Okay.. I can't check over the entire content of this article, and please double-check everything I have pointed out, but these are some of the more obvious mistakes:
-Identifying manic and depressed states as "extra happy" and "extra sad" is simplistic and misleading. A less misleading, though similarly simplistic description is that mania indicates periods of extremely high energy and depression periods of low energy. An individual with severe depression is generally incapable of experiencing any emotion (save perhaps despair), including sadness, and individuals with mania frequently experience irritability or rage. Identifying these states in this manner also encourages the misconception that these are simply emotional states which everyone on occasion experiences, and that the individual should therefore be able to control them.
-The distinction between Bipolar I and II is based more on the quality/severity of the moods, rather than the nature of cycling.
-Bipolar I is not known as "raging bipolar disorder," except perhaps in the media and popular mindset. A misleading and stigmatizing label like this really has no place in this article.
-Bipolar II is not rapid-cycling bipolar disorder. Bipolar II is defined as periods of hypomania (mild mania) alternating of periods of depression (and/or mixed states). These patients in turn, as well as those with any form of bipolar disorder, may experience rapid cycling, which is defined as having four or more episodes a year. In addition, you may want to mention cyclothymia (aka mild bipolar disorder), which is hypomania (mild mania) alternating with periods of mild depression, and bipolar NOS (Not Otherwise Specified - more-or-less bipolar disorder that doesn't fit neatly under the traditional descriptions). Individuals with any type of bipolar disorder typically also experience periods of relative stability, though they may nevertheless suffer from residual symptoms.
-Hypomania is a less severe form of mania, not a more severe form (this should be clear from the prefix hypo-, which means less or low). Hypermania is sometimes used to describe the most severe forms, which may include psychosis, which I don't believe is exactly mania combined with mania (I don't understand quite what you mean by this). Patients with Bipolar I typically have both manic and hypomanic episodes; patients with Bipolar II have hypomanic episodes.
-I believe that your statement that mania is the normal state for an individual with Bipolar I is incorrect. Mania does not necessarily win out over depression or hypomania, and neither of the three necessarily win out over periods that are not characterized by mood swings. Please double-check this, however.
-Dekapote is a mood stabilizer/anticonvulsant, not an antipsychotic, and I don't believe it's considered a "stronger" drug than Lithium (it's unclear, also, what criteria could be used to determine this). Examples of popular (second-generation) antipsychotics are Seroquel, Zyprexa, Risperdal, or Abilify. Popular anticonvulsants/mood stabilizers include Dekapote, Tegretol, and Lamictal. Lithium, a mood stabilizer, is in a class of its own, I believe. I also don't believe that your description of the mechanisms of these drugs or what symptoms indicate their use is entirely correct.
-You've written that Biplolar I is easily controlled with medication. This is not exactly the case. Although it is very treatable, patients with any form of bipolar disorder may have to go through many different medications, or medication cocktails, before they find something that works for them, which may take up to several years (and this in no way rules out the necessity of adjusting doses and medications, as needed, throughout the course of treatment, which is effectively life-long). You don't have to include that in your article, but it's not helpful to have (potentially) bipolar patients going in to seek treatment with unrealistic expectations.
I haven't referenced what I've written here, because most of this is very basic, uncontroversial information that can easily be found - however, I've included a couple of links that may get you started. Please double-check everything you have written, preferably with a mental health professional - I can understand that you want to help people, but misinformation like this can be very harmful to patients and their families, directly or indirectly. I'd like to ask that you take this page down until then. Sorry if I was incoherent, but I am bipolar myself :).
http://www.mcmanweb.com/ is excellent (this is a good place to start: http://www.mcmanweb.com/bpfaq1.htm)
Wikipedia should really not be used as a source, but it can point you in the right direction.
There are many excellent books - I'll provide you with titles and other references once I get through this brain fog :).
By K.
