![]() |
FAQ/Help |
Calendar |
Search |
#1
|
|||
|
|||
I've been researching for years, and still I'm not clear on the differences/similarities. Who would like to throw out some ideas or experiences about which is which, how the diagnoses overlap, and so on?
__________________
|
![]() Anonymous46341, still_crazy, Sunflower123, Wild Coyote
|
![]() Wild Coyote
|
#2
|
|||
|
|||
ugh. diagnosis. psychiatry is subjective...and that opens it up to all sorts of problems. anyway...
bipolar II usually means no mania, frequent depression, hypomania and/or milder mixed states (agitated depression I think qualifies with some shrinks). at the softer end, it seems to overlap with some 'personality disorders' ... at the more severe end, it can overlap with what would once, perhaps not so long ago, been considered 'severe endogenous depression.' bipolar i- mania. severe depression. it used to be understood that the person was normal(ish), even high functioning when not in the midst of an episode...that's changed, somehow. psychosis, if it occurs, is limited to the mood episode...severe mania might bring psychosis, less often psychotic depression is an issue. schizoaffective-- the manic type is more similar to bipolar I, in terms of long term outlook. psychosis occurs outside of mood states, but is not the core, defining feature, as one sees in Schizophrenia. the depressive sub-type is, from what I understand (and I could be wrong) a lot more like Schizophrenia, in terms of long term outlook and such...severe depressive states, psychosis both during the depressive states and when in a more or less normal mood. now, that's just -my- understanding of dsm-checklists. i could be wrong. i think its also worth noting that the labels are mostly useful for billing and guiding treatment, to a point...where the rubber hits the road, go to 2 shrinks, get 3 opinions. it is what it is... :-) |
![]() Wild Coyote
|
![]() *Beth*, cashart10, childofchaos831, luvyrself, Sunflower123, Wild Coyote
|
#3
|
|||
|
|||
Hi BethRags. I'm not a mental health professional, but from all of my research the following are the core similarities/differences:
Resources: 1. DSM-5 (Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition) 2. Statistics on average ratios of depression to hypomania (or mania) appears in several articles online, including The National Center for Biotechnology Information journal article at Treatment of acute bipolar depression which references the following: Judd LL, Akiskal HS, Schettler PJ, Coryell W, Endicott J, Maser JD, et al. A prospective investigation of the natural :history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry. 2003;60:261–9. Last edited by Anonymous46341; Nov 10, 2019 at 05:34 PM. |
![]() Wild Coyote
|
![]() *Beth*, Sunflower123, Wild Coyote
|
#4
|
||||
|
||||
As someone who has been diagnosed with all three at different times...
Bipolar 2: Severe depression with mild mania that doesn't interfere with life Bipolar 1: Severe depression AND mania that interferes with life and/or needs hospital to keep safe Schizoaffective: Same as the bipolars, but with the addition of psychotic symptoms (hallucinations and delusions) that occur even when mood is normal ("euthymic")
__________________
dx: schizoaffective bipolar type; OCD; GAD rx: clozapine, clonazepam PRN |
![]() still_crazy, Wild Coyote
|
![]() *Beth*, still_crazy, Sunflower123, Wild Coyote
|
#5
|
||||
|
||||
just to throw this in the loop:
bipolar 1 doesn't have to have depression, just hypo mania or mania. If you have been hospitalized with psychosis then you are BP1. bizi this is me.
__________________
lamictal 2x a day haldol 2x a day cogentin 2x a day klonipin , 1mg at night, fish oil coq10 multi vit,, vit c, at noon, tumeric, caffeine Remeron at night, zyprexa, requip2-4mg |
![]() *Beth*, Wild Coyote
|
![]() *Beth*, Moose72, Sunflower123, Wild Coyote
|
#6
|
|||
|
|||
Quote:
Schizoaffective bipolar type *literally* implies that you have bipolar with schizophrenic symptoms. For example, flat affect, catatonia, word salad, warped thought processes, etc.. (Basically, there are certain behaviors/mannerisms that come packaged with disorders on the schizophrenic spectrum.) Also, in some cases, level of functioning is taken into consideration as well. Psychosis is just one symptom of schizophrenia. I know personally that psychologists at one point thought I might have schizoaffective disorder because of my stubborn psychosis that never goes away no matter what. However, when I underwent specialized psychological testing, the psychologist said I didn't have enough of the schizophrenic type symptoms to qualify for such a schizoaffective diagnosis. For example, I have flat affect, flat vocal tone, social problems, isolation, etc., but the psychologist said I didn't 100% portray as someone who actually has schizophrenia or schizophrenia-like disorder. (Basically, I only somewhat portrayed and she wrote that down.) People who do not have schizoaffective disorder but who have psychosis independent of mood episodes are supposed to be Dx'ed with bipolar w/ mood-incongruent psychotic features, using the shortened "with psychotic features" specifier. Since there is no such "bipolar 2 w/ psychotic features" label, I guess you're automatically Dx'ed with bipolar 1 even though you technically have bipolar 2 w/ psychotic features. I'm not sure why there is no such "bipolar 2 w/ psychotic features" label, but I don't think bipolar 2 has more than one diagnostic code to begin with. Whatever you end up having, though, as long as you get treatment for your symptoms and your insurance doesn't complain about said treatment, then that's all that matters. But I just wanted to point out the differences between schizoaffective and the "psychotic features" BP specifier since, well, that was asked. ![]() |
![]() Anonymous46341, sophiebunny, Wild Coyote
|
![]() *Beth*, sophiebunny, Sunflower123, Wild Coyote
|
#7
|
|||
|
|||
Quote:
I've edited out my bit about this in my post above. |
![]() Wild Coyote
|
![]() Wild Coyote
|
#8
|
||||
|
||||
I was diagnosed schizoaffective when I had my first episode for mania because there were mood and thought processing issues together which met both . Then I had a severe depression episode and another manic episode so was diagnosed for bipolar. For a while it was there but less severe so I became bipolar 2 and later I became more severe and was determined to be bipolar 1 . I think diagnosis is used to treat and communicate sets of symptoms so as you have more history the easier it is to get right. I have psychosis in episodes also and a seasonal pattern.
