Four Things that Counselors Don't Know About Bipolar Disorder
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- Опубліковано 13 тра 2024
- This video attempts to answer the question: Can I discuss a few characteristics of bipolar disorder that most mental health clinicians wouldn't know. I titled this video “four things counselors don't know about bipolar disorder,” and when I use the word counselor here, I'm not using it in the professional identity sense, but rather in a general sense - so professional counselors, social workers, psychologists, psychiatrists, or anyone who can use psychotherapy to treat mental health symptoms. This video is in no way a criticism of the mental health professions, but rather just interesting facts about bipolar disorder that I think most mental health clinicians and most individuals in the general public wouldn't be aware of.
The first thing would be that hypomania appears in both Bipolar I Disorder and Bipolar II Disorder. A lot of times because of the way the criteria are written, counselors think that if somebody has Bipolar I Disorder they only have manic episodes, but actually they could also have hypomanic episodes.
The second thing that most counselors wouldn't know about bipolar disorder I call this the one-way street phenomenon of bipolar disorder. As long as someone has been correctly diagnosed, if they move to Bipolar I Disorder from Bipolar II Disorder or MDD, they can't move back to the diagnosis of Bipolar II Disorder Or MDD.
The third thing that most counselors would not know about bipolar disorder deals with the construct of rapid cycling. A number of mental health clinicians know that rapid cycling exists, but don't really understand all the aspects of it, ultra rapid cycling and ultradian rapid cycling.
The fourth thing that most counselors don’t know about bipolar disorder this deals with a personality disorder called borderline personality disorder. The item here is that bipolar disorder and borderline personality disorder can be comorbid.
Personal Hygiene can REALLY suffer in major depressive episodes. Embarrassing and very true.
Yes, it is.
I know this personally. Before, and during the first few years of marriage I kept my teeth immaculate. Dentists were actually surprised that I was a smoker. When my now late ex-wife began to develop, what was later diagnosed as schizophrenia, she treated me horribly. I already had depression, but it developed into major depression, and I stopped taking care of myself, because I literally had no desire to even exist. It went even far deeper than just depression. I resorted to self mutilation. I literally took small screw drivers and broke my teeth. Eventually we had children. Two daughters, blessings from God. They were the source of my recovery. They brought be from the darkness, and aside from nolonger having a perfect smile, I'm a far better man. Far wiser. More in control. And I have become admired for it throughout my community. Those two angels saved my life! ❤️❤️
@@SonsOfLorevery sad story
It took ten years to be diagnosed as Bipolar II and ten years later I'm still learning about how it affects me.
Me too. Took twenty years
One thing counselors probably know, but the fail to take into consideration, is that people with bipolar disorder are often unable to make an appointment when they have crashed. Or show up late during hypomania, because their time management may go haywire. During a crash, it's hard enough just to get up to eat something or to the bathroom. In situations like that, I feel the counselor should be open to either telephone appointment. I also feel the insurance company should allow payment less the co-pay. I can't tell you how many missed appointment charges I had to pay. I would change therapist because i would think they were mad at the number of appointments I missed because I couldn't get out of bed. Some actually fired me. Starting over with a new person sucks. I am a rapid cycler and when I crash, I crash hard.
Thanks for sharing that
I'll have to keep this in mind as symptom. My wife grew up with undiagnosed bipolar until a harsh surgery recovery triggered a really HARD cycle. She learned to mask her symptoms very well growing up, but now I'm thinking she's in depressive episodes when she doesn't want to go to therapy.
Yes, starting over $uX!
Or, getting Fired, or corporate takeovers, etc.
Great points. Thank you 🙏🏼
Rapid cycling sucks SOOO hard. It’s makes me a much “flakier” person with commitments than I’d like to be. Now that I know I’m BP1/rapid cycling, it helps to put lifestyle practices in place to stay well, but even the ups and downs cyclothymia can be exhausting and devastating to my calendar.
Dr. Gande describes and explains these disorders with far more clarity and precision than any other other "UA-cam" doctor I've ever seen.
I wonder how many counsellors in the world would have your level of dedication, compassion and reflexiveness on psychology issues. I've learned more from you than from any therapist I've been to all my life. Thank you, Dr Grande, for all your effort and dedication. I wish you all luck, health and success there is.
