I found an update on Bipolar Disorder on the psycheducation website:

"Soft Signs" of Bipolar Disorder (updated Feb. 2007)

from:
http://www.psycheducation.org/index.html (http://www.psycheducation.org/index.html)


You have probably figured it out by now: making a diagnosis of bipolar disorder can be pretty tricky sometimes! You're about to read a list of eleven more factors that have been associated with bipolar disorder. None of these factors "clinches" the diagnosis. They are suggestive of bipolarity, but not sufficient to establish it. They are best regarded as markers which suggest considering bipolar disorder as a possible explanation for symptoms. They are not a scoring system, where you might think "the more I have of these, the more likely it is that I have bipolar disorder." That way of thinking about these factors has not been tested.
Here's the list of items which are found with bipolar disorder more often than you would expect by chance alone. This list is adapted from a landmark article by Drs. Ghaemi and Goodwin and Ko. (Drs. Goodwin and Ghaemi are among the most respected authorities on bipolar diagnosis in the world. This important article is online (http://www.psycheducation.org/depression/CadesDisease.htm)).

The patient has had repeated episodes of major depression (four or more).
The first episode of major depression occurred before age 25 (some experts say before age 20, a few before age 18; most likely, the younger you were at the first episode, the more it is that bipolar disorder, not "unipolar", was the basis for that episode).
A first-degree relative (mother/father, brother/sister, daughter/son) has a diagnosis of bipolar disorder.
When not depressed, mood and energy are a bit higher than average, all the time ("hyperthymic personality").
When depressed, symptoms are "atypical": extremely low energy and activity; excessive sleep (e.g. more than 10 hours a day); mood is highly reactive to the actions and actions of others; and (the weakest such sign) appetite is more likely to be increased than decreased. Some experts think that carbohydrate craving and night eating are variants of this appetite effect.
Episodes of major depression are brief, e.g. less than 3 months.
The patient has had psychosis (loss of contact with reality) during an episode of depression.
The patient has had severe depression after giving birth to a child ("postpartum depression").
The patient has had hypomania or mania while taking an antidepressant (remember, severe irritability, difficulty sleeping, and agitation may -- but do not always -- qualify for "hypomania").
The patient has had loss of response to an antidepressant (sometimes called "Prozac Poop-out"): it worked well for a while then the depression symptoms came back, usually within a few months.
Three or more antidepressants have been tried, and none worked.
There is a very radical idea buried in these 11 items, which we should look at before going on, but you should be aware that this idea is unusual; uncommon even among bipolar experts; and likely to be dismissed with a "hmmmph" by many if not nearly all practicing psychiatrists. The idea is this: Dr. Ghaemi and colleagues propose in this paper that there might be a version of "bipolar disorder" that does not have any mania at all, not even hypomania. They call it "bipolar spectrum disorder".

This is strange, you are saying to yourself. "I thought bipolar disorder was distinguished from 'unipolar' depression by the presence of some degree of hypomania; don't you have to have some hypomania in order to be bipolar? How could it be 'bi' - polar if there is no other pole!?"

But Dr. Ghaemi and colleagues assert that there are versions of depression that end up acting more like bipolar disorder, even though there is no hypomania at all that we can detect (or, as in item #9, only when an antidepressant has been used). These conditions do not respond well, in the long run, to antidepressant medications (which "poop out" or actually start making things worse). They respond better to the medications we routinely rely on in bipolar disorder, the "mood stabilizers" you'll be introduced to in the Treatment section of this website. And these patients have other folks in their family with bipolar disorder or something that looks rather more like that (e.g. dramatic "mood swings", even if the person never really gets ill enough to need treatment).

In Dr. Ghaemi's description, then, there are people whose depression looks so much like unipolar that even a "fine-toothed comb" approach to looking for hypomania will not identify it as part of the "bipolar spectrum", who actually should be regarded as "bipolar", in a sense, because of the way they will end up responding to treatment. In other words, there is something in these people which doesn't look like our old idea of bipolar disorder, or even our newer idea of bipolar disorder (bipolar II, etc.), but will still better describe their future (their prognosis) and the medications that are most likely to help them. Remember that this is the very purpose of "diagnosis", to describe the likely outcomes with and without treatment, and to identify effective treatments.

The patient has had repeated episodes of major depression (four or more). Yep
The first episode of major depression occurred before age 25 (some experts say before age 20, a few before age 18; most likely, the younger you were at the first episode, the more it is that bipolar disorder, not "unipolar", was the basis for that episode). Yes again.