|
![]() Wild Coyote
|
![]() Wild Coyote
|
#9
|
|||
|
|||
Quote:
![]() I've always received the same diagnosis (over about 30 years) - until these past few years, when my standard BP2 seems to be spending some time in either BP1 or Schizoaffective.
__________________
|
![]() Wild Coyote
|
![]() Wild Coyote
|
#10
|
|||
|
|||
Quote:
![]() If you feel like sharing it...what is your experience of hypomania vs. mania?
__________________
|
![]() Wild Coyote
|
![]() Wild Coyote
|
#11
|
|||
|
|||
Quote:
Thanks, franz kafka. Short and sweet...I appreciate your experiential reply. Which dx do you feel fits you at this time in your life (if you'd like to share)?
__________________
|
![]() bizi, Wild Coyote
|
![]() Wild Coyote
|
#12
|
|||
|
|||
Quote:
Thanks, bizi. Your input is so helpful...makes sense.
__________________
|
![]() bizi, Wild Coyote
|
![]() Wild Coyote
|
#13
|
|||
|
|||
Quote:
Quote:
~~~~~~~~~~~~~~~~~~~~~~~
__________________
|
![]() Wild Coyote
|
![]() Wild Coyote
|
#14
|
|||
|
|||
I think so, too.
__________________
|
![]() Wild Coyote
|
![]() Wild Coyote
|
#15
|
|||
|
|||
Quote:
I don't hear as much about the seasonal aspects of BP as I used to.
__________________
|
![]() Wild Coyote
|
![]() USMCBIPOLAR7, Wild Coyote
|
#16
|
||||
|
||||
Schizoaffective makes the most sense for me. My biggest issue interfering with my life is psychosis, which happens frequently and often without mood symptoms. That, and I never responded well to mood stabilizers. Clozapine (which is an anti-psychotic) is the only med that has dealt with both mood and psychosis.
__________________
dx: schizoaffective bipolar type; OCD; GAD rx: clozapine, clonazepam PRN |
![]() *Beth*, Anonymous46341, still_crazy, Wild Coyote
|
![]() *Beth*, still_crazy, Wild Coyote
|
#17
|
|||
|
|||
Quote:
![]() I've heard some good stuff about Clozapine. My own pdoc mentioned the possibility of prescribing it, but then she went with Zyprexa for whatever reason. So far, the Zyprexa seems good.
__________________
|
![]() bizi, still_crazy, Wild Coyote
|
![]() Wild Coyote
|
#18
|
||||
|
||||
I have been diagnosed with all three during my mental health journey.
Bp 2 with mixed features and rapid cycling was my first bp dx. My symptoms were rather mild. No psychosis. Bp 1 by every other dr it seems because in my 20s I started getting more destructive mania. Then came she 25 when I had my first psychotic episode. I got dxd bp with psychotic features. Still rapid cycling and mixed features too. I’m 32 now and my pdoc still says bp1, rapid cycling with psychotic features. My psychologist however has seen me for longer and is convinced I have schizoaffective bp Type with rapid cycling and mixed features. So who knows! But I DO get psychosis even outside a mood episode.
