Depression Learning

Need Help

Question:

Ciara, Welcome to the group.  I know how hard your decision is.  I was diagnosed when I was in college but I was away at home.  I had already taken 2 1/2 semesters of college and didn’t want to waste it by dropping out. I went into the hospital. I came home, and have been taking a course or 2 every now and then if I feel I can I handle it. By the way, is Wellbutrin the only drug you take? Maybe you need a mood stabilzer with it, a lot of ppl are on both a mood stabblizer and anti-depressant. Betsy – Hide quoted text — Show quoted text – hey guys~i’m new to this news group thing, but i need some help and advice. here’s my sit i’m 20, a sophmore in college, and was diagnosed in 6/00 as BP II.  my psyc has me on wellbutrin. the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now? thanks

Response:

I’m reposting this reply with the errors fixed, dyslexia sucks ! As far as accepting manic-depressive illness, I think I’m there, but you never know.  Question.  You on Meds?  

I’ve been on meds for more years than i care to remember, when i first started seeing my shrink, i used to refer to her as "the bitch", but over time she got to know me, and we get on allot better now, Last year i went through a period, where she change my meds almost every month, then we found some that suit me, and i’ve been on them ever since. do most manic-depressive have shadows of mr Toad’s wild ride?

I’m not really the guy to ask about meds, i known almost nothing about them, i just take ‘em, and they either work or they don’t. but i have had some side effects, on some meds, have you had the one where you can’t keep still yet ? i spent a couple of months on that one, it drove me nuts ! I’m cool w/coming here and bitching if you are.

Go for it ! sometimes a good bitching session is the best therapy there is. Since I don’t talk anybody else about this stuff.

I don’t have anybody to share this with either, so i tell the groups almost everything ( sometimes a little too much ) all the best Zardos. May our bits collide, somewhere out there WebPage at www.hispc.demon.co.uk

Response:

(laughing)  yep dyslexia sucks, but that’s a converstion for anothor NG. later, Ciara

– Hide quoted text — Show quoted text – I’m reposting this reply with the errors fixed, dyslexia sucks ! As far as accepting manic-depressive illness, I think I’m there, but you never know.  Question.  You on Meds? I’ve been on meds for more years than i care to remember, when i first started seeing my shrink, i used to refer to her as "the bitch", but over time she got to know me, and we get on allot better now, Last year i went through a period, where she change my meds almost every month, then we found some that suit me, and i’ve been on them ever since. do most manic-depressive have shadows of mr Toad’s wild ride? I’m not really the guy to ask about meds, i known almost nothing about them, i just take ‘em, and they either work or they don’t. but i have had some side effects, on some meds, have you had the one where you can’t keep still yet ? i spent a couple of months on that one, it drove me nuts ! I’m cool w/coming here and bitching if you are. Go for it ! sometimes a good bitching session is the best therapy there is. Since I don’t talk anybody else about this stuff. I don’t have anybody to share this with either, so i tell the groups almost everything ( sometimes a little too much ) all the best Zardos. May our bits collide, somewhere out there WebPage at www.hispc.demon.co.uk

Response:

I’m reposting this reply with the errors fixed, dyslexia sucks !

Whabt erers?

Response:

hi ciara just thought i’d poke my head in and say that i’m a grad student… yes, mr toad’s wild ride is always around. check out your school’s resources… like i’m registered for disability services.. all that means for me is that if i can’t finish a class or something or "something comes up"–i’ve got my butt covered. and also the school health insurance sucks so i have COBRA insurance through my father’s employer (long story, esp cause i’m not speaking to my dad ) talking to other people… hmm… it’s kind of nice to have other people know… also, with the amount of drinking that goes on in college (in my experience) it’s sometimes nice to have a place or a person to get away from that with… a – Hide quoted text — Show quoted text – Zardos, As far as accepting manic-depressive illness, I think I’m there, but you never know.  Question.  You on Meds?  do most manic-depressive have shadows of mr Toad’s wild ride? I’m cool w/coming here and bitching if you are.  Since I don’t talk anybody else about this stuff.  At least not yet. Thanks Ciara the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now? My thoughts are, you should accept your condition, longing for normality doesn’t help, enjoy the periods of stability, enjoy the mainia ( my favorite ),  and when the depression hits, come here and bitch about how basically unfair the world is. it works for me also i find thinking of Gwen helps =-} Zardos. May our bits collide, somewhere out there WebPage at www.hispc.demon.co.uk