A first-degree relative (mother/father, brother/sister, daughter/son) has a diagnosis of bipolar disorder. No

When not depressed, mood and energy are a bit higher than average, all the time ("hyperthymic personality"). Sometimes

When depressed, symptoms are "atypical": extremely low energy and activity; excessive sleep (e.g. more than 10 hours a day); mood is highly reactive to the actions and actions of others; and (the weakest such sign) appetite is more likely to be increased than decreased. Some experts think that carbohydrate craving and night eating are variants of this appetite effect. Not Sure
Episodes of major depression are brief, e.g. less than 3 months. Most of the time just lasts for a day to a week.
The patient has had psychosis (loss of contact with reality) during an episode of depression. Never had psychosis

The patient has had severe depression after giving birth to a child ("postpartum depression"). Could never happen to me as I'm a guy

The patient has had hypomania or mania while taking an antidepressant (remember, severe irritability, difficulty sleeping, and agitation may -- but do not always -- qualify for "hypomania"). I get all three examples with my Zoloft

The patient has had loss of response to an antidepressant (sometimes called "Prozac Poop-out"): it worked well for a while then the depression symptoms came back, usually within a few months. Never had a "prozac poop-out"

Three or more antidepressants have been tried, and none worked. Only took one and it worked for my depressive symptoms.

sounds like I could fit a bipolar diagnosis.

Thanks for posting this Jeanie! The more informed people are about BP disorder in all its forms, the better IMHO.

I agree. We need as much information as possible out there so people can make informed choices.

WOW!!! NOW I REALLY CAN SEE MYSELF IN THIS!!!! What to do about it, though? What would the TREATMENT be? Is it that Trileptal and/or Lamictal I hear so much about (and which I believe my Bipolar sister is prescribed)?

Which brings up this -- my SISTER, who takes these meds, is ALWAYS lamenting about the side effects! And - although SHE may say she's feeling better - I've only seen (and this could just be something to do with OUR RELATIONSHIP - and, thus, interferes with my accurate perception of the situation) her behavior become far worse. She is increasingly cruel, unhappy and AGGRESSIVE these past 5 - 10 years. And this is the same period of time that she has ZEALOUSLY been educating us all (my parents & siblings) about Bipolar disorder, what it is, what she goes through, and how we all really need to look at ourselves a little closer if we EVER want to feel any better (when NONE OF US have ever complained to her about our lives. After all, she's not KNOWN to be the sensitive type that you feel you can open up to). So - from what I see with my sister, she seems to have become more GRANDIOSE, ARROGANT, AGGRESSIVE & HOSTILE since fine-tuning her Bipolar treatment. But, according to her, She's SERIOUS ABOUT WORKING on herself - and I'm not.

Anyway - I thought these medications are of the type that one would rather NOT experiment with UNLESS they are certain to be necessary. Am I correct in thinking that?

Thanks,
Sue

Treatment would probably consist of the medications that are most helpful to you, with the least amount of side effects possible. Just like ADHD meds, you may have to just try some and see what works.

I take Lamictal, an anti-seizure medication, at a much lower dose than what would be indicated for epilepsy/control of actual seizures. Many mood stabilizers nowadays are tiny doses of anti-seizure medications. For some reason, they seem to work very, very well, for some people. I tried 3 mood stabilizers of the same type (anti-seizure, tiny dose) before I discovered that the 4th med, Lamictal, was what I needed.

I also take Abilify, an atypical antipsychotic. Again, the dose is very, very small compared to the dose that would be used for true psychotic patients. APs work in BP patients to relieve agitation, or anxiety, and sometimes to aid with sleep. I tried one other AP before Abilify, and it gave me one of the rarer side effects, so I did have to discontinue it for that reason. My daughter can take it with no problem at all. In my case Abilify is Rxed for agitation.

I have an antihistamine called Atarax that also has anti-anxiety effects. I take this PRN for transient anxiety.

I tried 4 mood stabilizers and the last one worked. Trileptal gave me a side effect that was impossible for me to live with: constant, booming headaches. It does work well for other people, just not for me. Topomax...ahhhh yes, the medication that reduced me to the mental capacity of an eggplant. :faint: I fondly call it Stupamax or Dopomax. I did not wish to be that overly sedated, nor did I think it was fair to Rx me ADHD meds, then give me a med that would make me spacy and duhhhhhh on top of that. Interesting little side effect of Topomax, and from my understanding most if not all people will get this one:

It will make any carbonated beverage that you attempt to drink taste almost, but not quite, exactly like the inside of a dirty diaper! :eek: No thanks!

