Bi-polar diagnosis

[xanweaner]

Dear Dr. Gould,
I do not understand how a diagnosis of bi-polar disorder is made when a patient takes an antidepressant, such as Remeron, when they are seriously depressed, and they end up in a manic phase? What if the patient has never had a manic episode in their life and did not have another manic episode again? What if they do not fit the criteria of questions for the bi-polar diagnosis?
I have heard that this issue is now being discussed and the criteria may change?
What is your opinion of this? What is the most recent research telling us?
Thanks for your assitance.

[ILADVOCATE]

BP2 is still in discussion as a diagnostic criteria but in general for a person with bipolar, anti-depressents used alone will worsen the symptoms of mania or trigger them. That's why a mood stabilizer is used and an anti-depressent only used if one or more mood stabilizers in combination can treat the mania but not the depression. There are some good informational websites we have linked up and they might discuss this further.

[paranoid_cataclysm]

Everyone will cycle differently.  Some can cycle after months while others can cycle several times a day.

[Xila31]

I have also read that people cycle in different ways. I have read a lot of conflicting info on bipolar 2 and cyclomania, which only have hypomanic phases, and rapid cycling. I have also read people with bipolar 1 can have rapid cycling. But, since I'm not a doctor I don't know. Like any illness and any human we are all different in subtle ways. Although we have similarities, each one of us is different. Our bodies react to our illnesses differently, and to medicines differently.

If you are concerned that for some reason your doctor is wrong or is leading you down the wrong path the best advice is to get a second opinion. I would also say track your mood and then when you go to see your doctor let him/her look at it.

[beautifulbritty712]

I am not a doc and not positive about this, but I believe bp2 can be caused by meds. I also believe that some bipolar people feel normal much of the time, some get manic or depressed at the same time every year. Some cycle less than that. This is stuff I've read, I have read a lot but I'm not sure how up to date or accurate this is.