Response:

alexia, thanks.  hope your having fun w/finals, if your taking them.  I know disability support services (DSS) pretty well, in have CP (cerebral palsy) and use a chair. i know i can get ACCs under Ada, but last year was such a mess, that I’m afraid if I ask for ACCs for Bp, I’ll get the ‘Well you just can’t cut it.’ response.  Because although having CP, LD and BP sounds like a list of pathologies, they coexist pretty well together.  But if that’s the first thing people hear they kind of shut off.  and there are times when you get sick of asking for ACCs. i usually just tell my profs i was "sick", they probably think it has something to do w/CP and i have no desire to tell them otherwise. seems to work.  my BIO prof is concerned, but i just keep dodging her questions.  I am a Politics major it’s in my nature insurance is not a prob. thanks again, best of luck with the end of the term. Ciara

– Hide quoted text — Show quoted text – hi ciara just thought i’d poke my head in and say that i’m a grad student… yes, mr toad’s wild ride is always around. check out your school’s resources… like i’m registered for disability services.. all that means for me is that if i can’t finish a class or something or "something comes up"–i’ve got my butt covered. and also the school health insurance sucks so i have COBRA insurance through my father’s employer (long story, esp cause i’m not speaking to my dad ) talking to other people… hmm… it’s kind of nice to have other people know… also, with the amount of drinking that goes on in college (in my experience) it’s sometimes nice to have a place or a person to get away from that with… a Zardos, As far as accepting manic-depressive illness, I think I’m there, but you never know.  Question.  You on Meds?  do most manic-depressive have shadows of mr Toad’s wild ride? I’m cool w/coming here and bitching if you are.  Since I don’t talk anybody else about this stuff.  At least not yet. Thanks Ciara the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now? My thoughts are, you should accept your condition, longing for normality doesn’t help, enjoy the periods of stability, enjoy the mainia ( my favorite ),  and when the depression hits, come here and bitch about how basically unfair the world is. it works for me also i find thinking of Gwen helps =-} Zardos. May our bits collide, somewhere out there WebPage at www.hispc.demon.co.uk

Response:

nancy, depends you consider ‘just’ starting treatment.  officially i started a little over a year ago, but w/Prozac then Effexor so it wasn’t really treatment, things got a –LOT– worse before they got better. Yeah, I know the AD thing is weird, I think so too. Don’t get it either. Thanks.  It’s great to have someone to talk to about this stuff. Ciara

– Hide quoted text — Show quoted text – hey guys~i’m new to this news group thing, but i need some help and advice. here’s my sit i’m 20, a sophmore in college, and was diagnosed in 6/00 as BP II.  my psyc has me on wellbutrin. the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now? thanks Welcome Ciara- I have a friend who just turned 21 and is BP and has fibromyalgia.  She was a student at Cal Poly Tech–she had to leave due to her illnesses–mainly the fibro.  But, she is now married and just had a baby and is taking classes in NC at the local university.  :)))) So, there is a light at the end of the tunnel.  IMO–it is unusual to treat bp with just an anti-depressant.  I wonder if your docs are just starting treatment and maybe it is time to add another med to see if it will help you with your cycling?  Might want to ask him or her anyway? I wish you the best, Nancy to email me, remove the Z. administrator/creator/moderator alt.med.fibromyalgia.recovery.info (moderated) alt.support.depression.manic.moderated

Response:

As far as accepting manic-depressive illness, I think I’m there, but you never know.  Question.  You on Meds?  

I’ve been on meds for more years than i care to remember, when i first started seeing my shrink, i used to refere to her as "the bitch", but over time she got to know me, and we get on allot better now, Last year i when the a period, where she change my meds amost every month, then we found found some that suit me, and i’ve been on them ever since. do most manic-depressive have shadows of mr Toad’s wild ride?

I not really the guy to ask about meds, i known almost nothing about, i just take ‘em, and they either work or they don’t. but i have had some side effects, on some meds, have you had the one where you can’t keep still yet ? i spent a couple of months on that one, it drove me nuts ! I’m cool w/coming here and bitching if you are.

Go for it ! sometimes a god bitching section is the best therpoy there is. Since I don’t talk anybody else about this stuff.