Well Sue...so is it a Welcome to the Cycling Club for you as a Member now? And not just a loved one of? UH-OH...

LIke CF said....you will most likely be put on some of the meds she mentioned.
I think a lot of people whine more about the side-effects because they miss the side - effects of mania.......not to say there aren't any meds out there that caus yucky ones...CF would know , man has she had some good ones...
then on the good side of the spectrum....I have had none.....
I take both Lamictal...150mg and 1mg of Riserperdal (anti-psychotic :D ) and have not had ONE side effect.

Hope :)

But for people who don't really have the mania piece, I'm just wondering - what would be the point. Would I notice an improvement in my depression with these meds (which would be the only reason I could see taking them - not really having any significant form of mania that needs managing)?

And HOPE - I'm really just self-scrutinizing right now. Like I may have said earlier, I've mentioned the Bipolar thing to several different psychiatrists and therapists at different periods in time when I was going through a rough patch and was re-establishing connection with the mental health professional community. And quite quickly, after asking me several questions, they'd state that doesn't seem to be what I'm dealing with and would then give me a quick rundown of what Bipolar looks like -- and why I'm not Bipolar.

I certainly am not WISHING for the dx. No . . . I guess I'm just ruminating over the possibility because of the way my sister's treat me and what they say to me. They are SO INSULTING and -- even though they live miles and miles away, and we never really see or talk to one another (especially over these past couple of years) -- they seem DISGUSTED by me and are always asking me (and each other) WHEN am I going to get my _ _ _ _ together? When I'm feeling like I'm doing an outstandingly noble job of maintaining things for my girls -- and ALL ON MY OWN because my FAMILY is unable to help . . . which is FINE, but I think they feel guilty about this and/or they try to rationalize their lack of involvement (even just EMOTIONAL support) by telling themselves that I'M A BAD PERSON and I NEED TO LEARN how to BE BETTER so that I won't havy any problems any more.

I currently have financial problems. I became unemployed due to a prolonged ILLNESS (my depression, really) and am currently on disability. But - there was a period of time when I DIDN'T have any income, and I've had a difficult time recovering from it. I haven't ever WHINED to them about this, but when they've asked me - I've told them. And they are being so CRUEL about it. Like, they have this BLAME THE VICTIM mentality. Not that I see myself as this pathetic "VICTIM" - but sometimes life hands ya lemons - and you don't even have the water or sugar NEEDED to make LEMONADE!! And - ya - that's too bad. But WHY do people need to KICK THIS SAME PERSON when they are already DOWN by saying something like, "Well, if you had just left that lame job you had when you saw how bad it was, instead of just soldiering on - well, THEN maybe you wouldn't have gotten CANCER! I mean, do you even really HAVE cancer?"

BTW: I DO NOT have cancer. That was just my attempt at giving an analogy of the way my sisters talk to me. It is just UNFATHOMABLE the way they are to me. And I can't BELIEVE that they would be so hurtful!! So - I guess this is why I keep wondering to myself -- well, maybe they are right. Maybe there is something ELSE "wrong" with me that I must pursuit. (Even though, in my heart of hearts, I KNOW that I'm a fine, good, sober & sane, responsible single mom of 2 girls who are EXTREMELY SUCCESSFUL and happy and admired by their elders. And doing this all under personally trying circumstances - without even a kind word now and then from FAMILY that DOES live near me, that being my father & stepmother . . . And I also know that there is nothing MORE I could be doing to help myself. I've been seeing my therapist for over 2 YEARS now - on a WEEKLY basis (can you believe it?) - PLUS, I also am involved in another self-help group/community where there is MORE counseling and the like . . . Their MAIN BEEF about me is that (1) I have financial problems (for the FIRST TIME EVER, might I add), and (2) My house is extremely messy! They see this as surefire signs that I am BIG-TIME Whacko AND (as my sister said the LAST time we spoke) I OBVIOUSLY NEED TO BE IN THE HOSPITAL!!! (Can you believe this sh*t?)

Sorry guys . . . I'm quite upset about this, as you probably can tell, and I realize that I'm now rambling . . .

Sue

No problem. We vent over here all the time.

It sounds like a really good thing you don't talk to them. Toxic people are not good for anyone, especially depressed people.

