Poking at the DSM

Ok, so I know one need not have experienced all of these symptoms to be diagnosed with BPD, and yes the DSM is chock full of vagaries and generalities, but I'm curious about the following...

1. Which symptom have you NEVER experienced in mania/hypomania?

2. Which do you ALWAYS experience in mania/hypomania?

3. What would you add to the list?

• Inflated self-esteem or grandiosity
• Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
• More talkative than usual or pressure to keep talking
• Flight of ideas or subjective experience that thoughts are racing
• distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
• Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
• Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

Never experience inflated self esteem or grandiosity -- bummer probably the best on the list.

Always experience racing thoughts, sometimes pressured speech.

Hypomania (according to docs) for me has always been more agitation and irritability than inflation and "glee" or good mood. Anyone else have this?

Very rarely. The only time really was when I had a kitten that died and when I went to look to see if maybe I wanted a new kitten I came home with 2 kittens and a bunch of supplies, days after I bought a new TV. I'm too afraid to let go to get in trouble with this stuff, at least so far. I've had problems at work related to impulsivity but not in this way.

I would add sensory over-stimulation, isolation, impulsivity and possibly decreased insight.

I have every symptom on the list.

And I have had them both times I was manic.

Mostly

I would add that my anxiety goes through the roof too, and not necessarily the bad kind, the kind where you're on high alert and sometimes jittery. Also my body buzzes with vibrations, like I can feel the energy coursing through my veins

I have every symptom on that list. Spending and promiscuity are the worst for me.

I can identify with some of the symptoms that you have mentioned but not all.

Never experienced grandiosity either nor excessive involvement in pleasurable activities that have a high potential for painful consequences.

I've had every single symptom of bipolar disorder (mania and depression) at some point, but oddly enough 'decreased need for sleep' is the one I have the least. I've seen a lot of people talk about staying up for days on end and still not being tired, but that's only happened to me a handful of times (and usually no more than about 48 hours before I crash). During hypo/mania I can get by on less sleep than usual (like 4-5 hours vs my usual 8-9) for long periods, but I still feel tired and want to sleep in.

Goal-directed activity, always always always. I get completely immersed with a new hobby or become entirely romantically obsessed with someone. Also sensory overload, omg the colors.

I've had every item on the list the one time I experienced full-blown mania. The last item is the one I experienced the least. (I wanted to pay of my friend's car for him, but my husband wouldn't let me lol)

I would add possessiveness of other people (I got obsessed over the same friend and still am to some degree, and it was almost like I felt he was mine to do with as I pleased... control his life, etc. It was weird.) and extreme religiosity (elements of the religion I grew up with plus my own crazy stuff mixed in) to this list.

Thanks for this. Here it is, the DSM list. Okay.

• (1) Inflated self-esteem or grandiosity YES
• (2) Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) No, but the sleep can be very light, like electricity surfing my skin.
• (3) More talkative than usual or pressure to keep talking
Not really. I get a bit louder and faster, notice it, and scale back.
• (4) Flight of ideas or subjective experience that thoughts are racing
YES, ideas just pop one after the other
• (5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
YES, this is part of the danger that comes from the next item
• (6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
YES, this was the most confusing thing I learned. Like, both "oh, that's a problem" & "everybody doesn't do this?"
• (7) Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
YES, and the pleasure comes from succeeding at the goal-directed activity. Clearly, whoever approved this just doesn't get how good succeeding can feel.

Thanks for posting this list. I think each of these can be deconstructed and dialed down, or even dialed to off if necessary for our own or others safety.

I'll begin a new thread on my latest challenges with 'excitement.'
Revu2

Everything on that list. Except for the excessive engagement in pleasurable activities. And the grandiosity was just in what I believed I was capable of doing. I didn't have inflated self esteem.

I really never thought about any of this before as it pertained to myself... Ty...

Yes to the buzzy energy thing!

And bubbling chest feeling

Yep this is me. The sleep thing is how I feel too. I have often thought I must not be bipolar or manic because I still sleep. Pdocs have also blown off my manic symptoms because I say I am sleeping. I probably sleep less for sure but like you I still get tired. Even during my worst mixed I still slept. I just didn't fall asleep till like 4 am and then I would wake up at 9 or 10.

And yes! I always joke that I know a lot of the stuff I know because I obsessed over it during a mania.

I've had them all to some degree. Probably the least is the last one. That and the sleep are the ones that always made me think it wasn't really mania. However I get all of the other ones pretty much.

I think it is interesting how many people on here don't experience the last one or the first one that much. It is just interesting to me.

Thanks for this thread. This kind of thing fascinates me.

It makes me wish we the people actually had some sort of say in what goes into the DSM. imagine them asking US the crazy people.

It is interesting that the "famous" symptoms are the ones we aren't all having.

I remember blocking someone from my blog reader feed once because she'd been given a mood stabilizer and joked that if she was going to be treated as bipolar (I don't think she was diagnosed) she at least should have had some sexual fun. I didn't find it funny.

They did accept patient input before the new DSM came out. I don't think they necessarily listened but input was taken for a time. I do not trust how that whole book was done though. My therapist was a tester for the bipolar diagnosis and symptoms. He had a bunch of computer training and then since I was his established bipolar patient I did a computer assessment that was so badly done that I couldn't tell what some questions were asking. Then we had to go through a LOT of questions he asked me and he had to fill out things on the computer for that and then it was all submitted. We were supposed to do a follow-up in a few weeks. The selected so many testers indicating they planned to use so many tests but then they cut off the data collection before my 2nd round was done. It appeared to be cut off arbitrarily. Which makes me distrust DSM-V a lot. They used my first data so how could they not use the 2nd half to get the complete pairing? It made no sense.

I clearly get them all. Sometimes in very bizarre ways. I can't think of anything to add to the list...perhaps unhealthy obsessions? Of course, that could potentially be the same as either an increase in goal directed activity or excessive involvement in pleasurable activities depending on the obsession. Oh, and I talk to myself out loud and have loud bursts of laughter over nothing.

oh, yeah, the talking to myself. I have long conversations with myself. I have to be careful because my mom has an Australian cattle dog who hears EVERYTHING. She lives just a couple hundred feet from me. If the windows are open he hears me talk to myself and starts barking.

I forget that's not normal....

Actually self-talk is up for "review" in the culture/media. Kids are being encouraged to use it to scaffold their academic learning.

And, no writer worth a Tony or Oscar would release a script without reading it out loud.

No less an authority than Lawrence Olivier suggested to a writer he was working with that he ACT his drafts "outloud" to improve them.

Lawrence Olivier. 1952. "To digress a little. You know darling boy if you would act some of your roles, which I am sure you could do as well as any of us, you would find out so much that would cause you constructive pondering. ... It could never ever be right or desirable in the theatre that we lose our audience. …
The emotions of the audience last the longest of the contributions they bring to the theatre. Intellect wears out the quickest. After all they have paid their money to enjoy themselves."

Talk on!
Revu2

No Inflated self-esteem or grandiosity
No Foolish business investments
Yes to Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation, but I jump from goal to goal.
No Foolish business investments.
Yes to all the rest adding increase in anxiety.

This is fascinating to me. Thanks for sharing.