Mental Health
Bipolar Disorder Spectrum
If you think that Bipolar Disorder can be classified simply as a condition with extreme highs and lows - you are correct - to a certain extent. The presentation at the 153rd APA meeting (May 2000) by highly respected BP researcher Dr. Hagop Akiskal delved into “The Spectrum of Bipolarity”. Diagnoses within the DSM-IV and ICD-10 criteria for manic depression now expand to include Schneider-positive psychotic forms (often expressed during the manic phases), bipolar mixed states, and rapid-cycling states.
In General
Bipolar disorder type I (BP-I) is defined as those with extremes of mania and depression.
Bipolar disorder type II (BP-II) experience hypomania (not as severe as mania) rather than classic mania.
Bipolar disorder type III (BP-III) is defined as those who were depressed and became hypomanic due to antidepressant medication therapy.
Patients with Bipolar disorder type IV (BP-IV) experience cycles of depression and “hyperthymia”. Hyperthermia differs from hypomania as follows: in hypomania, the person’s high energy level is unlike the “usual” trait of that person. In hyperthymia, the person is being his or her usual cheerful self.
BP I to IV According to Akiskal
* BP-I Extremes of mania and depression
* BP-II Hypomania rather than classic mania
* BP-III Depressed and became hypomanic due to antidepressant medication therapy
* BP-IV Cycles of depression and “hyperthymia”
Not wanting to confuse you more (but I’ll have to), I’ve found yet another set of classification for bipolar disorder:
BP I to VI According to Klerman (1928-1992)
* Type I Mania and Depression
* Type II Hypomania and Depression
* Type III Cyclothymia
* Type IV Hypomania or mania precipitated by medication (particularly antidepressants)
* Type V Depressed patients with Bipolar relatives
* Type VI Mania without Depression
The inclusion of the spectrum of “softer expressions” of mania within the depression diagnoses bumped the prevalence of bipolar disorder from 1% in the U.S. to 5%. Even though I understood what I was reading, I admit to getting confused with the many variations of bipolar disorder. This underscores how important it is for patients to be proactive in communicating their symptoms to their physicians!
It is extremely critical that you make a list of symptoms which do not fall within the “normal” range of activities or behavior before you see the doctor. Don’t lock yourself into a label of a particular type of disorder by self-diagnosing. The majority of diagnoses for mental disorders happen within a primary care setting (general practitioners). This means you are seeing physicians who may not be fully equipped to recognize the subtle variations of a depressive disorder you may be suffering from. Help the physician help you by creating a list of symptoms and communicating this to the physician.
All information in Jane's Mental Health Source Page website is for your information and education. The information does not replace or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition.
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