Do I Have BIPOLAR II?
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- Опубликовано: 4 апр 2022
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Dr. B here with our series on demystifying the DSM and today I'm going to be talking about Bipolar 2 which is significantly harder to diagnose and I'm very cautious and conservative in giving this diagnosis. I feel like, sometimes people have been told that they're moody, that they're bipolar by their friends or their significant other because they have extreme fluctuations in mood. But depression can cause extreme fluctuations in mood. Anxiety can cause that, and PTSD is known for causing significant mood fluctuations. So, I'm very careful. I always tell my clients I'm considering bipolar for you, but I'd like to get to know you better. I would like to see how you respond to certain medications before I tell you for sure that I think Bipolar 2 is your diagnosis. And this is very important because people get diagnosed and then own it and I want to be very diligent, specifically with this one, that I'm not over diagnosing. Someone who maybe has depression, PTSD and they are presenting with fluctuating mood and we give them a bipolar diagnosis and they own that. So, I am always very conservative in giving this diagnosis. But when you're looking at the DSM you have to have one, at least, hypomanic episode in your lifetime. And these are periods of time where you have elated mood or elated self-esteem, maybe shopping sprees, but you feel like you're in control. So, hypomania: hypo means lower. So this is kind of a softer mania, one that looks functional. Most people with bipolar 2 are functioning. They go on a shopping spree and then they feel guilty. Then they budget their money and they pay off their bills so there's some compensation type behaviors. And it impedes function, because that's a DSM criteria, but not to the point of severity that mania does. And so, this is very hidden. I mean, many people with hypomania do not seek treatment during this time. This is when they're super productive. But the depressive episodes become so debilitating that they must begin to treat it like bipolar, because, unfortunately, in bipolar, although oftentimes they're only seeking treatment during the depressive episode, they feel like they want to keep that hypomania. They don't want to let that go. They only want to treat the depression, but the depression, when we try to treat it like major depressive disorder, it doesn't work, or it could cause problems of what we call activating. So, you could give someone with bipolar 2 an antidepressant and it would actually cause a hypomania. And they would think, this antidepressant is working so great because they got to their hypomania, but the crash will likely be quick and a significant crash back into the depression. So, watching for those kinds of things over time. It's not clinically appropriate to give antidepressants when we think it's bipolar 2. We used to do that 20-30 years ago, but we need to be watching very closely. If there's any indication of this bipolar 2 that we're looking more for mood stabilizing agents rather than just antidepressants. In both bipolar one and bipolar 2, you are likely seeing them for the first, second, third time in their depressive episode. Sometimes in that bipolar one they are hospitalized or arrested or something severe but typically in bipolar 2 you do not see them in their hypomanic state because this is productivity. For them, they feel very good and happy, and so it's very important to watch your client over time, to make sure that we have that right diagnosis, but that we don't do it right off the bat either, right? At Mentally STRONG we do frequent follow ups and we coordinate the counseling with the medication follow up so that we can begin to really look at those patterns and treat it accordingly. Because if we're just trying to treat the depression, we will not actually be successful long term.
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Dr. Cristi Bundukamara, Ed.D, PMHNP-BC --- A Psychiatric Mental Health Nurse Practitioner and a Doctor of Healthcare Education has experienced unimaginable trials that have caused many feelings such as depression, anxiety, anger, & overwhelming stress.
However, she has developed a new pathway to becoming Mentally Strong & Choosing to be Happy. With purpose, Dr. B has developed the phases that were refined within the Mentally STRONG Method that she created and wants to share with you.
www.mentallystrong.com
I've been suffering from OCD for nearly 7 years and have been on medication for 6 years, but nothing has changed. It used to feel very improved sometimes, and sometimes it used to feel really bad. and the side effects from those SSRIs are horrible. My doctor isn't properly able to understand me. I'm fed up with this conventional medication because of the side effects and the lower probability of success. So I finally decided to self-diagnose with alternative methods, but I know how dangerous it is. I may change my mind later. Then, while researching, I found out that I'm also suffering from bipolar type 2 disorder. I get hypomania sometimes and depressive episodes very often. The depressive episodes last longer. and it feels like I'm on top of the world when I'm in a hypomania state. As you said, it feels very productive, but I end up multitasking too much sometimes.
Comming to sleep
When im in hypomania i sleep like 2-3 hrs in whole 24 hrs due to the excitement
When I am in a depressive episode, I sleep almost 16 hrs in 24 hrs. which happens almost everyday except when I'm in hypomania. but it feels harder to sleep at night but feels sleepy the whole day. It may be because of using a lot of phone and laptop at night and before sleep.
My memory power has gotten worse.
I suffer from constipation.
I get brain fog.
My hair has gotten very thin, and I'm getting a bald pattern on my head.
My hands and body shake a lot sometimes, even when I'm not feeling anxious.
My communication skills slowly got worse and worse.
now im slowly tappering down my SSRIs on my own
I'm so confused. Is it possible that a person can have both OCD and bipolar II?
I'm very stuck and confused about what to do about my treatment. I'm planning to go on a ketogenic diet, which will help my mental health very much due to the low-carb and high-fat diet. and also helps brain health due to the ketones.
planning to do Intermittent Fasting
and I'm also going to the gym, doing yoga and breathing exercises.
and theres a MD, Dr. Eric Berg and another doctor MD KenDBerry who are on RUclips, they suggested alternative methods. Instead of SSRIs, but I don't know how much dosage to take, so I'm stuck there. I'm planning to take vitamin B, probiotics, fermented foods, and fish oil (high-quality supplements).
so basically i want to get into metobolic therapies
and im 21 years old now
Please correct me if I am wrong with my decision.
Please feel free to give me advice.🙏
It sounds like you're navigating a challenging journey. I'd highly recommend seeking guidance from a qualified healthcare professional, Psychiatric Nurse Practitioner or Psychiatrist who can provide personalized support and monitor your progress effectively, ensuring safe and effective treatment.
Wow no comments!?
I'm going to check out your channel. I would love to hear you thoughts on Bipolar 2 in a person with ASD & ADHD. Also extreme side effects with SNRI' and anticonvulsant's. I am the person and I think the anticonvulsant's cause extreme reactions because of the ASD being a neurological condition. Your thoughts and I can give more information if you want.
Thank you for watching! I hope you find the information that I have shared to be helpful. Navigating Bipolar 2 alongside ASD and ADHD presents unique challenges. It's crucial to work closely with your healthcare providers who are knowledgeable about the complexities of managing these conditions together.
@DrBMentallyStrong yes it is, and my health care providers are not well trained in all 3. I am also a recovering alcoholic to boot. I learned about Bipolar 2 in a PHP & IOP program. I'm my best advocate, and with videos like yours, I am able to bring my concerns to my providers. I think I can now see the difference between a ASD meltdown and a hypermanic episode. They both come with a depressive episode after. Medication has been a challenge. 18 meds as a kid, 3 in my 20s, 1 in my 30s, and just now 5 more. All were not effective. Xanax from 10 to 24 and now on Quetiapine and Mirtazapine with the occasional Hydroxyzine.