About Type 1 Bipolar Disorder
Many people are not aware that in the last few years doctors have begun diagnosing bipolar disorder as two different types, based on how the moods cycle in the patient. Bipolar disorder type 1, also known as raging bipolar disorder, is diagnosed when the patient has at least one manic episode lasting at least one week or longer. Bipolar disorder type two, also known as rapid cycling bipolar disorder, is diagnosed when the patient has at least one manic episode and one depressive episode within four days to one week.
Hypomania is a severe form of mania that typically occurs in bipolar disorder type 1 patients. This state occurs because the patient is almost constantly up; the normal state for the patient is 1 of mania. Therefore, mood cycling in bipolar disorder type 1 patients often involves mania combined with the mood change. Mania combined with mania creates hypomania. Hypomania also can be accompanied by psychotic symptoms such as the patient becoming delusional or having hallucinations. This is a very simplistic way to describe how hypomania and mixed episodes occur.
Mixed episodes also often occur with bipolar disorder type 1. A mixed episode is hard to explain to the general public. It consists of being both happy and sad, up and down, all at the same time. Generally, this translates into the patient being very depressed emotionally, but displaying symptoms of mania such as inability to concentrate and lack of sleep.
Bipolar disorder type 1 is the most common type of bipolar disorder, and the most treatable. Because bipolar disorder type 1 typically manifests itself in the form of long manic periods with possibly one or two short depressive periods each year, treatment options are much more simple. Since mania requires one type of medication and depression requires another type of medication, the ability to treat only mania makes finding effective medications a much simpler task. Mood stabilizers are also quite effective with type 1 bipolar disorder, without the use of mania or depression medications.
The symptoms that the bipolar disorder type 1 patient experiences determines the type of mania medication used to control the excessive moods. In cases of mild but constant mania, lithium is the drug of choice. However, in cases in which mixed mania or hypomania are consistently present, a stronger drug or anti-psychotic, such as Depakote, is typically prescribed.
Bipolar type 1 is also the likeliest candidate for treatment via Cognitive Behavioral Therapy (CBT). This is because the patient is most often in a state that allows them to easily focus their mind on rationalizing situations, recognizing triggers, and suppressing severe episodes. However, when the patient displays symptoms of hypomania, as some bipolar type 1 patients often do, cognitive behavioral therapy is not as effective during these episodes.
Overall, bipolar disorder type 1 is easily controlled through appropriate treatment and medications. If you experience any symptoms of bipolar disorder type 1 you should contact your doctor to make arrangements for diagnostic testing and to discuss treatment options. Ultimately, the patient is responsible for their own illness, and therefore, their own treatment.
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Comments
24th November 2007 - 1:23pm
19th March 2008 - 7:35am
Just thought u should know, to whoever made this site...not sure who u talked to but BP type 1 is the worst,
Ummm - By Katie
16th June 2008 - 8:00pm
Thank you!! I was getting really frustrated reading this article. Reading your replied helped me to feel much better, because I have Bipolar disorder. I guess I get pretty delusional when I'm too manic. I don't sleep, I started having auditory and visual hallucinations. It's actually pretty scary. I thought the world was going to end a few years ago, and I thought the dead had already risen. I tried barricading my apartment to keep them out. So, no, I wasn't really in a "happy manic" state.
Also, starting last year around this time, I started getting hypomanic, which, as you stated, is a mild form of mania. I worked late into the night, and then I would come home and play video games most of the night, sleep 1 - 3 hours, feel completely refreshed, and go back to work to start it all over again. It was great!! Well, that is until it ascended into the spheres of full blown mania. I got all super-sex-crazed, went out every night was too late, until...well, one night... I'm not sure how to explain it. I was okay one minute, but then my belly was awash with acidic dread. Guilt and shame flooded my brain. I couldn't stop it. So...I downed all my bipolar meds and went to sleep hoping I wouldn't wake up. But...I did. I was vomiting, and I couldn't move. An ambulance was called by a friend who found me like that.