I don’t have anybody to share this with either, so i tell the groups almost everything ( sometimes a little too much ) all the best Zardos. May our bits collide, somewhere out there WebPage at www.hispc.demon.co.uk

Response:

Zardos, As far as accepting manic-depressive illness, I think I’m there, but you never know.  Question.  You on Meds?  do most manic-depressive have shadows of mr Toad’s wild ride? I’m cool w/coming here and bitching if you are.  Since I don’t talk anybody else about this stuff.  At least not yet. Thanks Ciara

– Hide quoted text — Show quoted text – the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now? My thoughts are, you should accept your condition, longing for normality doesn’t help, enjoy the periods of stability, enjoy the mainia ( my favorite ),  and when the depression hits, come here and bitch about how basically unfair the world is. it works for me also i find thinking of Gwen helps =-} Zardos. May our bits collide, somewhere out there WebPage at www.hispc.demon.co.uk

Response:

Lynda, I know that moodstablizers are SOP for Manic Depressive Illness, and that anti-depressants can cause a manic episode.  Before I went to psych doc my GP had me on Prozac then Efexor (very bad idea). I don’t really get the anti-depressant thing either. Thanks Ciara

– Hide quoted text — Show quoted text – Hi Ciara, Wecome to ASDMM. i’m 20, a sophmore in college, and was diagnosed in 6/00 as BP II.  my psyc has me on wellbutrin. the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. I have enclosed information on BP DIsorder for you. Peace, Lynda The mainstay of treatment for Bipolar Disorder is a mood stabilizer. An antidepressant (AD) can be added to help with depression. Howver, an AD taken without the coverage of a mod stabilizer can trigger mania in susceptible perons. Here is an excerpt regarding ADs and BP indeced mania. From "Ask the Bipolar Expert": http://www.mhsource.com/bipolar/bp980914a.html Q. I read about Bipolar III (BP III) disorder on your web site. In the DSM-IV, there are only categories for Bipolar I and II. I brought up this topic to my colleagues, and the general response was, "What is Bipolar III? There’s only I and II." My own psychiatrist is unaware of it. My colleagues and I have never used a diagnosis of BP III, because we couldn’t back it up using the DSM-IV. Since there is no code for BP III, I doubt that insurance companies and the federal government would pay for such a diagnosis. How do you handle such a situation and what is the distinction that creates a whole new category for BP III? A. Bipolar III was a proposed way to distinguish bipolar symptoms that occurred specifically from antidepressant use. Most experts think that when antidepressants trigger episodes, the significance is not different than if they occur without antidepressant use. In other words, it has the same long-term implications and warrants the same general treatment strategies. Singling it out with a separate number, therefore, seems more misleading than helpful. Certainly don’t judge your psychiatrist as lacking because he was unfamiliar with the term. http://www.press.jhu.edu/press/books/titles/sampler/mondimor.htm Uncorrected Proof BIPOLAR DISORDER A Guide for Patients and Families Francis Mark Mondimore, M.D. Chapter 1 Normal and Abnormal Moods Bipolar disorder is a mood disorder, one of several emotional disorders whose main symptom is an abnormality of mood. The first step in understanding the illness, then, is to understand what we mean by the word mood. Perhaps more to the point, I want to talk about what psychiatrists mean by the word. The dictionary isn’t much help here; it defines mood simply as "a conscious state of mind or predominant feeling." The "predominant feeling" part of this definition begins to capture the psychiatric concept, but mood is much more than just a feeling. Our mood includes our happiness or sadness, our state of optimism or pessimism, our feelings of contentedness or dissatisfaction with our situation, and even physical feelings such as how fatigued or robust we feel. Mood is like our emotional temperature, a set of feelings that expresses our sense of emotional comfort or discomfort. When individuals are in a good mood, they are confident and optimistic, relaxed and friendly, patient, interested, content. The word happy captures part of it, but good mood includes a lot more. People in a good mood usually feel energetic and have a sense of physical well-being; they sleep soundly and eat heartily. It’s easy for them to be sociable and affectionate. The future looks bright and the moment ripe for starting new projects. When we’re in a good mood, the world seems a wonderful place to live in; it feels good to be alive. When we’re in a low mood, an opposite set of feelings takes over. We tend to turn inward and may seem preoccupied or distracted by our thoughts. The word sad captures some of the experience, but low mood is a bit more complicated. There may be a sense of emptiness and loss. It’s difficult to think about the future very much, and when one does, it’s hard not to be pessimistic or even intimidated by it. We may lose our temper more easily and then feel guilty about having done so. It’s difficult to be affectionate or sociable, so we avoid others and prefer to be alone. Energy is low. Self-doubt takes over; we become preoccupied, worrying about how other people see us. Abnormal Mood Some of life’s more common stresses and the normal human reactions to them are such common experiences that common terms have been coined for some mood changes–and most people recognize these mood changes as quite normal. Moving to a new community where we don’t