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In your mind, or, rather, to your understanding, how is bipolar 1 different from 2?

Is psychosis a necessary feature? Is it the treatment it responds to? Time spent depressed vs. not? Insight?

Right now I think I'm NOS on paper and while I'm a type B wannabe, ugh, I'm soooo a type A personality deep down and I like things neat and tidy. NOS makes me nuts because it's neither.

My doctor makes me crazy because he doesn't care for labels at all, I'm just "somewhere on the spectrum." I'm too uptight for that, dammit! ;)

I could go on and on with my symptoms but I know how annoying it is to be asked for a diagnosis here so I will spare you and instead just ask, how do you categorize the subtypes?

Edited by ray_of_sunshine
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Mania is the hallmark of Bipolar 1. You don't even need to have depressive episodes, just one mania. Even if that is the only mania you have in your life (that isn't drug induced). You can also get mixed episodes, but my understanding is that they now "accept" that bipolar 2 patients can get mixed. It's the mania that is the focus, BP 2 only has hypomania.

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I don't know which type I am...I think mood wise I tend to be more II, though I could be wrong, but I get psychotic features which shoots me over to I, though SZA also is a possibility.  To me the BP/SZA clarity is more important than BP I/II. 

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I believe the main criteria distinguishing mania from hypomania is the impact on functioning, the severity, and presence of psychotic symptoms. I like the example of me and my sister. My sister is bp 1 and I'm bp 2. During mania, she bought a bunch of guys some guns. When I was hypomanic, I bought cookies for a homeless man. Very different severity. :P of course, only pdocs can truly make the distinction and, its muddled anyway given that its a spectrum.

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Mania involves losing touch with reality, which can take the form of delusions of grandeur, where one thinks they have special powers, a special purpose, are Jesus, the virgin, god, a prophet or something like that. It can also be other forms of psychosis such as other delusions or hallucinations. That's my understanding anyway.

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I had psychotic features, but I also felt like I had "the scoop" on life, how it should be lived, and who was not meeting my criteria. Since practically no one could meet my over-inflated expectations, I felt that they were a waste of space, and started getting pissed at how SO few people DID IT THE RIGHT WAY. Most of my manias have been dysphoric.

 

My pdoc only saw two of them he was certain about, because usually my mood swings and his vacations overlapped. After he officially saw me manic, he became, pretty convinced there were at least three manias he had't seen, and that I just present better than the covering pdocs expected me to if I had "really" been sick.

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The others are right. It's hypo vs full blown mania that is the difference.

Hypo is less severe than mania. It doesn't interfere with functioning as much and causes less problems for a person. You can't get psychotic during a hypo but can with mania. I'm not saying hypo is a walk in the park, but it is noticeably different than full blown mania.

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Mania involves losing touch with reality, which can take the form of delusions of grandeur, where one thinks they have special powers, a special purpose, are Jesus, the virgin, god, a prophet or something like that. It can also be other forms of psychosis such as other delusions or hallucinations. That's my understanding anyway.

 

This i what made them finally decide i had BP1 

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Even though I'm usually more often depressed, which seems to be more common in II, I think the fact that I became delusional and psychotic automatically makes me I. I can't tell if I get hypomanic or manic. I don't see my manic/hypomanic episodes at that, even afterwards, really. Like I bought a website during one and signed up to pay for a year of ancestry.com during another. I don't recall being that different otherwise, but obviously, I was. It's weird since I have a very, very, poor memory. I still can't tell if I get manic or hypomanic or somewhere in between. I do know I can feel mixed sometimes.

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I've been slowly coming to terms with my own diagnosis for awhile now, and have had some trouble figuring it all out, too. I think a lot of the problem for me was having poor personal insight; I'm not a good judge of what's usual and what's not, because I've been unregulated and all over the place, mood wise, for so long. It's hard to see what the docs are talking about when, to me, it's all been part of how I've lived for umpty years.

 

The way it was explained to me, what I have is hypomania. Periodically, for anywhere from four days to a week or so, I have some or all the following occurrences: I sleep less (often in small increments spread out over the day); I'm "at loose ends," having trouble being still, but not able to concentrate on anything; I'm irritable, moody, and sometimes have honest "Hulk smash!" rages, because I'm over sensitive and easily overwhelmed; anxiety tends to spike during these periods, as well. With the meds I take, these cycles aren't gone completely, but they're shorter and easier to handle. I do cycle rapidly, too, but that's a different issue altogether.

 

Honest mania is, to my understanding, much more full-blown than that; a member of my extended family is BP1, and she has problems with grandiose delusions, impulsiveness, and recklessness, financially and personally. For example, one of her children was conceived during a mania. (I'm not saying having a kiddo was not a good thing, just saying that she doesn't guard her decisions as carefully as she normally does.) I don't want to talk too much here, since I'm basically talking out my ass without personal experience of what it's like. But actual mania can result in much greater loss of contact with reality than just hypomania, in my understanding.

 

I'm also way more prone to depression than she is, which I've been told is characteristic of BP2 as well. I have depressive episodes maybe four or five times a year, roughly, and they can be quite lasting. I was diagnosed with depression first, for a long time.

 

For me, figuring it out has involved a lot of personal reading, as well as listening to what my docs were saying and asking them to explain things to me in different ways. I've also gotten better personal insight by keeping a mood journal. Charting on paper has pretty clearly described my tendency to cycle, and put the kibosh to my misgivings about the diagnosis, heh.

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If you're hypomanic (type 2) you can even functioning better and there are no delusions/hallucinations. When manic (type 1) the delusions and hallucinations can destroy and mess with your personal life. I don't say hypomanic (and bipolar) is also nice, because for every bipolar person this is difference.

 

And when I'm manic my toughs race, speak very very very much, so people while throw me out of there house, because they get tired... I sing also very much  (most stupid songs for other people :P )

 

----

 

But if manic: financial, social, relations aspect can be damaged very very hard.  Most people where I was with or be in there house were tired of me, so they don't like me... 

Edited by InnovatingProfessor²
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