Thank you for this. I'm diagnosed Biploar 1 and I've been struggling with rapid cycling but I doubted myself because it seemed to happen so often. I was unaware that ultra-rapid cycling existed and I might bring this to the attention of my psychiatrist during my next visit. I'm a 31 year old woman for refrence. Thank you for your thoughtful insight.
I am not a counselor but I enjoyed this video very much.
Thanks, Dr. Grande.❤
One thing counselors may not know - Psychosis can be prevalent when in a mixed episode, and even sometimes during a depressive episode. Wonderful video. Thank you. I am Bipolar 1 with rapid cycling. (Which now I know might be ultra, and will discuss with my psychiatrist).
Thank you! Excellent point!
I have been cycling for many years. Good fun, but exhausting nightmare never ending hell.
Yus, I only have psychosis during depression/mixed, it goes away with mania.
@@abandonedchanneld8031 It's been 14 years since I was diagnosed with bipolar 1. At the beginning, I used to have really strong psychosis episodes during depression, but during the last 5 years, I only get psychosis during manic episodes, and not always.
I'm ultradian and it's no fun at all
Another thing to do: ASK your therapist and/or psychiatrist what he or she has diagnosed you with, if anything. My original dx at age 18 was BPD with MDD. Later in life, I was dx with PMDD. Then in my early 50s, after a few suicide attempts in a few years, I was finally dx with: Complex PTSD, informally (yes, I know, not in DSM) and formally Bipolar 2 disorder, mixed episodes. I feel that my current dx makes the most sense clinically. It really helped to discuss this with my therapist. I now need to discuss it with my psychiatrist. Your videos have helped me so much!
It's so defeating when you spend a few hours on UA-cam and you know more about your diagnosis than your therapist and realize your psychiatrist couldn't care less. I've been diagnosed less than a year and I'm rapid cycling hypomanic and originally was diagnosed MDD/CPTSD(still have post traumatic stress)/others. It's a nightmare. I'd take the physical pain of just about any injury over the emotional pain and hopelessness I feel on a daily basis. This illness is hell. I wouldn't wish it on my worst enemy.
I've gone from MDD to Bipolar 1. I thank you so much for your helpful explanations- you make these complex situations much more easy to understand and digest.
It took 10 years on every ssri in the book to finally 1 doctor recognized my diagnose as bipolar 2 and not "just" depression. Im on 500 mg Lamictal a day, and it chanced my life. It's now 9 years ago.
That's really interesting. I took Lamictal for a couple of years for my Epilepsy, plus it worked well as an antidepressant, which is kind of a packaged deal with Epileptics haha I had to quit though because I have a hard time remembering to take my medication and I'm sure you know that with Lamictal, you can develop Steven Johnson Syndrome from stopping and starting abruptly . I was having nightmares over it haha
Great to know! Thanks!
My story is similar. This gives me hope!
@@stefanieniglio Good luck to you. If you can, go to your doctor asap. No need to suffer more than you have done since your story is similar to mine. Take care
Thank you so so much for this video. I'm bipolar and do a lot of research on the disorder to try better understand it and therefore understand myself, and I've had a lot of questions i couldn't seem to find answers to, and literally every single topic you addressed were things I was looking for answers to. Keep it up and thank you for raising awareness!
Hypomania may not have gotten me arrested but it fluffed up my life plenty anyway.
Saame! 😥
@@carris3ringcircus390 Same here
While not actually arrested ive had my run in with the cops more than once :|
Samie samie same same 😂
What an exciting bunch we are
When I was working we called it something very unsophisticated, I guess. We called it “manic depressive.” We checked Lithium levels and it would often help. A woman we treated was a PhD in Psychology. she was really brilliant, but she tricked us a LOT. Eventually she took her own life, but it isn’t because we didn’t try to constantly help. Walking naked down a freeway in California isn’t a very good way to survive it. I have no doubts we all miss her very much at this time of year. RIP old friend.
Your point that hypomanic episodes can occur for those diagnised with Bipolar 1 was really helpful. I was diagnosed Bipolar I a few years ago but still have occasional (fairly mild) hypomanic and depressive episodes. I've always questioned the diagnosis because if it was right I thought I should be completely stable between episodes. So your video is great! You could also cover agitated depression/dysphoric mania, perhaps the worst experience I have had. It's very common, utter torture, yet hardly acknowledged by mental health workers, who pass it off as anxiety or treat it as a diversion from the bipolar elements.