know anyone often leads to a sense of dislocation and loneliness that we know as homesickness, an unpleasant experience that may last for days or even weeks and that everyone has probably experienced at one time or another. When someone close to us dies, a profound sense of sadness and loss occurs that can become temporarily incapacitating–the deep sorrow that we call bereavement or mourning. At the time of various milestones of personal achievement, we experience changes of mood in the other direction. On the occasion of a graduation or wedding or the birth of a child, a person can be filled with joy and pride and a sense of limitless optimism that can be nearly overwhelming. We wouldn’t call any of these moods "abnormal," even though they may be extreme. Like many other things we can measure in human beings–body temperature, blood pressure, or hormone levels, for example–a person’s mood state normally varies within a certain range. People are not in the same mood state all the time; it is quite normal for everyone to have ups and downs of mood. Do persons with bipolar disorder simply have higher ups and deeper downs? Well, it’s certainly true that the bipolar patient’s ups and downs are sometimes so far outside the range of normal that it doesn’t take a psychiatrist to know that something is very wrong. But to say that persons with bipolar disorder simply have more extreme ups and downs of mood isn’t quite right. Rather, the symptoms of bipolar disorder seem to be caused by a defect in the brain’s regulation of mood. Laura is a forty-year-old vice-president of one of the largest banks in the country. When I walked out into the waiting room to call her for our first appointment, she was sitting with a lap-top computer balanced on her knees and a cellular telephone held up to her ear. "No, Steve, that’s not good enough," she was saying into the phone as she nodded to me. "No, that won’t work either, we need the last quarter’s real numbers, not an estimate. Listen, I’m . . . ah . . . in the doctor’s office. I’ll call you in an hour." I raised my eyebrows and shook my head. "Make that two hours. Bye." Click, click, snap, the LEDs went dark, phone and computer were shut, and in a moment we were sitting in an interviewing room. "I made this appointment as soon as I could after I read this." Laura handed me a pamphlet called A Guide to Depressive and Manic-Depressive Illness. The local chapter of the National Depressive and Manic-Depressive Association had been handing them out at a local shopping mall during a health fair recently. "I’ve known for years that something was wrong, but I didn’t know what. Reading this has made me think medication might help." "What have you noticed that’s ‘wrong,’ as you put it?" I asked. "I go into these, these things," she started. "I get this wired, can’t-slow-down feeling. I’ve always called it ‘the crazies,’ and I usually crash after it’s over. Sometimes I can’t get out of bed for days." "You seem to have a very high stress job," I offered. "Maybe that’s part of the problem." "You sound like my mother. ‘You don’t have to take every promotion they offer you,’ she says. But this isn’t just stress, there’s something else going on. The worst part is, I think these things are getting worse." Laura’s use of phrases like "the crazies" and "these things" seemed to indicate that she felt that these feelings were foreign, not like her normal feelings. "Are you saying that sometimes your feelings and moods are controlling you rather than the other way around?" I asked. Laura sat up straight in her chair. "That’s the best way I could possibly describe it," she said decisively. "I can feel them coming on; it’s almost physical. But I know they’re . . . well, mental, I guess, is the best way to put it." Her face suddenly clouded over. "Does this mean I’m mentally ill?" "Well," I said, "we know that there are illnesses that affect mood, and mood is certainly a mental state. But we have a lot more to talk about before I’ll be able to say just what explains your ‘crazies’ the best." Laura looked slightly relieved and said, "Well, that’s why I’m here, for mood, the disorder can present different symptoms at different times. Persons afflicted with the classic form of the illness have periods of severe depression as well as periods of mania (a mood state that is in some ways the opposite of depression). The observation that these two mood states both occur at various times during the course of the illness gave rise to the older name for the disorder:

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Response:

- Hide quoted text — Show quoted text – hey guys~i’m new to this news group thing, but i need some help and advice. here’s my sit i’m 20, a sophmore in college, and was diagnosed in 6/00 as BP II.  my psyc has me on wellbutrin. the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now? thanks

Welcome Ciara- I have a friend who just turned 21 and is BP and has fibromyalgia.  She was a student at Cal Poly Tech–she had to leave due to her illnesses–mainly the fibro.  But, she is now married and just had a baby and is taking classes in NC at the local university.  :)))) So, there is a light at the end of the tunnel.  IMO–it is unusual to treat bp with just an anti-depressant.  I wonder if your docs are just starting treatment and maybe it is time to add another med to see if it will help you with your cycling?  Might want to ask him or her anyway? I wish you the best, Nancy to email me, remove the Z. administrator/creator/moderator alt.med.fibromyalgia.recovery.info (moderated) alt.support.depression.manic.moderated

Response:

the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now?

