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When I first visited my psychiatrist (few yrs ago), I was told I had rapid cycling Bipolar Disorder II. This made sense to, as I majored in Psych, and done my research.

At one visit, I mentioned to my Dr that I often had auditory illusions. For example, if my roommate was using the shower, I'd think the noise of the water running was actually a low-volume radio. My Dr said my brain was probably overactive and she confirmed her suspicion by administering an ADD questionnaire. So then I was diagnosed with ADD.

So my question is, what's the difference between someone with Bipolar II vs someone with the combo of ADD and depression?

I don't think I have ADD, but god forbid I dispute the allmighty questionnaire!! lol

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So auditory illusions make you ADD? Weird. I'm guessing it just has to do with what meds will help your particular brain cooties. Did your doc prescribe something new because of the dx? You can be BPII and ADD, the ADD doesn't cancel out the BP and knock you back to depression.

I personally don't give a crap what some dude with a degree calls me, as long as the treatment is working. People have told me BPII rapid, BPI, ADD... I think it just helps with insurance and whoever likes people in nice little categories.

Congrats on acing the questionnaire.

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Anybody want to guess what my current official (marked-on-the-charts diagnosis is)? Highlight the below lines between the asterisks to find out... and also get my rampant rantings on psychological diagnoses:

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My official diagnosis is "Bipolar I, most recent episode mixed". I assume that's because I told the pdoc I was irritable a few weeks ago, since that's about when my chart diagnosis changed from II to I. I have never (yet) had anything even resembling full-on mania... or a prolonged mixed state, for that matter. I had a brief truly mixed state for about 3 days after getting acrimoniously fired in 11/2005, but I went back to more normal very quickly.

If anything, I more meet the criteria for BP2 (I only have occasional and mild silicovaginosis, and really, who doesn't??). Hell, I just might have well-controlled atypical MDD and dysthymia with mild euphoric cyclothymic (sort of like a diet hypomania, which in and of itself is considered one-calorie mania) states. Also, I'm known to be rapid-cycling, which is an exclusion for the diagnosis of BP2 as per the DSM.

That sort of stuff leaves people like you and me in a diagnostic hole in the charts, and many docs like to put the "worst" diagnosis down on the chart. That's why if I were you, Berkely, I'd be questioning a BP1 diagnosis just because you have ADD and illusionary phenomena. I also recommend questioning any treatment the pdoc wants to give you (some are especially uptight and want to treat the ICD/DSM diagnosis, and not the patient or even the patient's symptoms!!!).

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Do the illusions go as far as being psychotic? in this case I think it would mke you BPI. Otherwise- not really sure why a dx change is warrented unless you are actually having symptoms of ADD. Are you?

mrsloony--

I assume by 'psychotic' you mean clear and/or disturbing. I get audio illusions all the time, they just don't happen to be pointing me in any particular direction... they all just sound like muffled background conversation or music. I consider the latter a benefit, since sometimes I hear vague melodies that I then compose/write.

My main visual illusion (with eyes open) is a field of translucent "static" all over my vision's field. Apparently, that visual phenomenon is common as dirt in auties and a lot of people with ADD as well as BP2.

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None of my illusions have ever been psychotic or have negatively impacted me.

I looked up the DSM-IV symptoms on Wikipedia (where would we be without Wikipedia?!), and I think only the following apply to me: Often has trouble keeping attention on tasks or play activities, Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time, Is often easily distracted. Apparently you need more than 3 of the statements to be classified as ADD.

Eh, I don't know. I'm not anything for ADD or BPD, and I'm fine. If it ain't broke, don't fix it... or question it, lol.

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Dittoing what others say about the difficulty with "labels." My diagnosis is BPII, ADHD, and GAD, but I have mixed states so does that make me BPI even thought I've never had a full blown manic attack (yet)? I've decided to let my pdoc and tdoc argue that out.

As for my own limited experience on the difference between ADHD and BPII, when it is my ADHD, my experience is "working, working, oooh that's pretty and shiny, let's go touch it," whereas a hypomanic episode is "working, oooh that's pretty and shiny and I AM A GENIUS for noticing it's shinyness, and why don't I spend $1000 on a new laptop to help me be even more of a genius and GOD IS TALKING TO ME and he wants me to be an astronaut."

