ideas. Like the guy who went off of Neurontin cold turkey because his Pdoc said it was ok to do. Don't they realize anything about these meds? Did they bother to read the PI sheet (almost typed shit, har)? Or do any research on what they were putting into their bodies?

I'm BPI but this kind of thing still pisses me off. How can they completely discount another persons condition? Calling it "Life's little ups and downs" is such bullshit. Don't they realize how they are contributing to the mental health stigma? Not to mention the fact that by not controlling mania/hypomania can cause even more serious issues down the road?


AARRRGGGHHH! I just want to rip these idiots a new asshole or two!

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#3 reddog

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Posted 15 May 2007 - 08:45 PM

Maddy: they already ARE assholes. *sigh* (i keep having issues with a coworker who believes 'stress' causes MI..that you 'snap' and develop schiz or bp or MD or whatever. *sigh*)
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#4 LikeMinded

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Posted 16 May 2007 - 07:58 AM

This here's a lovely combination...

A relatively newly-adopted but pervasive maxim of modern allopathic medicine is "treat the patient, not the symptoms".

It seems that these pop-psych pundits (and perhaps a few doctors) haven't yet gotten past "treat the symptoms, not the DSM-coded diagnosis".

Edited by herrfous, 16 May 2007 - 09:00 AM.

CAUTION: I'm a graduate computational medicine/allied health information student, and NOT a licensed clinician of any sort in any part of the world.  I can come up with lots of algorithms, generalities, and statistics but cannot provide specific medical advice for you!  You, along with your healthcare provider/pdoc/tdoc/etc. are the best decision makers for what is best!

 

Me: MDD, AD/HD, Asperger's/HFA/PDD-NOS/WTF, REM behavioral disorder/misc. sleep issues, some variant of PTSD... toss in hypothyroidism, post-meningitis-related Parkinson's disease/tremor, early stage pulmonary hypertension from a connective tissue disorder that wants me dead before age 60, and a few misc. manly hormone issues, and you'll get a few insights on where that PTSD came from.

 

Now on: Cymbalta, mirtazapine, oxybutynin, clonazepam, lamotrigine, clonidine, levothyroxine, metformin, Testim.  As Velvet Elvis implied, I sound like a freakin' maraca salesman when I go through airport security.


#5 GroovyGwen

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Posted 16 May 2007 - 08:25 AM

It seems that these pop-psych pundits (and perhaps a few doctors) haven't yet gotten past "treat the symptoms, not the DSM-coded diagnosis".

That's good. I'll have to remember that.

Depressive bipole on Venlafaxine (Effexor) 225mg & Lamotrigine (Lamictal) 200 mg


#6 Velvet Elvis

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Posted 16 May 2007 - 03:28 PM

dorks like these are why I really want to start a real, non-invision blog here once I get our server upgraded.

I'd go so far as to accuse them of folk psychology, but I tend to be a proponent of eliminative materialism.

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#7 mel1

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Posted 23 May 2007 - 05:18 PM

How about this fabulous dx? One of the substitute teachers at our school told me that he is an expert at diagnosing bipolar people because he use to be a minister. Here is his list of common characteristics that all BP's share: 1. They are vindictive.
2. They are pathological liars.
3. They are sociopaths.
Hmmmm.....It was reeeaaallly hard to keep my mouth shut on that one! It's too bad there's so much misinformation on BP and other forms of MI. It creates such a stigmatism-as if we don't have enough problems. I would love to be able to be open about my illness, but that's an impossibility. I would love for people to understand me, my moods, actions, reactions are a result of a disease. Migraines are socially acceptable (except for those who say,"It's all in your head")heehee. It is a neurological problem, not much different than BP is a neurological disorder.
"I cannot do everything, but I can do something."-Helen Keller
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current dx: Bipolar 2, GAD s/ Panic Disorder, dysthymia, MDD, ADHD
current rx: seroqel- 100 mg-50 am and 50 at bedtime; Lamictal-100-am, 200-pm; Klonopin-.5-TID

#8 resonance

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Posted 23 May 2007 - 05:27 PM

yeah, I talk openly about my migraines. and migraine medication. that one's easy. people might or might not believe you really have them but if they do believe you have them they're generally nice to you.