I definitely have Bipolar 1 but now with medication I do control it in a way I can say. The deep dark depression waves aren't there really anymore but I can feel the mania trying to kick in every now and then.
Like I've commented on your other videos. Thanks for this interesting explanation Dr Grande 👍🏻👍🏻👍🏻👍🏻
This is next level, useful information Dr. Grande! They say, "You don't know what you don't know." Well, now I know! Thank you!
I think the “hyperfixation” of ADHD could be mistaken for hypomania. It’s a semi-euphoric obsessive state with racing thoughts.
That sounds exactly like hypomania/mania yes 😂
yeaaaahhhhh they thought I had ADHD at first, and gave me ritalin. but I'm bipolar, so my manager thought I was on mountains of cocaine for a month. so yeah there should be more consideration there before medicating.
As well as, a possible comorbidity of ADHD + ASD/ Asperger's*? and both with "c-PTSD"???
Which severely exacerbated the 2? marginally-subclinical and undiagnosed 1st two.
I see where Bi-Polar and BPD are frequently Misdiagnosed for complex/ "c-PTSD".
I'm 69 y.o. My little 'ptsd' is more like ADD, but, in a weird way. A Super Focus on NPD, Law and crime. Authoritarians, Cults and Terrorism+. . . . And completing that degree, in Psych.
It's "hyperfixation" AND that Autist's sole, Super FOCUSED Life Interest+! Starting w/ 🐬. AND SURVIVAL!!!
More like heightened OCD and an Addiction, too. ... "Trauma Bonded" and complexity of it all, with 2 Nazi narcopath bros.
Oh yeah makes sense
@@getwthenewage4871 Some people genuinely do have both ADHD and bipolar. In those cases, stimulant medications MAY be beneficial (for both the ADHD symptoms, and actually the bipolar depressive symptoms too), but typically should be prescribed _alongside a mood stabilizer,_ to avoid the stimulant meds triggering mania.
I was only diagnosed as bipolar II 3 years ago. Up until then I just thought I was reeeeeally bad at life😂.
Thank you for making this video about Bipolar! Very insightful!
i m bi polar one, you explained all this extremely well. i find that the thing with my condition, since so many people can t relate and i ve been thru so much pain, they have no idea how much i ve been thru, and they judge....i have to escape people, and i m judged anyway...as my functioning is sometimes poor. i have to run and hide.
"Escape people..." that's me, also feeling ashamed of
I don’t know how I missed this! Fantastic video…..I have always had a few of these questions but never could have them answered sufficiently from anywhere Thank you very much for your work!
Excellent!!!!. I am glad that you opened this channel.
There is a lot in the social media but not as professional as your channel.
Thanks Dr. G have a great weekend.
Thank you so much for this. I certainly learned a lot!
Thank you for your videos, they've been very informative. I wish I could pursue a career in the field but my mental health really hinders me (or at least that's what I believe) from pursuing a degree. These have given me the opportunity to take all I've read about psychology and hear it talked about in a casual almost lecture-like format.
Stating all that though; you've helped me to realize that I have Ultradian (SP?). I never understood why I couldn't find information on the symptoms in rapid cycling literature.
I have periods where I'll go from feeling "normal-ish", then switch to intense suicidal depression out of nowhere, and then switch to a hypomanic excited state of mild euphoria that lacks any motivation. In the span of one hour I can switch LITERALLY 60+ TIMES. Sometimes it's seconds before an intense switch and less than seconds before the next. It is the most horrible state of mind to be in I've ever experienced.
I don't have a BP diagnosis though because I was only sustained in hypomania once from trying an SSRI, which lasted about 9 days. Also, I have very often in the past gone into inconsistent degrees of hypomania for only a few hours or moments, only to go back to my baseline depression for the remainder of that episode. Depression has preceded hypomanic behavior all but two times that I can recall.
The DSM needs to do some serious work with how they categorize and assess Bipolar. It should absolutely be viewed as a type of spectrum disorder, though not in the traditional sense. Not to mention treatment options and methods aren't optimized what-so-ever due to a clinical hesitation paired with a lack of understanding of the condition, especially when you get into the many co-morbidities that are practically always present in BP II.
