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Can you be bipolar I and have hypomanic episodes?


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That is a tough question, because everyone's experience is different.

BPI is classed as having episodes of flat-out mania alternating with flat-out depression. But reality is somewhat more gray.

Your progression might initially start as hypomanic episodes that self-resolve but then get worse and closer together until you hit true mania. But in that case you probably will have been diagnosed as BPII or NOS and only get your final diagnosis once you experience true mania.

And of course you will go through hypomania as you escalate toward true mania.

Then you have the question of, Who decides, and how do they decide, whether you've hit true mania? Does anybody on the board know how this decision gets made?

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I'm asking because I've apparently had one severe mania (according to doctors) and was hospitalized involuntarily. After that, I was prescribed antipsychotics in addition to lithium. Since then (January this year), I've had eight hypomanic episodes which have resolved themselves without turning into mania (despite some fleeting psychosis in some of these episodes). I'm really confused by what's going on - should I be feeling hypomanic this frequently? Is the diagnosis of BP1 from the hospital likely wrong because of my more recent experiences? 

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We can't diagnose you here.  You're going to have to resolve that with your doctors.
I assume you are in contact with them about the recurring hypomanic episodes.
Did lithium seem to largely resolve your severe episode of mania?
Your response to lithium is, I think, a diagnostic marker
For me, I stayed sick for months taking various antipsychotics until they finally gave me lithium and I had marked improvement.

 

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2 hours ago, Will said:

We can't diagnose you here.  You're going to have to resolve that with your doctors.
I assume you are in contact with them about the recurring hypomanic episodes.
Did lithium seem to largely resolve your severe episode of mania?
Your response to lithium is, I think, a diagnostic marker
For me, I stayed sick for months taking various antipsychotics until they finally gave me lithium and I had marked improvement.

 

I actually had the severe episode on lithium, but my dose was increased in the hospital, and antipsychotics were added. I think the antipsychotics helped to resolve my mood more than lithium, and when I play around with my antipsychotics I become symptomatic again (hence the recurring hypomanias). Lithium did seem to improve a depression, but that might have been due to cycling upwards anyway. 

Not expecting anyone here to diagnose, just appreciate hearing perspectives :) 

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I am not bipolar I - I am schizoaffective bipolar, so have psychosis throughout all of my episodes, thus it could be argued that they all of them are tinged with mania - but I do believe that I experience "proto-manic" episodes, episodes in which I am not flying as high as I do during true mania, but experience milder manic symptoms. So, I would argue, yes. I know a few bipolar I people, and have seen clearly recognisable hypomania in them.

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8 hours ago, survivingbp said:

Not expecting anyone here to diagnose, just appreciate hearing perspectives :) 

Sorry if I sounded dismissive.  Not my intent.  You had asked if the diagnosis from the hospital was wrong and I was trying to respond to that, without sounding authoritative.

In response to your initial post, I'm not sure if I have ever avoided mania after becoming hypomanic.  On several occasions, lithium seemed to help me avoid going manic after reaching altered mood states, during which I was sleeping much less than normal.  Lithium definitely seemed to be regulating the manic end of the spectrum.  It seems now that if I do reach hypomania, it is going to go to full mania.

Not sure what you mean when you say you play around with your antipsychotics.  That doesn't sound too good.  I hope you can get it resolved and get your meds straightened out

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I've had full blown manic episodes that started off as hypo ones. The AAP's I take make it so I mostly don't experience manic episodes. It's when I want to lower doses or switch AAP's that I get into trouble with full mania. So I understand that.

I change meds or adjust doses with dr consent though. I would recommend this for sure because having your dr on board is best. (Although you probably know that already.)

Like Melissa I know I'd have more full manic episodes off of my cocktail of meds. With this combo I get hypo but generally speaking not full manic. And I get depressivd stuff too and I can't take AD's due to manic tendencies. 

I have SZA bipolar too if that makes any difference. I go through a lot of bipolar stuff though, as well as psychosis when mood is fine. 

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