Posted by Blue Cheer 1 on February 10, 2002, at 0:20:02
In reply to Yes Puzzle! » Elizabeth, posted by spike4848 on February 8, 2002, at 1:13:02
> > In mania, you might see a lot of impulsivity, rage (not just irritability, but serious anger and aggression, maybe violence), delusional thoughts, psychomotor agitation (not being able to sit still, that kind of thing), feeling like you have lots of energy and can do anything, etc. Anxiety might include things like excessive worrying, jitters, and avoidance behavior.
> >
> > But really, what's the difference, as long as the meds work?
> >
> > -elizabeth
>
> Cause if you give a patient an SSRI who you think has severe anxiety and it turns out they really are bipolar .... things get ulgy fast .... mania, depression, cycling, suicide, etc. It would be nice to know the difference before.
>
> Spike
Comorbid bipolar disorder and anxiety disorders (OCD, agoraphobia/panic attacks, social phobia, etc.) are quite common, and they come and go during the course of bipolar illness. I had several limited-symptom panic attacks in the mid-80's (probably a result of genes and the stress associated with raising two children every day (well, until 6:00 P.M. or so - when the changing of the guard took place), and OCD symptoms developed in 1981 (birth of first child). The thing to do is to treat the bipolar disorder primary, and the other disorders as they appear. Comorbid conditions are associated with worsening of course (i.e., rapid cycling, severe episodes, early onset and duration). Anxiety and agitation can be features of all phases of bipolar disorder (e.g., the anxiety you feel when you're in a manic frenzy or dysphoric mania). Treatment with SSRIs and other ADs for depressive phases is alright, as long as you discontinue them within two months or so following the resolution of the depression. Using anticonvulsants for sub-baseline episodes is optimal because they're effective as stabilizers too. (For example, Lamictal.)I can't see how a psychiatrist would have difficulty distinguishing between bipolar disorder and anxiety/agitation if he's seen the patient for any length of time, though.
Blue
poster:Blue Cheer 1
thread:92727
URL: http://www.dr-bob.org/babble/20020208/msgs/93540.html