That was so informative, thank you Dr. Grande ❣️
i made a video about what it was like for me being misdiagnosed with BPD but i have bipolar disorder ... i went years with out proper treatment bc the drs were so narrow minded.. it took me leaving public care for private to get help
its not just therapist either it can be DRs too.. bc that is what happened to me, when hospitals get these young people in that are only educated a little and refuse to educate themselves beyond what they learned or know.. not to mention dont take proper intake and medical history
I do not quite understand...Aren` t you treated based on your symtoms, your struggles and not on a construction of a "disorder"?
How are you today?
Best wishes to you!!
eichhorn that would be the idea but not really how it worked.
@flagschange111 Both disorders are treated with therapy and mediation, however, for bipolar the main treatment is medication and then therapy, for BPD is main treatment therapy and then meds.
It's still individual tho, I hope it makes sence
@flagschange111 They are not comorbit most of the time, only 20% of the time. And it's bipolar spectrum, not BPD spectrum. Most doctors believe that they're two different disorders.
also the bipolar disorders are mood disorders and BPD is a personality disorder; and afaik BPD's mood swings come from hypersensitivity to the environment. very different constructs. from my understanding, because of this, as @Name pointed out, therapy (DBT or CBT, usually) may be prioritized for BPD, and mood stabilizers for the bipolar spectrum (ofc both can be the best option a lot of the time)
Great video! All your videos are very interesting. Thank you very much, Dr. Grande for taking your time to make them! I know you have mentioned in earlier videos rapid cycling bipolar disorder. But could you please consider making a video about ultradian bipolar disorder only? A video with in depth information. And/or talk about the difference between ultradian bipolar (severe mood shift in a day or even within the same hour) and mixed episodes/mixed states in bipolar disorder? I am so confused if it is ultradian or mixed states when someone shifts their mood in the same day or the same hour of the day. From very strong suicidal thoughts because they feel they have not enough strength to continue their life/that they do not have anything to live for to feeling happy and thinking that they are able to continue living after all. They suddenly feel that they have something to look forward to and that they want to live, even though their life is tough and not what they wanted it to be. This sudden shift in mood and thoughts - I do not know if it is ultradian or mixed state. I know you have many requests, about many topics. But maybe if you got more requests about this particular topic, maybe you could then consider to explain it more. Best wishes! : )
Let me see if I can find enough information in the literature to make a video on ultradian BP - thank you for the topic idea!
@@DrGrande Super great! Thank you so much for your reply and for wanting to look into it! Bless you!
Interesting that you described borderline personality disorder with the chronic emptiness. I was trying to explain the horrible empty feeling I had for years. It was so painful and my psychologist couldn’t comprehend it. I am diagnosed with bi polar II by a psychiatrist but I’m pretty sure that’s not the end of it. It may be borderline personality.
I definitely had a strong narcissistic personality when I was younger until about 18-20 when it started to fade off and more into horrible depressive episodes.
The ultra cycling thing is definitely real too. I could change in 2 weeks or 2 months. The hypomania didn’t last for anywhere near as long as the depression. Maybe a few days to a week at a time but it was intense.
You can also have Bpd and bipolar disorder....🌟
I'm someone diagnosed with Bipolar Type 1, but I have had many days where I have gone from a high to a low
This was very interesting
You don't know everything??! I don't believe it! I think you might! I have just been dx'd with bipolar 2 at age 56, although I have been struggling for years, and these videos really help me right now! I'm interested in the dilemma of the patient being reluctant to take meds because the mania is preferable to the depression. My hypomania is manageable and it is only about 20% of my disorder, the rest of the time I am in varying degrees of depression. Thoughts? 💜
I’d say as something that peeps may not know is that it is still possible to have episodes when you are on medication. It might be just that I need a higher dosage of meds but in my experience medication controls but does not completely eliminate symptoms. It’s a miss conception I encounter a lot.
Also that the happy version hypomania can be really destructive. I explain it like this, if you think you are a super hero, literally or figuratively, you believe all your worst ideas and act on all your worst impulses because how could a brilliant super star be wrong, right? I have hurt many people I care about because I thought I could walk on water, so to speak.
Also, and this is a mistake I don’t see with professionals but with people encounter online but bipolar is a spectrum disorder so no one manifests it exactly the same way.
Psychiatrist 's must all be a bit retarded as they do not understand
Dear Puma thank you so much for your honesty. I wish my husband could be as self reflective. Any damage that’s ever done is always my fault or another family members fault.