My thoughts are, you should accept your condition, longing for normality doesn’t help, enjoy the periods of stability, enjoy the mainia ( my favorite ),  and when the depression hits, come here and bitch about how basically unfair the world is. it works for me also i find thinking of Gwen helps =-} Zardos. May our bits collide, somewhere out there WebPage at www.hispc.demon.co.uk

Response:

hey guys~i’m new to this news group thing, but i need some help and advice. here’s my sit i’m 20, a sophmore in college, and was diagnosed in 6/00 as BP II.  my psyc has me on wellbutrin. the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix. so what to do now? thanks

Response:

Hi Ciara, Wecome to ASDMM. i’m 20, a sophmore in college, and was diagnosed in 6/00 as BP II.  my psyc has me on wellbutrin. the have been times over the last year when i’ve thought it’s been working great. but there hv many times when i’ve been severly depressed and/or suicidal or hypomanic.  but i’ve been telling everyone i’m fine for so long that i don’t knw how to break it. but rapid cycling and college don’t mix.

I have enclosed information on BP DIsorder for you. Peace, Lynda The mainstay of treatment for Bipolar Disorder is a mood stabilizer. An antidepressant (AD) can be added to help with depression. Howver, an AD taken without the coverage of a mod stabilizer can trigger mania in susceptible perons. Here is an excerpt regarding ADs and BP indeced mania. From "Ask the Bipolar Expert":

