38: Bye, Polar

[dannyhatch]

Am I bipolar? TELL ME! I don't really care, it is what it is. I DO CARE! HOLY FUCK! TELL ME! TELL ME NOW! FUCK! But really, it's fine, I'll be okay. NO I WON'T!!!

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[littlp]

Danny's not Bipolar. It is a misnomer that people who get "super happy" and then super depressed are Bipolar. He likely just has depression. There are very specific criteria for what is considered to be mania and from what I've heard on the shows, he doesn't meet that criteria. I'm coping and pasting the criteria which is really tl; dr for those who aren't really interested.

Also, Danny, please don't be too proud to get government help. You are NOT a piece of shit, it does not make you a lesser person in any way. I came very close to it but I was lucky to have a family who was willing and able to provide monetary assistance, if I did not not have them I would have signed up for it. It is meant to help you get onto your feet and untreated mental illness can really hold you back from achieving your full potential. It damn near happened to me. You are too talented and funny-please listen to Chemda, she has your best interests.

Diagnostic Criteria:
The criteria is presented for the mood episodes that are significant in the diagnosis of Bipolar I Disorder (Manic Episode, Major Depressive Episode, Mixed Episode). Although the various episodes are central for the disorder diagnosis, they cannot be diagnosed as separate entities (American Psychiatric Association, 2000).

Diagnostic Criteria for Bipolar I Disorder - (American Psychiatric Association, 2000)

A. Criteria have been met for at least one Manic or Mixed Episode.

B. The symptoms cause social/occupational distress or impairment.

C. The symptoms are not better accounted for by Schizoaffective Disorder, and are not superimposed on Schizpophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.


Diagnostic Criteria for a Manic Episode - (American Psychiatric Association, 2000)

A. Persistent elevated, expansive, or irritable mood for at least one week
(unless hospitalization is required).

B. At least three of the following symptoms are present during mood disturbance
(four if mood is irritable):
• inflated self-esteem or grandiosity
• decreased need for sleep
• increased talkativeness
• flight of ideas or racing thoughts
• distractibility
• increase in goal-directed activity or psychomotor agitation
• increase in risky behavior

C. Symptoms don't meet criteria for a Mixed Episode.

D. Level of severity sufficient to cause social or occupational impairment, hospitalization, or psychotic features.
E. Symptoms are not due to a substance or medical condition.


Diagnostic Criteria for a Mixed Episode - (American Psychiatric Association, 2000)

A. Criteria for both Manic and Major Depressive Episode are met (excluding duration) almost every day for at least one week.

B. Level of severity sufficient to cause social or occupational impairment, hospitalization, or psychotic features.

C. Symptoms are not due to a substance or medical condition.


Diagnostic Criteria for Major Depressive Episode
- (American Psychiatric Association, 2000)

A. At least five of the following symptoms present during a two-week period nearly every day; at least one symptom is either depressed mood or loss of interest/pleasure:
• depressed mood most of the day
• diminished interest in nearly all activities most of the day
• significant change in weight or appetite
• insomnia or hypersomnia
• psychomotor agitation or retardation
• fatigue or decreased energy
• inappropriate guilt or feelings of worthlessness
• difficulty concentrating or making decisions
• recurrent thoughts of death, suicidal thoughts, plans, or attempts

B. Symptoms don't meet criteria for a Mixed Episode.

C. Symptoms cause significant social/occupational impairment or distress.

D. Symptoms are not due to a substance or medical condition.

E. Symptoms are not better accounted for by Bereavement.



On Being Bipolar Home Page


Presence (or history) of one or more Major Depressive Episodes.
Presence (or history) of at least one Hypomanic Episode.
There has never been a Manic Episode or a Mixed Episode.
The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.






Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
insomnia or hypersomnia nearly every day
psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
fatigue or loss of energy nearly every day
feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
The symptoms do not meet criteria for a Mixed Episode
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.



A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
inflated self-esteem or grandiosity
decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
The symptoms do not meet criteria for a Mixed Episode
The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).


The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.
The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).


A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
inflated self-esteem or grandiosity
decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
The disturbance in mood and the change in functioning are observable by others.
The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder.



DepressionMania
Characteristics Bipolar IBipolar II



On Being Bipolar © 2000
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[Keith]

Littlp was so bored by all that information also that she couldn't be bothered editing it down at all for consumption.

You're bipolar, buddy.

[AlyssaN]

So around Danny's age, I was frequently depressed, but also frequently fine and happy. Things would switch seemingly unprompted or at random, and pretty frequently.

The therapist that I saw called it "psychothymia" and the way it was explained to me was that, in contrast to bipolar, which is extreme ups and downs with each extreme lasting for an extended period of time and with periods of calm between, psychothymia is milder fluctuations, but more frequent, sometimes happening multiple times within a day or week.

[dannyhatch]

Wow. That's really helpful. Thanks, Alyssa And thanks, littlp And hi, Keith.

[Keith]

How's that helpful?

[dannyhatch]

Because I can't get over bipolar being a pejorative word even though I know it isn't and this thing sounds closer to what I have and it's not called "bipolar," so it's helpful. You're helpful too. I was just being funny.

[Keith]

I know, I just don't know how this news helps. But I'm happy that you're happy (for now.)

[dannyhatch]

Fuck! I'm sad again!

And what's helpful is that people care enough to get involved in what we talked about on the show and the like.

[Keith]

But you have to do something about it.

If you ask me, 'psycho anything' sounds worse than 'bipolar.'