This is so true. And it made me think that when you hear lifestyle advice, it will tend to be along the lines of, be who you really are. But the opposite is true for bipolar sufferers because 'being who we are' gets us and everyone around us in trouble. In order not to cause any more hurt, I've restrained who I am. In part, I'm glad to, as I'm calmer, more considerate, less egotistical and greedy. But I am also less instinctive and gregarious. I have more anxiety and am plagued by shadows. I can't be who I am as a bipolar person, I have to find a way to live with the thing that both influences my personality and tries to overwhelm it.
I find it hard to know what Im experiencing until afterwards with Bipolar 1. I often feel very dissociated when Manic, Hypomanic or depressed. It can take me a minute to notice if my mood has shifted or if I am feeling intense emotions for days weeks or months. After a few weeks I start to be able to tell the difference. I do not know if clinicians hear this a lot. It isn’t something I’ve heard spoken about very often.
Love your videos. Maybe you could do one about Marriage and divorce rates for bipolar.
This is really interesting! Learned some things I never was taught in Abnormal Psych!
Diagnosed bipolar 1 last summer at 56 talk about a late diagnosis. Although my father was diagnosed at 75 after going manic. looking back on my life I know I had it since childhood honestly I'm glad I wasn't diagnosed as a child it's made me who I am
I enjoy your videos. I learn so much. Do those who have mental health issues ever underreport their symptoms and compulsively believe it themselves ?
As with borderline, there can be a lot of overlap between bipolar and adhd.
I feel like I have seen a real comorbidity in an adult ADHD person whose natural talkativeness veers into what I see as manic pressured speech. But I think you were referring to symptom overlap without any actual bipolar disorder. The person doesn't agree, btw.
From what I heard, a bipolar person may get diagnosed with ADHD as a child. Typically they don’t like to diagnosis someone under 18 with bipolar disorder. A child with bipolar disorder would have similar symptoms and behaviours / traits as a child with ADHD. I don’t know this to be fact, it was just something that I was ether told or read/heard when I first got diagnosed with bipolar 2 and started with my research into the diagnosis. I myself wasn’t brought for examination as a child, however my teachers noticed that i was different and instead of insisting to my mom to take me to a doctors, I got put into a program called learning strategies. Which was a program designed to help emotional students better deal with their emotions. Basically anger management. This was in 2000-2005. I have been curious as to what my diagnosis would have been if I got brought in for examination.
Thank you Dr. Grande. Interesting how Bipolar Disorder classification is similar to how the disease of Diabetes is classified into more than one category. I wonder how those categories could appear in senior citizens within in a nursing home. How can a health care worker soon enough recognize a patient who is in danger of giving up altogether while they have that disorder when not relating to them on a day to day basis over time? In a nursing home with a high turn over of staff that kind of patient in a nursing home would be so hard to treat.
I love your explanation it really helps me understand thank you
It took 20 years to get a proper diagnosis I didn’t even recognized that something was wrong with me. By now I’m almost sure I was suffering from Bipolar Disorder since I was a child. I was always labeled as the weird one, the crazy one, on the other hand shy and quite. Nobody even considered something was not right. I started having hallucinations when I was about 18 nobody told me that something was wrong and for me everything was real totally real. When I got married I was full blown manic they put it down to the wedding jitters. I can’t even remember my own honeymoon. The only thing I remember was like 6 month into my marriage I got horrible depressed they put it down to oh she is missing her family and the adjustment to married life ( I’m from a traditional family we don’t date or live together before marriage ) fast forward I got the diagnosis Bipolar 1 Disorder with psychosis 2018 after an full blown manic and psychotic episode that ended in an attempted suicide. I’m on the road of finding the right treatment unfortunately some medication made me start rapid cycling. I’m again on new medication well fingers crossed that they are the right ones. The progress is painstaking but at least I know what is wrong with me.
Ask for amphetamine to stop the suicidal thoughts...
@Brandy Baker I wish you good luck to find treatment that works for you. This is not always smooth sailing so don’t give up and be patient with yourself. Some days are better than others. The pandemic was a huge setback for me it had such a bad influence on my mental health my anxiety is literally through the roof.
I'm not Bipolar but I was on a migraine med a month ago that gave me terrible mood swings and pressured speech. It seemed similar to Bipolar but symptoms changed within minutes.