http://www.mhsource.com/bipolar/bp980914a.html Q. I read about Bipolar III (BP III) disorder on your web site. In the DSM-IV, there are only categories for Bipolar I and II. I brought up this topic to my colleagues, and the general response was, "What is Bipolar III? There’s only I and II." My own psychiatrist is unaware of it. My colleagues and I have never used a diagnosis of BP III, because we couldn’t back it up using the DSM-IV. Since there is no code for BP III, I doubt that insurance companies and the federal government would pay for such a diagnosis. How do you handle such a situation and what is the distinction that creates a whole new category for BP III? A. Bipolar III was a proposed way to distinguish bipolar symptoms that occurred specifically from antidepressant use. Most experts think that when antidepressants trigger episodes, the significance is not different than if they occur without antidepressant use. In other words, it has the same long-term implications and warrants the same general treatment strategies. Singling it out with a separate number, therefore, seems more misleading than helpful. Certainly don’t judge your psychiatrist as lacking because he was unfamiliar with the term. http://www.press.jhu.edu/press/books/titles/sampler/mondimor.htm Uncorrected Proof BIPOLAR DISORDER A Guide for Patients and Families Francis Mark Mondimore, M.D. Chapter 1 Normal and Abnormal Moods Bipolar disorder is a mood disorder, one of several emotional disorders whose main symptom is an abnormality of mood. The first step in understanding the illness, then, is to understand what we mean by the word mood. Perhaps more to the point, I want to talk about what psychiatrists mean by the word. The dictionary isn’t much help here; it defines mood simply as "a conscious state of mind or predominant feeling." The "predominant feeling" part of this definition begins to capture the psychiatric concept, but mood is much more than just a feeling. Our mood includes our happiness or sadness, our state of optimism or pessimism, our feelings of contentedness or dissatisfaction with our situation, and even physical feelings such as how fatigued or robust we feel. Mood is like our emotional temperature, a set of feelings that expresses our sense of emotional comfort or discomfort. When individuals are in a good mood, they are confident and optimistic, relaxed and friendly, patient, interested, content. The word happy captures part of it, but good mood includes a lot more. People in a good mood usually feel energetic and have a sense of physical well-being; they sleep soundly and eat heartily. It’s easy for them to be sociable and affectionate. The future looks bright and the moment ripe for starting new projects. When we’re in a good mood, the world seems a wonderful place to live in; it feels good to be alive. When we’re in a low mood, an opposite set of feelings takes over. We tend to turn inward and may seem preoccupied or distracted by our thoughts. The word sad captures some of the experience, but low mood is a bit more complicated. There may be a sense of emptiness and loss. It’s difficult to think about the future very much, and when one does, it’s hard not to be pessimistic or even intimidated by it. We may lose our temper more easily and then feel guilty about having done so. It’s difficult to be affectionate or sociable, so we avoid others and prefer to be alone. Energy is low. Self-doubt takes over; we become preoccupied, worrying about how other people see us. Abnormal Mood Some of life’s more common stresses and the normal human reactions to them are such common experiences that common terms have been coined for some mood changes–and most people recognize these mood changes as quite normal. Moving to a new community where we don’t know anyone often leads to a sense of dislocation and loneliness that we know as homesickness, an unpleasant experience that may last for days or even weeks and that everyone has probably experienced at one time or another. When someone close to us dies, a profound sense of sadness and loss occurs that can become temporarily incapacitating–the deep sorrow that we call bereavement or mourning. At the time of various milestones of personal achievement, we experience changes of mood in the other direction. On the occasion of a graduation or wedding or the birth of a child, a person can be filled with joy and pride and a sense of limitless optimism that can be nearly overwhelming. We wouldn’t call any of these moods "abnormal," even though they may be extreme. Like many other things we can measure in human beings–body temperature, blood pressure, or hormone levels, for example–a person’s mood state normally varies within a certain range. People are not in the same mood state all the time; it is quite normal for everyone to have ups and downs of mood. Do persons with bipolar disorder simply have higher ups and deeper downs? Well, it’s certainly true that the bipolar patient’s ups and downs are sometimes so far outside the range of normal that it doesn’t take a psychiatrist to know that something is very wrong. But to say that persons with bipolar disorder simply have more extreme ups and downs of mood isn’t quite right. Rather, the symptoms of bipolar disorder seem to be caused by a defect in the brain’s regulation of mood. Laura is a forty-year-old vice-president of one of the largest banks in the country. When I walked out into the waiting room to call her for our first appointment, she was sitting with a lap-top computer balanced on her knees and a cellular telephone held up to her ear. "No, Steve, that’s not good enough," she was saying into the phone as she nodded to me. "No, that won’t work either, we need the last quarter’s real numbers, not an estimate. Listen, I’m . . . ah . . . in the doctor’s office. I’ll call you in an hour." I raised my eyebrows and shook my head. "Make that two hours. Bye." Click, click, snap, the LEDs went dark, phone and computer were shut, and in a moment we were sitting in an interviewing room. "I made this appointment as soon as I could after I read this." Laura handed me a pamphlet called A Guide to Depressive and Manic-Depressive Illness. The local chapter of the National Depressive and Manic-Depressive Association had been handing them out at a local shopping mall during a health fair recently. "I’ve known for years that something was wrong, but I didn’t know what. Reading this has made me think medication might help." "What have you noticed that’s ‘wrong,’ as you put it?" I asked. "I go into these, these things," she started. "I get this wired, can’t-slow-down feeling. I’ve always called it ‘the crazies,’ and I usually crash after it’s over. Sometimes I can’t get out of bed for days." "You seem to have a very high stress job," I offered. "Maybe that’s part of the problem." "You sound like my mother. ‘You don’t have to take every promotion they offer you,’ she says. But this isn’t just stress, there’s something else going on. The worst part is, I think these things are getting worse." Laura’s use of phrases like "the crazies" and "these things" seemed to indicate that she felt that these feelings were foreign, not like her normal feelings. "Are you saying that sometimes your feelings and moods are controlling you rather than the other way around?" I asked. Laura sat up straight in her chair. "That’s the best way I could possibly describe it," she said decisively. "I can feel them coming on; it’s almost physical. But I know they’re . . . well, mental, I guess, is the best way to put it." Her face suddenly clouded over. "Does this mean I’m mentally ill?" "Well," I said, "we know that there are illnesses that affect mood, and mood is certainly a mental state. But we have a lot more to talk about before I’ll be able to say just what explains your ‘crazies’ the best." Laura looked slightly relieved and said, "Well, that’s why I’m here, for an explanation." She picked the brochure up from the edge of the desk. "This is the best explanation I’ve come across yet," she said some of these cases that a diagnosis of schizophrenia can be mistakenly made in an individual and proper treatment go wanting.) If the mood-disorder patient and his or her situation are examined with enough care, however, the basic underlying problem will be found: a problem with regulation of mood. Since the basic problem in bipolar disorder is one of regulation of mood, the disorder can present different symptoms at different times. Persons afflicted with the classic form of the illness have periods of severe depression as well as periods of mania (a mood state that is in some ways the opposite of depression). The observation that these two mood states both occur at various times during the course of the illness gave rise to the older name for the disorder: manic-depressive illness. Both of these opposites of mood occur in affected persons because the brain mechanisms that normally regulate mood don’t work properly. This … read more »

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