All I can say is if you are on meds for your depression and they are working. Then why fix something if it's not broken. I can't see why anyone would want to have BP. However, if the Spectrum includes BP that doesn't have "true" mania. And your meds are not working, perhaps it's worth looking into. Anti-depressants didn't work for me. However, the Lamictal does. It's a "mood" stabalizer. So it works on both. I dunno. If your life is fine except what they are telling you. Then who cares what they say. If a messy house is a sign you are nuts then there are a lot more people I know that need medication. For me it depends on the extreme of messy. There are times my is messy because life is hectic with kids/work..now school. It gets picked up, eventually.
Now the times that it goes weeks and it's a pit, that's when I am depressed. I don't do it often anymore. My life has taken on a pretty good rhythm now.

I dunno Sue...it's your call, of course. And you are certainly welcome to vent to stop by to chat over here regardless of being BP or not!

I hope it all works out for you and I hope getting it all of your chest..makes you feel a little better today...


Hope :)

Thanks so much, HOPE!!

Ya - ya know something? Maybe somewhere in the back of my noggin' I really AM hoping to have a tad of a bipolar dx because I LIKE THIS SUB-FORUM SO MUCH!!! SUCH GREAT PEOPLE!!! SUCH FABULOUS DISCUSSIONS!!

Although I'm kidding - I AM a smidgen serious. Really - I've looked for something similar to the ADDForums on the Internet, but for Depression. But I haven't found any sites that I like - usually there just isn't much traffic on them or there's not much substantial discussion. And the Depression subforum on here doesn't get much traffic either. But YOU GUYS!! This subforum is . . . LIKE . . . where ALL THE KEWELL GIRLS HANG OUT (sassy hair flip 1, sassy hair-flip 2)!

Luv,
Sue

Well....I always wanted to be a cool girl! LOL
Just not this way!

Well come on over anytime dear! There is always something going on over here....that's the great thing about BP...when one of us is quiet...the other one's are bouncing around....not quiet for long....

Thanks so much, HOPE!!

Ya - ya know something? Maybe somewhere in the back of my noggin' I really AM hoping to have a tad of a bipolar dx because I LIKE THIS SUB-FORUM SO MUCH!!! SUCH GREAT PEOPLE!!! SUCH FABULOUS DISCUSSIONS!!

Although I'm kidding - I AM a smidgen serious. Really - I've looked for something similar to the ADDForums on the Internet, but for Depression. But I haven't found any sites that I like - usually there just isn't much traffic on them or there's not much substantial discussion. And the Depression subforum on here doesn't get much traffic either. But YOU GUYS!! This subforum is . . . LIKE . . . where ALL THE KEWELL GIRLS HANG OUT (sassy hair flip 1, sassy hair-flip 2)!

Luv,
Sue:D Well thank you so kindly, Sue! We are just as glad to have you here, too, ya know.

http://i110.photobucket.com/albums/n100/justhope_36/untitled.jpg

Look I posted a Pic in BP!

It's the Cool Girls..LOL

I wish I could be a kewl girl too, but I am okay being a silly boy instead. :-)

http://i110.photobucket.com/albums/n100/justhope_36/coolboys.jpg
OH but Spongie..you are so one of the cool boys! Here sweetie!

Hey what happened to my pic??? hmmm

Well if this thread is taking the creative direction, here's a few I think add to the spirit of teamwork here in Co-Ex.

http://i3.photobucket.com/albums/y92/kzrainbow/ADDFMagicAni.gif


And I think this about sums it up for all of us.



http://i3.photobucket.com/albums/y92/kzrainbow/Cycling_Team_Banner.png

Hey what happened to my pic??? hmmm

That is sort of curious...better ask around. I am wondering that myself, since there is no remark as to who might have edited it....check the bottom.

:rolleyes: Weird....

No I know , no one edited it. All of my pictures did it? Even my sig line was missing when I logged in at home? Who knows..I just downloaded my sig line again?

I like the new tag.....!

No I know , no one edited it. All of my pictures did it? Even my sig line was missing when I logged in at home? Who knows..I just downloaded my sig line again?

I like the new tag.....! OK now that's really weird! Still using the same imagehosting site? Sigline is showing now, pics are not :confused: TOO weird!

Which tag? Cycling Team?

Hmm then it's not just me then? Perhaps it's ADDF? HF might know?


No the new art work! LOL

The jester? That's actually kind of ancient, :o an early attempt at animation...which I really stink at. Glitter is about all I can do. Animation programs have very intimidating user interfaces.















"Crazy~Feet, you are off-topic again!" :mad:

"But Crazy~Feet! There is stuff VANISHING! Don't you want to find out why??" :eek:

"Perhaps I do, and perhaps I don't, that's inconsequential. I still have to remind you to stay on topic, Crazy~Feet!" :mad:

"Um, Crazy~Feet? What was the topic again?" :confused:

One of these days I am going to have to issue myself a warning...