So I've generally taken ADHD to have a hyperactive component and a distractibility component similar to a hypomanic episode without the accompanying grandiosity, dangerous behavior, and delusions. But that's just my brain and my take on the differences. ;)

When I first visited my psychiatrist (few yrs ago), I was told I had rapid cycling Bipolar Disorder II. This made sense to, as I majored in Psych, and done my research.

At one visit, I mentioned to my Dr that I often had auditory illusions. For example, if my roommate was using the shower, I'd think the noise of the water running was actually a low-volume radio. My Dr said my brain was probably overactive and she confirmed her suspicion by administering an ADD questionnaire. So then I was diagnosed with ADD.

So my question is, what's the difference between someone with Bipolar II vs someone with the combo of ADD and depression?

I don't think I have ADD, but god forbid I dispute the allmighty questionnaire!! lol

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*snip* ...and GOD IS TALKING TO ME and he wants me to be an astronaut."

So I've generally taken ADHD to have a hyperactive component and a distractibility component similar to a hypomanic episode without the accompanying grandiosity, dangerous behavior, and delusions. But that's just my brain and my take on the differences. :)

If God is talking to you you may be moving a little beyond hypomania. ;)

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Yeah, I've been skating the line from BPII to BP I for quite a while now. In the case where "God was talking to me," what actually happened was that my daily Bible reading included a verse about taking a vow, I stumbled upon blog by a nun, had finished watching "Into the Great Silence" (which is a wonderful film on Carthusian monks that's great to watch when you are in "normal mood"), and my daily Catholic podcast was on discernment. Taken together by my manic mind, I made the leap from "Wow, these are a bunch of coincidences" to "God wants me to be a nun (I used an astronaut as an example). So I took a bunch of online discernment quizzes, and made a bunch of rosaries (I make rosaries anyway) and then I crashed. The dangers of being religious and bipolar. :) My pdoc and tdoc seem to think that since it was more delusional than hallucinatory (and I am a deeply religious person who does believe that God does speak to people in subtle ways through the Bible and the still, small voice of our conscience) then it probably fits under BPII.

Probably TMI, but I'm in rare chatty mood today.

*snip* ...and GOD IS TALKING TO ME and he wants me to be an astronaut."

So I've generally taken ADHD to have a hyperactive component and a distractibility component similar to a hypomanic episode without the accompanying grandiosity, dangerous behavior, and delusions. But that's just my brain and my take on the differences. :cussing:

If God is talking to you you may be moving a little beyond hypomania. ;)

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Regarding the "mixed states" thing:

The DSM-IV defines mixed states as full-on depression and full-on mania. By the DSM, you aren't having a mixed state if it's just hypomania mixed with full-on depression (or with any degree of depression).

But, in everyday life a lot of people use "mixed state" to mean depression mixed with hypomania. If you're having that, you're not considered BP-I because it doesn't involve mania and so is not a mixed state by the DSM definition.

Personally I think this is stupid and that mixed state is a very useful term for describing any level of hypomania mixed with any level of depression.

I'm pretty sure that at the time the DSM-IV was put together there wasn't recognition of mixed states in BP-II.

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i think i hear you saying that you aren't sure whether or not your hypomanias are hypomanias or ADD symptoms. there is a huge difference between the two. you'll know it for sure if you experience either. sometimes ADD-like symptoms can sneak into a hypo episode, but usually the hypos are just elevations, maybe with some jitters or sleeplessness and euphoria. you may be cranky= that's a symptom of hypomania too, not necessarily a mixed state.

i'm no DSM junkie, but as far as i know, you have to be DXed BP1 if you have genuine mixed states, those being manias mixed with depressions. people use the term more loosely and maybe it shoudl be applied that way. i don't know because i'm no pdoc and not a DSM writer. i'm just another crazy person.

ADD feels, to me, like i can't keep my head on straight. i'll just abandon projects (like laundry folding or cooking or reading a book), zone out when spoken to, and otherwise be a scatterbrain. i'm accused of being a scatterbrain unless i'm on adderall, and even then (now) i have to work at it.

you probably are correctly DXed with BP2, and perhaps ADD. i think the best thing is to treat symptoms and not worry about lables. insurance companies like lables, so pdocs give them out. the gov likes lables, so for SSDI my pdoc/treatment team had to quantify exactly what is wrong with me according to lables (i've had these lables for a long time, but they had to use them to get my ssdi). you get teh drift.

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