Bipolar with Mania only?

[kitkat31625]

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?

[Natasha Beaverhausen]

Actually this is more of a question than a comment.  I was taking fluoxetine and wellbutrin XL as prescribed by a psychiatrist.  I have also been seeing a therapist.  I stopped taking the medications when I began to have violent imaginings (like throwing an unsuspecting person off the platform of the el tracks).  I have not discussed this with anyone except I did tell my therapist that I have stopped the medications.  I stopped several months ago.  Now I am having very happy days (manic?) and a terrible time sleeping.  When I do sleep I have nightmares where I am travelling and don't know where I am going (that's a mild one) or where mafia men are chasing me and trying to murder me and my family. I can wak up from such dreams and go back to sleep in the same dream/nightmare. I am becoming a little sleep-deprived. None of the black moods I had experienced before taking any medications have returned. Could this be something new like manic-attacks? What's going on?  Is it a side effect from the meds I was taking that's just taken a while to appear?  I know you can't diagnose, but I am curious and a little frightened.

[ckg]

Dear 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

[10yr old Bipolar son]

I have a bipolar son who is 10 now and was diagnosed at age 4. So my experience is primarily in juvinile bipolar--which can look somewhat different. But you described phases of mania and then phases of anger. That is my son. He primarily cycles from mania to anger and displays very little "depression" except when angry (will threaten to kill himself when he is in an angry rage). We have been told that anger is a form of depression... or at least one of the ways depression displays itself in bipolar disorder. But docs from some other camps say that the anger is a form of mania. Whatever it is, my son is helped greatly by bipolar meds. That's what it really comes down to. No matter what the label or diagnosis given, if he is helped by the treatment, that's what's important. Depakote is a great first line of defense for bipolar. It is an anti-convulsant that doubles as a mood stabilizer. Yes, it can, and often is, layered with an anti-depressant--if needed. We have never layered in an anti-depressant for our son. Unfortunately though, the Depakote was not enough for him. We have had much success layering in an anti-psychotic medication (sounds scary but VERY helpful) called Abilify. I think your husband has done a couple of things right-- 1. he was willing to seek help. 2. he sought the help on a psychiatrist, not a family doctor. They know so much more about these meds and are so much more capable of managing them. 3. He was willing to take the medication prescribed by the doc and not just blow the doc's recommendations off. Keep on keeping on with your husband!

[kitkat31625]

If anybody with the disorder could answer this for me. It would be greatly helpfull and appreciated!! My husband went in to see a Therapist.  Who sent him to see a Psychiatrist. I went with my husband to see the Therapist and he seemed to think my husband has Bipolar.  My husband went to the appointment to see the Psychiatrist by himself.  My husband said that the Psychiatrist didn't think that he was Bipolar and didn't really say what he thought was wrong with him. That he wanted to treat him for his moodiness and help him with his anger. He prescribed him Depakote. I read up on the drug to see what it is usually precribed for. It said it was for mania associated with Bipolar. What is the difference between Hypomania and Bipolar?  It appears to be the same thing!! Am curious if the psychiatrist was thinking my husband was suffering from Bipolar... That maybe my husband was just ashamed and feeling like people would think he was crazy if he told them they thought he did have it.  So he told me what he did so I wouldn't know?   Do they usually treat bipolar people with Both antideppressants and Mania medications?

[kitkat31625]

Thank you in advance for your help,
Kitkat

[Roger Gould, M.D.]

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....