Better you than me...LOL


But being O/T is what makes you CF..member the first line? 0 to off topic at the speed of smell...yeppers that's you....
Luckily it's mostly just you over here with Jeanie on hiatus...tee hee hee..I won't tell if you don't...

Now let me see what other fun stuff I can root around in while I am reading...

WOW!!! NOW I REALLY CAN SEE MYSELF IN THIS!!!! What to do about it, though? ......


Anyway - I thought these medications are of the type that one would rather NOT experiment with UNLESS they are certain to be necessary. Am I correct in thinking that?

Thanks,
SueI'm sure there are those who would disagree with me, but I think you're thinking is right on. Those drugs are known for having some potentially problematic side effects. Whether these symptoms eventually are included on the bipolar spectrum or not, treatment IMHO should progress to these choices only after other choices have failed and one's life is being very negatively impacted. While those with more severe bipolar disorder may not have much wiggle room when it comes to mood stabilizers and such, I'm not sure that is true for those on the milder end of the spectrum - of course I'm not a doctor or anything, this is just my personal take on things.

For example, treatment resistant depression was one of the criteria listed under signs of soft bipolarity. Dr. Ratey shared in his class a study of 12 people, 10 of whom had treatment resistant depression (tried several anti depressants and other options). These folks were put on daily exercise at 70% of their max heart rate for 10 days. Half of the treatment resistant folks had significant improvement by the end of 10 days! In a much larger study (around 120 people) that went for 10 months comparing exercise to Zoloft for treating depresssion, they found that not only did exercise do as well as Zoloft at 4 months, it had little relapse and did better at 10 months than either Zoloft alone or Zoloft and exercise combined.

I'm not anti med (although because of my experience I'm very med cautious), but I think when someone has a milder case of any psychological condition (or medical for that matter), that it makes sense to explore options with few risks of side effects. If one can lower their cholesterol, blood sugar, blood pressure, etc by diet and exercise while it is still mild, that makes sense to me too. If you can't then you move on to the next step.

I think what might be most important about correctly identifying mild bipolar signs is that depressed folks are usually given anti depressants and if it is a bipolar type problem rather than uni polar (which is actually the case in 40 - 60% of diagnosed uni-polar cases) the anti depressants can make things worse and not better (Jamison and Goodwin's book Manic Depressive Illness) by creating mania or hypomania and they may be responsible for triggering shorter cycles.

those with more severe bipolar disorder may not have much wiggle room when it comes to mood stabilizers and such :( No, we sure don't.

:( No, we sure don't. Sorry!:(

Sometimes the need for something is real clear. I think that it just gets kind of fuzzy as they keep including milder and less typical symptoms.

It certainly does! Its a spectrum to be sure...but how far does it go and where does it end?

Kind of like ADD is a spectrum. The old DSM's used to recognize that with mild moderate and severe categories, but those got lost along the way, mostly so people would qualify under the American's with Disability Act from what I've read. However, someone with mild or subthreshold ADD might be able to get along very well without meds by adding structure, exercise, and such while someone with severe ADD might not be able to stay out of major trouble without medication along with structure, etc.

:o I would be in the "meds necessary" category for ADHD too (severe). When I got medicated and got to max relief? I was actually astonished that I had not injured or killed anyone due to extreme inattention. True story!

:o I would be in the "meds necessary" category for ADHD too (severe). LOL - My psychologist would also put me in the "meds necessary" category (moderate ADHD he says - and I thought I had mild:rolleyes: ), although he understands why I don't take them because of the tics. It doesn't prevent him from suggesting other ADD meds either.

Heh :o my doc is an expert in certain disorders, ADHD is one of them...he said I was one of the most severe cases he had ever seen! :eek: That's some kind of distraction!!

To this day I refuse to drive unmedicated...:faint:

Heh :o my doc is an expert in certain disorders, ADHD is one of them...he said I was one of the most severe cases he had ever seen! :eek: That's some kind of distraction!!

To this day I refuse to drive unmedicated...:faint:
Well, I read somewhere once a psychiatrist describing BP as ADD on steriods!:p It's hard to say I would think which is BP and which is ADD -- pretty hard to tease apart sometimes.

