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.
© 2007 Just Great Advice Inc.
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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
You have NO business writing this filth. You are misleading the entire world with your lack of knowledge on the subject. People shouldn't, but often do, take what they find on the Internet as solid advice. Take it down!
Bipolar Tempest -Bipolar 1 w/ psychotic features - By Kim Pratt
14th August 2009 - 11:58am
my doctors just gave me notice that i, bipolar type 1 somedays i sleep for 3 or fours days then i get so much engery i do something then i crash.. i don't like people no more i can't even talk to some one with out yelling at them im mad at the world. i go from being happy to getting ready to bite someone head off people don't even have to do anything to me. i know of a few people all they got to do walk in the same room with me and it like a bomb ready to go off .. they also told me i'm just depressed. if the doctors don't know what's wrong with me how m i going to know
bipolar - By vicky
28th October 2009 - 6:26pm
My partner is bipolar type 1. Is it normal for him to hunt sex all the time? He used to want it from me 5, 10, 15 > times a day. he now sorts it from elsewhere and still tells me he loves me and he needs to be with me. He blames it on the bipolar. Is the cheating and lying caused by the bipolar or is he just a dirt bag?? Please help.
By Annette
14th December 2009 - 5:58pm
right you made some pretty damn obvious mistakes hypomainia is not a sever type of mania hypomania is less serious and does not have psychotic symptoms and mania is not present in bipolar type one but present in bipolar type two.
By Chelsea
8th July 2010 - 4:18am
and Annette a manic episode which is present in bipolar type 1 can cause an increased need for sex as their energy is so high and has psychotic symptoms as well so he may loose insight although it is treatable with medication and if he does love you, you should tell him to at least try to control it so he can be faithful to you as it is still painful to be cheated on what ever the reason. And ask yourself is he like this when he is not having a manic episode if not then there will be no need for sex all the time and look if he is talking very fast having delusions and other symptoms you notice when he is having a manic episode and if he does have sex while he isn't having an episode then yes he is a dirt bag and you deserv better
By Chelsea
8th July 2010 - 4:23am
I am a board certified psychiatrist and have treated patients with this disorder for more than 10 years. I also agree with the commentary by K in November 2007. Mania is defined as a period of mood elevation lasting seven days or more with a predominate euphoric or irritable mood associated with pressured speech, racing thoughts, inattention, multitasking, decreased need for sleep, excessive energy, a sense of grandiosity, impulsity over spending money or sex or both, making more plans for the future which are not reasonable for a person to achieve, and loss of insight and judgement.
Patients can manifest intrusive behavior both with euphoria (happy, happy, exuberant) or irritability (with anger and rage). People with BAD Type I often wind up in jail or prison secondary to the behavior they have manifested while manic. Typically once a manic episode begins to remit, there is a rapid crash into bipolar depression which is neurovegative in nature. However, some patients cycle up into mania after an episode of bipolar depression. Mania as well as bipolar depression can be associated with psychotic symptoms such as paranoia, other delusions, and/or auditory hallucinations. Often times patient's with ultra rapid cycling can manifest mood switches daily, and present as mostly irritable and dysphoric, which could represent a mixed state - which is associated with irritability by definition. Patients often panic and become very irritable when switching from a manic episode into a depressed episode and vis versa (mood cycling).
It is not appropriate for me to diagnose Mel Gibson. He is not my patient, but several observation raise a hight index of suspicion that he suffers from this mood disorder:
1. Previously diagnosed with BAD Type I
circa mid 2000's
2. The fact that his Russian
girlfriend stated on the tapes "you
need medication" is consistent with
the diagnosis.
3. His emphasis on oral sex may
represent increased libido assoc-
iated with mania.
4. If he is panicking, and this may
explain his hyperventilation noted
on the tapes. With panic attacks
he could experience feelings of rage
5. His verbal threats could be due to a
sense of grandiosity associated with
mania. This does not justify his
actions whether mood driven or per-
sonality driven. He is external-
izing everything which could be
grandiosity of bipolar illness, or
severe narcissitic personality
traits.
6. It is possible that he stopped
bipolar medications, or that he had
break though symptoms despite psych
med compliance.
7. 50% of patients with BAD suffer from
comorbid substance abuse. Although
he is known to have a problem with
alcohol abuse; one cannot rule out
whether he is using stimulants such
as cocaine/crack cocaine, or crystal
methamphetamine. These stimulant RD
can present as an imposter for
primary BAD,
8. I find it interesting that Whoopi
Goldberg never experienced the
rageful side of Mel Gibson. His
illness may have been controlled
well on psych meds with good
compliance when she had frequent
contact with him.
9. It would be a better prognosis
clinically for a primary diagnosis
of bipolar affective disorder Type I,
rather than manifesting narcissistic
and sociopathic personal traits
not associated with mood dysreg-
ulation.
10.I in no way condone his alleged
physical, verbal, and possible
sexual abusive behavior towards
his GF (with physical injury). He
made terrorist threats towards her
that alluded to potential homicide
(putting a gun to her head). The news
had indicated that he was feeling
suicidal and homicidal according to
outside sources which could represent
a mixed manic episode.