Anyway, I don't which bipolar I am. I do know I cycle from hypomanic, which typically last anywhere from a few days to a few months for me, to full mania. I don't sleep, I don't really eat. Sometimes I'm happy and my libido is kicking, which can be difficult for my boyfriend. Sometimes I get compulsive and find myself needing to play video games or write or work on my computer all night. Sometimes I get delusional. My manic can last anywhere from a few hours to a couple of months. Sometimes I crash hard. I've overdosed on my meds 4X so far. Each time...well, I can't believe I've been saved by someone each time.
So, no, mania is not all happiness and fun.
BB
Reply to K's comment - By BB
Also, starting last year around this time, I started getting hypomanic, which, as you stated, is a mild form of mania. I worked late into the night, and then I would come home and play video games most of the night, sleep 1 - 3 hours, feel completely refreshed, and go back to work to start it all over again. It was great!! Well, that is until it ascended into the spheres of full blown mania. I got all super-sex-crazed, went out every night was too late, until...well, one night... I'm not sure how to explain it. I was okay one minute, but then my belly was awash with acidic dread. Guilt and shame flooded my brain. I couldn't stop it. So...I downed all my bipolar meds and went to sleep hoping I wouldn't wake up. But...I did. I was vomiting, and I couldn't move. An ambulance was called by a friend who found me like that.
Anyway, I don't which bipolar I am. I do know I cycle from hypomanic, which typically last anywhere from a few days to a few months for me, to full mania. I don't sleep, I don't really eat. Sometimes I'm happy and my libido is kicking, which can be difficult for my boyfriend. Sometimes I get compulsive and find myself needing to play video games or write or work on my computer all night. Sometimes I get delusional. My manic can last anywhere from a few hours to a couple of months. Sometimes I crash hard. I've overdosed on my meds 4X so far. Each time...well, I can't believe I've been saved by someone each time.
So, no, mania is not all happiness and fun.
BB
17th September 2008 - 9:19pm
This is the most irresponsible and possibly damaging article that I've ever read on this disease. I don't understand why you would even write and publish an article on a disease that you neither suffer or know anything about. You seem to fancy yourself an expert on the subject, and obviously want others to believe the same. Having suffered this disease from childhood, it has taken me over 20 years to find a proper balance of medications (yes, plural - we are rarely treated with a single drug). My story is not unique, nor do I suffer from anoverly severe form of the disease. Nothing about our disease is easily treated, and our doctors do not reclassify us if we surpass our yearly quota of "episodes".
Your lack of respect for us by failing to do even the simplest of research is insulting to those of us who live with this every day, and I can't fathom your motivation for this.
It does, however, smack of a little thing our doctors call narcissistic personality disorder. You should be ashamed of yourself - someone could come here looking for help or information.
You should be ashamed of yourself - By Zina
Your lack of respect for us by failing to do even the simplest of research is insulting to those of us who live with this every day, and I can't fathom your motivation for this.
It does, however, smack of a little thing our doctors call narcissistic personality disorder. You should be ashamed of yourself - someone could come here looking for help or information.
18th September 2008 - 11:22pm
To me it seems like you are dumbing down or even numbing the disorder. Like other people have mentioned is terribly upsetting to me. Being someone who suffers with this everyday. This is my favorite line. "Overall, bipolar disorder type 1 is easily controlled through appropriate treatment and medications. If you experience any symptoms of bipolar disorder type 1 you should contact your doctor to make arrangements for diagnostic testing and to discuss treatment options. Ultimately, the patient is responsible for their own illness, and therefore, their own treatment." WRONG WRONG AND WRONG! Most people dont even realize they have it first off. This is just flat out insulting. And yes you should be ashamed. Know what youre talking about better you start spouting on about something this serious.
This is all wrong! - By Ashley
18th October 2008 - 8:18pm
I am Bipolar Type 1, and I agree with your description of the disease and its treatment. I was diagnosed 23 years ago and after many med changes, I am currently on Depakote, Seroquel, Tomamax, and Invega Er. They seem to do quite well. I had a manic episode last winter--first in 6 years, and I am now in a state of depression--first in 3 years. I enjoyed your article--disagreed with some of the comments. G.S., Ed.D.
Bipolar 1 - By Gause Smith, Ed.D.
21st October 2008 - 1:26pm
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