#9 cockers.everywhere

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Posted 23 May 2007 - 06:37 PM

How about this fabulous dx? One of the substitute teachers at our school told me that he is an expert at diagnosing bipolar people because he use to be a minister. Here is his list of common characteristics that all BP's share: 1. They are vindictive.
2. They are pathological liars.
3. They are sociopaths.
Hmmmm.....It was reeeaaallly hard to keep my mouth shut on that one! It's too bad there's so much misinformation on BP and other forms of MI. It creates such a stigmatism-as if we don't have enough problems. I would love to be able to be open about my illness, but that's an impossibility. I would love for people to understand me, my moods, actions, reactions are a result of a disease. Migraines are socially acceptable (except for those who say,"It's all in your head")heehee. It is a neurological problem, not much different than BP is a neurological disorder.


Send the idiot to me. ;)
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#10 LikeMinded

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Posted 23 May 2007 - 10:14 PM

How about this fabulous dx? One of the substitute teachers at our school told me that he is an expert at diagnosing bipolar people because he use to be a minister. Here is his list of common characteristics that all BP's share: 1. They are vindictive.
2. They are pathological liars.
3. They are sociopaths.


The sad thing is, if I ever heard that from someone, I wouldn't have said a word (namely since I fit the criteria reasonably well).


...or I might be lying, you never know. ;)

CAUTION: I'm a graduate computational medicine/allied health information student, and NOT a licensed clinician of any sort in any part of the world.  I can come up with lots of algorithms, generalities, and statistics but cannot provide specific medical advice for you!  You, along with your healthcare provider/pdoc/tdoc/etc. are the best decision makers for what is best!

 

Me: MDD, AD/HD, Asperger's/HFA/PDD-NOS/WTF, REM behavioral disorder/misc. sleep issues, some variant of PTSD... toss in hypothyroidism, post-meningitis-related Parkinson's disease/tremor, early stage pulmonary hypertension from a connective tissue disorder that wants me dead before age 60, and a few misc. manly hormone issues, and you'll get a few insights on where that PTSD came from.

 

Now on: Cymbalta, mirtazapine, oxybutynin, clonazepam, lamotrigine, clonidine, levothyroxine, metformin, Testim.  As Velvet Elvis implied, I sound like a freakin' maraca salesman when I go through airport security.


#11 december_brigette

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Posted 24 May 2007 - 03:10 AM

Hi,

Mel wrote:

One of the substitute teachers at our school told me that he is an expert at diagnosing bipolar people because he use to be a minister.


why is this dude not ministering anymore??? hmmmm.....

db

dx: bipolar 1, anxiety, and a little ptsd

current meds:
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other meds ive tried: abilify, ambien, effexor xr, lamictal, lexapro, lithium, lunesta, paxil, provigil, tegretol, trazodone, wellbutrin, zoloft.
 
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#12 chinacat

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Posted 24 May 2007 - 06:22 PM

Because he's a pathological liar and and a sociopath, and obviously vindictive about it all.

china who has little faith in those men of faith
Dx: Batshit NOS,MAINLY ADD, BPII(used to be the world's fastest cycler, a humbling accolade), knee-buckling, killer anxiety with ANY stress (makes me stupid beyond words)--------- I have finally disvcovered Lithim and I amd as close to human as I have been in muy years!
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#13 Guest_mspen1018_*

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Posted 23 June 2007 - 09:08 AM

It is annoying when people like me who have legit manic episodes have experience with talking to the new age bipolars (i.e. borderline personalities with PMS etc.) and get nowhere. I carry the diagnosis of ADHD and a nasty case of antisocial PD as well, so add that to my lack of Depressive episodes and doctors are even pricks. I just know that mania is not my cup of tea and mania for me is staying awake until I go mad, whether or not I give a rat's behind about anyone but myself and appear "hypomanic" 24/7 due to my untreatable ADHD (speed dependence sort of stops that) I still deserve credit at least in respect to my need for lithium.





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