IN CONCLUSION: There is a high index
suspicion that Mel Gibson has manifested
irritable mania in the context of BAD
Type I, likely associated with panic and
anxiety; plus or minus substance abuse. This is my clinical suspicion, but he
may be in a state of narcissitic rage
which is not associated with a mood
disorder, and could be exacerbated by
alcohol or other substance abuse. It
would be a shame if he has BAD and he
gets villified so this becomes ignored.
Adquate treatment could stabilize his mood and therefor his behavior.
I do believe he remains responsible for his actions. I do tell my bipolar patients and they typically concur, that when manic they feel driven by their mood like as if they were on a rollercoaster and not necessarily reacting to outside stressors alone without a driven mood state.
I find what Mel Gibson said as highly offense. He is responsible for his behavior whether he has bipolar disorder or not. I would hate to see this missed which would serve no purpose to anybody. If he is deemed to serve jail or prison time, I would hope that correctional psychiatric services are available to assess his mood and need for mood stabilizers if indicated.
DR. B
About Type I Bipolar DIsorder - Mel Gibson - By Ben - Homepage
Patients can manifest intrusive behavior both with euphoria (happy, happy, exuberant) or irritability (with anger and rage). People with BAD Type I often wind up in jail or prison secondary to the behavior they have manifested while manic. Typically once a manic episode begins to remit, there is a rapid crash into bipolar depression which is neurovegative in nature. However, some patients cycle up into mania after an episode of bipolar depression. Mania as well as bipolar depression can be associated with psychotic symptoms such as paranoia, other delusions, and/or auditory hallucinations. Often times patient's with ultra rapid cycling can manifest mood switches daily, and present as mostly irritable and dysphoric, which could represent a mixed state - which is associated with irritability by definition. Patients often panic and become very irritable when switching from a manic episode into a depressed episode and vis versa (mood cycling).
It is not appropriate for me to diagnose Mel Gibson. He is not my patient, but several observation raise a hight index of suspicion that he suffers from this mood disorder:
1. Previously diagnosed with BAD Type I
circa mid 2000's
2. The fact that his Russian
girlfriend stated on the tapes "you
need medication" is consistent with
the diagnosis.
3. His emphasis on oral sex may
represent increased libido assoc-
iated with mania.
4. If he is panicking, and this may
explain his hyperventilation noted
on the tapes. With panic attacks
he could experience feelings of rage
5. His verbal threats could be due to a
sense of grandiosity associated with
mania. This does not justify his
actions whether mood driven or per-
sonality driven. He is external-
izing everything which could be
grandiosity of bipolar illness, or
severe narcissitic personality
traits.
6. It is possible that he stopped
bipolar medications, or that he had
break though symptoms despite psych
med compliance.
7. 50% of patients with BAD suffer from
comorbid substance abuse. Although
he is known to have a problem with
alcohol abuse; one cannot rule out
whether he is using stimulants such
as cocaine/crack cocaine, or crystal
methamphetamine. These stimulant RD
can present as an imposter for
primary BAD,
8. I find it interesting that Whoopi
Goldberg never experienced the
rageful side of Mel Gibson. His
illness may have been controlled
well on psych meds with good
compliance when she had frequent
contact with him.
9. It would be a better prognosis
clinically for a primary diagnosis
of bipolar affective disorder Type I,
rather than manifesting narcissistic
and sociopathic personal traits
not associated with mood dysreg-
ulation.
10.I in no way condone his alleged
physical, verbal, and possible
sexual abusive behavior towards
his GF (with physical injury). He
made terrorist threats towards her
that alluded to potential homicide
(putting a gun to her head). The news
had indicated that he was feeling
suicidal and homicidal according to
outside sources which could represent
a mixed manic episode.
IN CONCLUSION: There is a high index
suspicion that Mel Gibson has manifested
irritable mania in the context of BAD
Type I, likely associated with panic and
anxiety; plus or minus substance abuse. This is my clinical suspicion, but he
may be in a state of narcissitic rage
which is not associated with a mood
disorder, and could be exacerbated by
alcohol or other substance abuse. It
would be a shame if he has BAD and he
gets villified so this becomes ignored.
Adquate treatment could stabilize his mood and therefor his behavior.
I do believe he remains responsible for his actions. I do tell my bipolar patients and they typically concur, that when manic they feel driven by their mood like as if they were on a rollercoaster and not necessarily reacting to outside stressors alone without a driven mood state.
I find what Mel Gibson said as highly offense. He is responsible for his behavior whether he has bipolar disorder or not. I would hate to see this missed which would serve no purpose to anybody. If he is deemed to serve jail or prison time, I would hope that correctional psychiatric services are available to assess his mood and need for mood stabilizers if indicated.
DR. B
19th July 2010 - 8:17am
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My Articles About Type 1 Bipolar Disorder Bipolar disorder, also known as manic depression, is a mental.. About Bipolar II Disorder Bipolar disorder is also known as manic depressive disorder... Concerns Of Bipolar Disorder Self Injury In bipolar disorder, there is sometimes concern about bipolar.. CBT As Treatment For Bipolar Disorder Bipolar disorder, known by many as manic depression, is a.. |
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