May 08, 2007Just How Bipolar Is America, And Treatment NotesA new article in the Archives of General Psychiatry estimates that the lifetime prevalence of bipolar disorder in the US is 4.5 percent. That's comprised of 1 percent BP-I, 1.1 percent BP-II and 2.4 percent for "subthreshold" bipolar disorder. The latter is defined as "recurrent hypomania without a major depressive episode or with fewer symptoms than required for threshold hypomania." In other words, 2.1 percent of the population has bipolar disorder of some kind and the rest are just kinda, sorta weird. The study is following the recent fashion of trying to turn bipolar disorder into bipolar spectrum disorder, which would serve to label behavior that is weird but not clinical per se. I am against this. America has such a dicey relationship with its weird side to begin with. This will only worsen matters. The 12-month (ie, current) prevalence of all three groups is estimated to be 2.8 percent. What's interesting is that NIMH and damn near everyone else have long hyped bipolar disorder as a lifelong condition, but it appears that this study indicates that there is some flux in that hype. Which is good. In other news, I have mentioned before that my psychiatrist and I have been having a year-long chat about whether I should be on or off-meds. Yesterday, we decided that I'd drop my Lamictal to 100 mgs. a day over the next few weeks and hold there until I am past my traditional early-June dip in mood and, then, taper the rest of the Lamictal out of my system by August. We are doing this as an experiment and, if things don't work well, then I'll go back on meds. After 18 years and a 98 percent compliance rate in taking meds, this feels like an achievement of some kind. It will also be a nice 45th birthday present for myself. Of course, if I do well, then the tricky question will be whether I am bipolar anymore or if I am just weird--er, I mean subthreshold. Posted by Philip Dawdy at May 8, 2007 12:05 AM
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First, I think that would be an amazing thing; if after all of the years of hardcore medication trials and learning what works for you beyond medication; you could go med-free. That would be a gift for sure. Also, I thought that Hagop S. Akiskal, MD rang a bell, and realized I had a post quoting him about bipolar III. It's an older magazine article I posted. Bipolarity and narcissistic personalities; rainbow spectrums, Lithium or wonder drugs? .."Now psychiatrists talk not only about bipolar III, bipolarity triggered by antidepressants, but also other gradations of the illness, like bipolar IV, an agitated depression that predominantly affects people over 50 with “extroverted personalities that are sometimes, in my view misleadingly, described as ‘narcissistic,’ ” according to Hagop Akiskal, professor of psychiatry at the University of California, San Diego."
"Of course, if I do well, then the tricky question will be whether I am bipolar anymore or if I am just weird--er, I mean subthreshold." That's exactly the question. I was diagnosed BP type I just over two years ago, when out of the blue, I became hypomanic and then rapidly progressed to full-blown mania and psychosis. Before being discharged from the mental hospital, I was told that if I didn't consistently take my meds (Depakote ER, 1500mg/day) for the rest of my life, then I could almost certainly look forward to another forced visit to the asylum.
Now it's two years later, and I haven't had another manic episode, but how can I know if the drugs are actually helping, or if I would naturally have been mania-free? The only way to find out is to stop taking the drugs and see what happens, but confinement was hell (no insurance/state-run hospital, etc.), and I'm unwilling to risk going back. What a mess! Posted by: Anonymous at May 9, 2007 09:40 PM |
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