__________________
schizoaffective bipolar type PTSD generalized anxiety d/o haldol, prazosin, risperdal and prn klonopin and helpful cogentin |
![]() *Beth*, still_crazy, Wild Coyote
|
![]() *Beth*, still_crazy, Wild Coyote
|
#19
|
|||
|
|||
Quote:
I have bipolar 1 disorder with psychotic features, DID with a psychotic part, and PTSD with psychosis. No therapist would ever figure that out. It takes an MD. |
![]() Anonymous46341, still_crazy, Wild Coyote
|
![]() *Beth*, still_crazy, Wild Coyote
|
#20
|
|||
|
|||
wow. i think it depends on where you get treatment, too. im at a clinic. they do lots of injections there (eek!), but...for a lot of non-psych reasons, I've been spared that. so....my label has bounced from bipolar I, the kind that = no antidepressants, ever...
to 'high functioning' schizoaffective, manic type...anxiety disorder with a side order of hyper-vigilance; prozac to the rescue. at -this- place, if it wasn't for my family, I'd be labeled 'schizophrenic, too smart' and probably find myself on injections with a thorazine booster or something ridiculous like that...I've seen it happen. i dunno. a former shrink swears up and down im 'schizophrenic, too smart', which...makes me scared of shrinks. true story. |
![]() Wild Coyote
|
![]() *Beth*
|
#21
|
|||
|
|||
Quote:
|
![]() Anonymous46341, sophiebunny, Wild Coyote
|
![]() *Beth*, Wild Coyote
|
#22
|
|||
|
|||
Quote:
__________________
Bipolar 1 Lamictal: 400 mg Latuda: 60mg Klonopin: 1 mg Propranolol: 10 mg Zoloft: 100 mg Temazepam: 15 mg Zyprexa 5-10mg prn (for Central Pain Syndrome: methadone 20 mg; for chronic back pain: meloxicam 15 mg; for migraines: prochlorperazine prn) |
![]() Anonymous46341, still_crazy, Wild Coyote
|
![]() *Beth*, still_crazy
|
#23
|
|||
|
|||
hi. i was just trying to point out that the old school, 'manic depressive psychosis' diagnosis was usually reserved for people who had intense depression, severe mania, and didn't have significant psych problems outside of episodes. however...
fun fact: from the 50s-70s, US psychiatrists diagnosed -most- hospitalized people and severely mentally ill people with some form of Schizophrenia. The manic depressive label was not used nearly as frequently. Psychiatrists in the UK, western Europe...not so big on Schizophrenia. They had (and I think still have) a broader view of Bipolar I, to include varying degrees of psychosis, anxiety, obsessive stuff, etc. On the one hand, its "just a label," but on the other hand... in probably most modern societies, Schizophrenia is an extremely stigmatizing label/diagnosis. Over-use of the label of Schizophrenia is just one reason the anti-psychiatry movement popped up and was able (for 15, 20 years or so...) to exert some influence. personally, I'm not really 'anti-psychiatry' so much as I am for a more drug-centered psych treatment, which...is how a lot of old school psychiatrists did things, especially in the UK and Western Europe. match pills to problems, basically, no matter the label/diagnosis in use. For whatever reason(s), back in the day, US doctors were a lot more heavy-handed with thorazine and other older neuroleptics (in particular...), compared to foreign doctors... as a result, the US shrinks had to deal with a whole lotta TD litigation, from I think the 80s onward, etc. TD happened (and still happens) everywhere neuroleptics are used, but since lower dosages were employed (outpatient, at least) in the UK, western europe...it occurred less frequently, wasn't generally as severe, as often as in the US. true story. |
![]() Wild Coyote
|
![]() *Beth*, Wild Coyote
|
#24
|
|||
|
|||
I was diagnosed in my 40s with Bipolar with with psychosis. Eventually I started having delusions that appeared outside of any mood episode. For awhile my pdoc and I thought maybe i am schizoaffective. But after sometime my pdoc settled back to the view that I am bipolar 1 since my predominant symptoms by far are mood disturbances rather than thought disturbances.
In any case I take a small dose of Rexulti (which is for schizophrenia not bipolar) at night and that seems to keep all the psychotic symptoms at bay. I have tried mood stabilizers to lift the depression but they didn't help or I couldn't tolerate the meds. For instance lithium greatly exaggerates my hand tremor to the point i was not able to eat soup with a spoon even on a small dose of 450mg a day. Neither lamictal nor lithium at the dose I was able to take prevented manic episodes. Standard antidepressants either make me manic or do not help. So my depression is intractable. I keep very close track of my sleep and if I start to not sleep at least 7 hours a night i take a small dose of 1.25 mg olanzapine prn. Since it is only every now and then it functions like a great sleep medicine for me. If I don't maintain my sleep I can slip into a psychotic mania. I have been stable the last 2+ years.
__________________
BP 1 with psychotic features 50 mg Lyrica 50 mcg Synthroid 2.5 mg olanzapine |
![]() Anonymous46341, still_crazy, Wild Coyote
|
![]() *Beth*, still_crazy, Wild Coyote
|
#25
|
|||
|
|||
Quote:
I am close friends with a European psychiatrist who told me something worth noting. Until he retired, he worked at an inpatient psych hospital in eastern Europe. He said that no psychiatrist he worked with prescribed psych meds without also prescribing something called "Lipovitan." It's a vitamin supplement - mostly B's, I think.
__________________
|
![]() still_crazy, Wild Coyote
|
![]() still_crazy, tecomsin, Wild Coyote
|
Reply |
|