View Full Version : Bipolar I or II

10-16-07, 09:03 PM
Ok, taking into consideration everything the DSM says, what is the real difference between I and II? I am confused. Sometimes I think I may be "I" but my pdoc say I am "II". I need to be more honest with him but it is hard because I know him in a professional setting. I have never stayed up straight for several days, but I have gone several days, even weeks with only a couple hours sleep each night and find that I function fine this way. Would that be considered mania?

10-17-07, 08:08 AM
I think BP I is a higher level of intensity. The mania is really out of control and you might think you are godlike, etc. Being honest is important because it is the only way to be treated.

Matt S.
10-17-07, 11:18 AM
bipolar II's dont experiences full mania whereas bipolar I's do, II's get hypomanic, the difference is only in intensity

10-24-07, 11:54 PM

The difference is the length of time the cycles last, and the severity.
Like Matt said, we don't reach the more psychotic levels....and often don't end up hospitalized.

I think that is why we are misdiagnosed more often. I believe that for me.
I seemingly functioned and often appear to even now, pretty normal. More often than not I think people just thought of me as a moody person. It also wasn't until the disease progressed that I was really presenting the more obvious criteria that is described in the DSM...the only time I did before was as a teen. That was really in the dark ages, and they really just deemed me as a troubled teen, blamed my mom...and that was it. The years after were a series of bad relationships, jobs that I held no longer than a year, etc. So easy to write off as just another dysfunctional loser.

Basically as a teen I was just a write off...lazy and destined to live far below my obvious potential. The victim of not having a dad, and being the child of a workahlolic mom.

Even the "before his time" (whom I still think is great) neurophysc who diagnosed me as ADD missed it. The 20 year doc who diagnosed me as mildly clinically depressed missed it. The talented and well known physchiatrist I see now , missed it for over a year, until my symptoms got my attention and the denial unraveled.

Heck I cycle so rapidly it's hard to pin a mood. And then I have the "normal" in between. If I went to the doctor at these times, or when I was in hypomania I could convince anyone I was just great...

I am not braggin here, I am above average intelligence. That combined with the fact I know a lot about the medical field including the phychiatric aspects, because mother and sister both worked in those fields, and my mom still does. I just knew what to say, and how to act, steeping further in the denial, pulling off the perfect farse.

I can be devastated and in tears, and near a mental break in the presence of those I trust, and then wipe my face walk out the door and go back to work like nothing happened.

That nearly fatal flaw, has cost me years of my life.

The ultimate perfecter of the mask of deception. I remember that becoming really clear when I was in therapy with Keenan in the phsyc ward he was in . The therapist there was a great lady. She pegged me dead on. She looked at me the first day and said you are exceptionally bright. That is both a good thing and a very bad one. She watched me break down in a meeting with 3 others that worked on his case, (and I prided myself on not being a crier, at all) and admit some things I am not so proud of about myself and our family life...( on a lunch break from work, which is how I had to do them to keep my job) and she looked at me and said I bet you will walk out of here and go to work and no one will know what you have just done, and I bet they have no clue how lost and hurt you are right now. She was exactly right. The mask and the cycles, easy to miss.

And directly back to a point ...stupid ADD bunny trails...

My Aunt by marriage was a classic BPI. She had the very atypical , 3-6 month cycles. She would go from hiding in her room, living in Pj's and existing outside of that room only to eat and go to the bathroom. Then she would pop out like a everything in sight, head out to the store for a shopping spree, come home dress to the nine, talk our ears off for hours before grabbing us for a night out on the town....after barely grunting at us for months...then she would do the same again, over and over again. You could almost literally set a clock by it.

I often explain it as a cycle within a cycle. I will have rapid cycles in the same day. I can wake up in a foul mood, dragging myself out of bed, then by the end of the day I am chatty Kathy..but the cycle is not long and severe. Then I will have days 2-4 in duration...I am chatty Kathy, obsessively doing something like writing or here, don't sleep one night, the next night perhaps 2 hours , then 4 hours...(feeling fine the whole time) then I the end of it, and hit the depression. That can last for a day or two or longer. Often it is more of a clear pattern with my female cycles, worse now that I am clsing in on my 40's. (then looking back I can remember waking up and realizing I had felt like crap and pretty hopeless for as long as a month or so.

In the last 6 months...I could almost time it, except the ones that were brought on by triggers , unexpected my son trying to kill himself, etc. Now , not so much, except the female thing again. I have always struggled more with the depression, both the ones that left me sleeping away entire weekends, and the ones that left me a crabby, snippy, forked tongued b i t ch. I don't remember having very long cycles of hypomania. Not until about 6 months before I got dx. The lack of sleeping (which I loved to do, nice escape) and spending money like an idiot (when I was more of a miser by nature) was the last straw.

Does that make sense? And btw you don't have to do the full blown not sleeping thing to be in mania. The criteria states 2-3 days of "little" to no sleep and it basically not effecting you. For more than 3-6 months at a time.

So I guess that is a cycle within a cycle? So yes you sound like you are in hypomania when you are doing that. And perhaps you are BPII. The problem we face is without being properly medicated, we end up being BPI's...which I am not interested in on little bit.

If you don't journal, my suggestion is start. Then you will be able to clearly see the cycles yourself, not only will it help you spot triggers you might not be aware of, but it will help your doctor tremendously. The time, and severity are key..and we often lose a lot of the details by the time we get there, and depending on our mood at the time..might not always be forth coming...

Matt S.
10-25-07, 08:50 AM
If you become a bipolar I, you will be in my caliber and trust me you don't want that... LOL

11-23-07, 04:29 PM
I'm guessing from that statement you are bipolar 1 Matt?

I don't think I have bipolar 1 or 2 but I may meet some NOS dx criteria.

I don't get severe hypomanias but I do get good times followed by bad sometimes good and bad in the same day...

11-23-07, 08:17 PM
Part of the difficulty in diagnosing the less severe types of BP is identifying hypomania, Andy. Early on in the illness, hypomanias are mostly what we call "white" ones. Symptoms such as elation, mild euphoria, inflated sense of self-esteem, increased productivity and increased energy feel wonderful. The fact that this state of mind is out of character or an inappropriate response is denied. How could could something that feels so great be a bad thing? Other symptoms like irritability, racing thoughts and pressured speech are not perceived as being very serious can be easily explained away: "Everybody is cranky sometimes. In fact, my family must be cranky, and that's why they don't feel like talking right now."

With no kind of framework other than that which they experience, the person comes to believe that hypomanias are happiness. The depressive cycles are painful and easily identified as a problem. This is why so many people with the milder types are misdiagnosed with depressive disorders. They seek treatment and report those symptoms. When the doctor asks how long they stay depressed, they say that sometimes they are happy.

As the years go by and the illness progresses, hypomanic cycles begin to turn "black". There is less elation and more irritability. Increased energy levels aren't as productive as they used to be and become agitation. Rages start happening, and mixed cycles become more common. It seem like black hypomania more severe, but they're not! It's subjective in the mind of the person with BP. White hypomanias can be just as severe as black, but they don't seem to be because they feel good.

Severity of hypomanic cycles, as the mind of the person cycling perceives them, is probably not going to be anywhere near what the people observing them perceive them, anyway. It's not a rational state of mind and the ability judge situations is definitely effected. That's why those of here remind each other that this illness lies. We have to accept that we are not the best people to judge our own behavior sometimes.

11-23-07, 09:25 PM
I see...