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Med-induced hypomania/mania.

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Question:  Is med-induced hypomania/mania always a sign of bipolar disorder?


Could one have unipolar depression even if one has experienced hypomania/mania on one or more medications?


Background:  I'm just curious.  I have certainly experienced hypomania in the past, but most of the occurrences were caused by medication.


Thanks for any input.

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Many medications could induce "hypomania" symptoms in normal functioning people but it would almost surely cease once the medication was stopped. Certain antidepressants especially ones with stimulants properties such as Wellbutrin (Burpropion) and psychostiumalants such as Ritalin, Adderall, Vyvanse, even excessive amounts of caffeine, or certain decongestants containing ephedrine or pseudoephedrine. However, medication/drug induced should not be handled or treated the same as someone experiencing symptoms caused by biological causes. The actual condition when someone experiences what you are experiencing is called "Substance-induced disorders are distinct from independent co-occurring mental disorders in that all or most of the psychiatric symptoms are the direct result of substance use. This is not to state that substance-induced disorders preclude co-occurring mental disorders, only that the specific symptom cluster at a specific point in time is more likely the result of substance use, abuse, intoxication, or withdrawal than of underlying mental illness. A client might even have both independent and substance-induced mental disorders. For example, a client may present with well-established independent and controlled bipolar disorder and alcohol dependence in remission, but the same client could be experiencing amphetamine-induced auditory hallucinations and paranoia from an amphetamine abuse relapse over the last 3 weeks." "A mood disorder can be classified as substance-induced if its etiology can be traced to the direct physiologic effects of a psychoactive drug or other chemical substance, or if the development of the mood disorder occurred contemporaneously with substance intoxicationor withdrawal. Also, an individual may have a mood disorder coexisting with a substance abuse disorder. Substance-induced mood disorders can have features of a manic, hypomanic, mixed, or depressive episode. Most substances can induce a variety of mood disorders. For example, stimulants such as amphetaminemethamphetamine, and cocaine can cause manic, hypomanic, mixed, and depressive episodes."




Edited by Forbidden91
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So, what was said up there^^^.


But, if you have a history of affective disorders, tendencies toward bipolar symptoms, and any family history of bp... a lot of doctors are going to start writing R/O 296 [bipolar] when they need to jot down a diagnosis for you.  Sometimes that ends up sliding into a straight on diagnosis, even without organic mania, for various reasons.


This is not by-the-books procedure, but in practice, it makes a fuck of a lot of sense in some distinct cases.


Another factor is that while the DSM is generally regarded as the psychiatric bible, there ARE actually other bipolar criteria out there that are considered and used.


One of them is based on work done by Young and Klermann. This classification structure includes 6 subtypes of bipolar, including what would be termed Bipolar IV- med induced hypo/manias.  


The party line is that everyone goes by the DSM. 


The reality, in my totally unprofessional, personal and amature experience, is that more and more doctors are taking some from column a and some from column b.

Working with things that they have found apply according to their patients and their professional experience.


But ya know... loony on the net, amiright?


Hope that was more helpful than confusing.


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I've only been (arguably) manic/hypomanic when it's med induced.  SSRIs and hormones, specifically, are not my friends.


Over the years I've done much better being treated as straight bipolar with ACs and mood stabilizers, so my diagnosis is now bipolar II disorder, though my symptoms fit neither bipolar I nor bipolar II very neatly.


The label only matters insofar as you're getting the right treatment.


There isn't a clear cut line between all the mood disorders where everyone fits into one neatly.  Biologically, we have no clear idea how these diseases work, so all the categories are based on symptoms only.  Hopefully when we understand the biological bases of mental illness better, categorizing and treating will be easier and make more sense.

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I stand to be corrected here (so please do if I am wrong) but hasn't the new DSM5 changed this? I'm sure I read that a med- (or was it AD-?) induced hypo/mania will now earn you a bipolar diagnosis.

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