Luv ya -- ya distractable soul you!:)

Luv ya -- ya distractable soul you!:) Awwwwww shucks, ma'am,,,right back atcha! :o

which "poop out" or actually start making things worse)

:eek: I can’t take ANY classes of antidepressants at all they make me more depressed to suicidal or super *itch with a capitol “B”


by telling themselves that I'M A BAD PERSON and I NEED TO LEARN how to BE BETTER so that I won't havy any problems any more.

I would tell them the only people without problem are dead and still they could have problems but we simply are not aware of them in this space time continuum.

Sue when I had my brush with hypomania it was every one else that had an attitude problem I didn’t even perceive the change in my temperament I just thought we were getting a string of arguementive jerks on this site. Had Gary not been married to a bi-polar woman before we met I may have never noticed. I was too ADD to notice those five consecutive nights of sleeping less than three hours {ADD what a wonderful tool for not remembering a thing} My point is I blamed every thing on others and this is not my “style” but in all honesty it really seemed like it was every one else who had a suddenly developed a problem. They may not even realize they are hurting your feeling and if yo point it out to them they may blame you because they are unable to perceive a "variation" of reality. {how their behavior is on the receiving end}


My perception of really made sense then although it doesn’t now. . according to Gary I was more irritable but every thing with me tends to cause irritability. Depression causes irritability pain causes irritability, annoyance causes irritability, my dyslexia can be irritating Several antidepressants and certain benzodiasepames like valium cause irritability. I am pleasantly hyper active but any thing that interferes with pleasant quickly become unpleasant. So far the only thing that interferes with hyperactive is age. . . .

The blaming may be bipolar related but I don’t know about the purposeful cruelty. . . .it may or may not be. It is sure a sign of being out of control that is for sure. People with bipolar all react differently to the mood swings.


My sister tries to save the world and every one {two to four legged} in it at times. She is closer to bossy than to cruel Then there was the depression because she couldn’t save the world. . ..

My daughter can be cruel at times but I could tell even when it was happening she didn’t want it to . Bipolar or not you do not deserve to be treated in this manner.

My bipolar daughter is adult and when she gets ugly and refused to listen I draw the “hard line” called my personal boundaries. I will not tolerate being verbally abused by her period.

When she is in the mood to be abusive ask her to please be respectful to me if that doesn't bring about an immediate change in approach and she continues to be abusive I tell her “ When your mood becomes such that you can treat me like a responsible adult worthy of common courtesy I will be more than happen to talk with you. Until then good day” I end communication no matter what she says.

My daughter is really hard to explain. She can be a difficult person but she has a heart of gold .

Your sister’s credulity is indicative of how their conditions interact with their personality. I would take them with a gain of salt When they act like you are crazy I would help their version of reality by suggesting a diet consisting of six legged creatures and plenty of plant food If this didn’t work I would ask that they visit a reality not inhabited by other living creatures. {with feelings} that is known for it’s rather warm climate.

You could try the line I use with my daughter as it directly addresses the boundary being violated and lets them know you will not be tolerating verbal abuse period Their opinion of the matter is not desired nor is their permission necessary. Communication requires two parties and I simply end to interaction with my daughter when she refuses to treat me with some degree of respect. . . I hang up the phone I walk off when in person I delete e-mails and I do not engage in further conversation until an attitude change is detected.

My daughter claims all sorts of things but I do not respond or continue interactions unless it is presented in an acceptable manner.






However, someone with mild or subthreshold ADD might be able to get along very well without meds by adding structure, exercise, and such while someone with severe ADD might not be able to stay out of major trouble without medication along with structure, etc.

Hmmm I am wondering if some one truly has ADD then they would not understand structure if it came at them with a whip and a chair. . . I know I am married to Mr I ain’t got no ADD bounce bounce bounce. . .. .





LOL - My psychologist would also put me in the "meds necessary" category (moderate ADHD he says - and I thought I had mild

Interesting to note that people with either condition {but especially with both} are poor self observers. . . . or tend to be any way. The major difference being with ADD I know my reality is probably skewed but I do not know how to be any thing but ADD but the manic thing was a totally different twist on reality that was unpleasant for people who have never even met me in person and even caught the attention of my husband {who basically doesn’t normally have a detectable attention span }

It's certainly logical not to bother with the meds unless you definitely need to but it sounds like if you did get to that point, these meds would be the place to start rather than the traditional anti-depressant route.
Lamictal is the most effective anti-depressant I've come across. I love it. Took me a long while to get to it but now I'm soooo glad I found it. And even better, I get NO side effects at all. <3<3<3
I definitely think it's far superior to SSRIs and would venture to say it should be look at more as a place to start with many people's depression treatment.