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Mental Health (Expert Forum)
Bipolar with Mania only?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Bipolar with Mania only?
by kitkat31625, Aug 05, 2005 12:00AM
Hi,
Just to give you some back ground. My husband has had some issues with having a quick temper and getting moody for no apparent reason that will last for more than just a few days. After having a episode of losing his temper at work last year. Then recently flying off the handle at me for something so minor that it took me by a complete surprise. (He is not abusive) I suggest that he looked into going to seeing a Therapist for Anger management. I do not really see my husband as being a depressed person. He does however have all the symptoms of Mania as described with bipolar disorder. Basically, He will have episodes where he is very hyper. He goes with little sleep 2-3 hours a night. He is bubbly, easy going and in a good mood. During this time, He also has to be doing something all the time. (He wears me out :>) First, He will want to start doing some landscaping of our yard. He will read up on it. Internet searches, Write out a diagram of how he wants it to look, Wants to go shopping and looking at shrubs, plants, flowers, stone, mulch ect.. After a week or more he seems to lose interest. Then he will want to do the pipes in the house going through the same thing. Then it will be that he wants to start his own business..
He will sometimes start this stuff work day and night. Then it is like he crashes and has totally worn himself out. He sleeps more normal. Gets very crabby,moody, quick tempered, takes things the wrong way ect... Some times I see a switch in him where he will be in the best mood then suddenly acts really mad or upset about something. Leaving me to wonder what is bothering him, very uncomfortable and on edge. ( I already suffer from anxiety) When I ask him what is wrong he just snaps at me. This episode last for a week or so. I try to stay away from him. Then he will be back to the hyper, easy going guy. I have asked him if he ever feels depressed. He says that he doesn't ever feel depressed. My husband come from a rough childhood. His father was abusive and his Mom Left him when Jerry was 7 yrs old. They grew up poor and his mom has remarried several times. Can you be Bipolar with out any symptoms of depression?
Just to give you some back ground. My husband has had some issues with having a quick temper and getting moody for no apparent reason that will last for more than just a few days. After having a episode of losing his temper at work last year. Then recently flying off the handle at me for something so minor that it took me by a complete surprise. (He is not abusive) I suggest that he looked into going to seeing a Therapist for Anger management. I do not really see my husband as being a depressed person. He does however have all the symptoms of Mania as described with bipolar disorder. Basically, He will have episodes where he is very hyper. He goes with little sleep 2-3 hours a night. He is bubbly, easy going and in a good mood. During this time, He also has to be doing something all the time. (He wears me out :>) First, He will want to start doing some landscaping of our yard. He will read up on it. Internet searches, Write out a diagram of how he wants it to look, Wants to go shopping and looking at shrubs, plants, flowers, stone, mulch ect.. After a week or more he seems to lose interest. Then he will want to do the pipes in the house going through the same thing. Then it will be that he wants to start his own business..
He will sometimes start this stuff work day and night. Then it is like he crashes and has totally worn himself out. He sleeps more normal. Gets very crabby,moody, quick tempered, takes things the wrong way ect... Some times I see a switch in him where he will be in the best mood then suddenly acts really mad or upset about something. Leaving me to wonder what is bothering him, very uncomfortable and on edge. ( I already suffer from anxiety) When I ask him what is wrong he just snaps at me. This episode last for a week or so. I try to stay away from him. Then he will be back to the hyper, easy going guy. I have asked him if he ever feels depressed. He says that he doesn't ever feel depressed. My husband come from a rough childhood. His father was abusive and his Mom Left him when Jerry was 7 yrs old. They grew up poor and his mom has remarried several times. Can you be Bipolar with out any symptoms of depression?
Doctor's Answer
by Roger Gould, M.D., Aug 05, 2005 12:00AM
, Aug 05, 2005 12:00AM
Its really not possible to establish a clinical diagnosis with this kind of information, but your husband certainly sounds like he has hypomania, if not bipolar. He can be treated effectively with medications and psychotherapy, so encourage him to get that kind of help if you can....
Kitkat
There is a clear difference between hypomania, bipolar-I, and bipolar-II disorder.
first -- bipolar I disorder is characterized by 1 or more manic (or mixed episodes) and is (usually) accompanied by a major depressive episode.
-- whereas bipolar II disorder is characterized by 1 ore more major depressive episodes and is (usually) accompanied by at least 1 hypomanic episode.
that said ... a diagnosis of bipolar disorder is very hard to make. often patients go 10 or more years without being diagnosed and usually have to see more than 4 different practioners (this info is from an article in the Am. Journal of Psychiatry by Dr. Hirschfeld -- one that you might find interesting to read).
but back to the point -- hypomania is defined as a distinct period during which there is an abnormally and persistently elevated (or irritable mood) that lasts for at least 4 days. mania follows all of the same criteria, but it happens to a more severe degree and for a longer time period. (see how the diagnosis can be very hard?).
however, both are treated the same way. hypomanic patients are those who we see in everyday life - and actually represent a lot of very successful people (top industry leaders, etc.).
Your husband might find some relief with Abilify (as mentioned earlier) or any of the atypicals. Abilify is a very new drug, which I use quite often in my practice. Seroquel is another drug which I've found doesn't cause as many negative side effects as Abilify. Both are very effective.
hope this helps -- let me know if you have any other questions.
-ckg