My sister noticed it. I got so crazy, my therapist asked if I was taking any new med and I said yes and she told me to tell my MD right away. I'm so thankful she asked. I felt like killing myself.
Thank you Dr. Grande for explaining the types of Bipolar disorder. I am more empathetic now due to my reaction to that med even though it was not Bipolar. Great job 👍
This was very informative thank you. I’m bipolar 1 and I’ve often thought, I might have something else besides it.
Thank you so much! I don't think that my psychiatrist knows about rapid cycling because he told me that I didn't have a bipolar disorder because my episode are too fast (2-3 weeks). I have no idea what my episodes are, maybe they're something else, I'm not going to question a person that actually studied this for years and years, but there's definitely something where he said there was nothing.
Very educational thank you. Do you have a video on the difference between mania and hypomania?
Very interesting and helpful!!!
Excellent explanation!
Thank you!
How long can an episode last for Bipolar I ? My best friend has been hospitalized 3 times in a six month period. The whole time in a delusional grandios state with mania. She is 40 and typically has an event every year for around 3 months. Im so scared she will not come back from this .
Thank you...appreciate your help...I am Bipolar I...God bless💖
Hey..Dr. Grande..loved your video! Can you do a video about a topic that has been concerning me..here on UA-cam there are several UA-camrs who have "mental health" channels without the education or licensure discussing mental health in "factual" terms...giving out mental health information ..and charging for mental health "interventions". Example Rewired Soul who is charging 100.00 for a mindfulness and substance abuse course but has no education but there are many more than just him. My concern is that they are exploiting individuals with mental health concerns who are turning to them for help. Why not just say they are self help gurus- I think its cause they will lose points with those seeking mental health help. I know that many individuals can't afford therapy and are vulnerable to these types of individuals.I even had a client come in telling me that they heard this or that from a Mental Health provider that can eliminate anxiety ..when I Google the person its a lay person with no education in the field and was putting down professionals and their degrees. Many of these individuals are usually repeating basic psychology 101 information..what are your thoughts about charlatans in the mental health community.
This is an excellent video suggestion, and I will add to the production list - Thank you!
@@stoneyvowell1239 Hunh? i doubt the dislike of abuse is a conspiracy... also not sure why you put masculinity/dark triad together like that, with the slash between them, as if you saw them as somehow the same??? equating them? that is like deliberately defining masculinity as something negative, by equating masculinity with something negative like the dark triad. it could almost sound as if you were in on the conspiracy and trying to make males sound bad, by equating masculinity with bad things????? maybe that's not what you mean and maybe you are not being clear????
@@stoneyvowell1239 also you may be using the word schizophrenic in a confusing way?
as per dark triad, narcissistic traits, and abusive behaviors, you betcha that no/neither gender has any corner on any of those things
i never much agreed with the idea that males vs females have entirely, inherently different natures as such. I think some people just like the idea of that being true.
As I am a paranoid scitzophrenic and bipolar. I have the truth of what I received from the front line mental health services teamwork. I get no real help from psychiatry. They are all useless. At least with the mindfulness and substance abuse therapists are more likely to listen to mental health patients properly. They might not have degrees in psychiatry but they are all good at listening. Psychiatrist's are rude and insulting and refuse to talk or listen. They are too busy and important to care properly. So we have to look elsewhere for any meaningful action. So reduced to
relying on drug therapist's to try and help me. Total sanity, as there is no other proper therapy, worldwide. As I have double checked already. So stop bullying the drug addiction therapist's. As they are only trying to sort out the damage that psychiatry has inflicted onto many people worldwide. You are jealous therapist's and you know that you are pathetic and useless. So stop ruining our life and chances of getting a better deal and some real help for once. As it would seriously be a change.
Oooooh, I definitely rapidly cycle. It makes sense.
Quick question: what journals do you typically subscribe to for current research?
Hello, again! Fascinating. Was not aware of the "one-way street" practice. Curious -- origin? Pervasive cultural intolerance/fear of mania? (The word itself speaks volumes 🙄 to most modern/western ears.) Also, wondering what you may know about clinical practice around the "rapid cycling" specifier in combination with cyclothymia - ? Had not heard clinical community was opening to awareness of faster cycles -- good news. I have only heard nightmare anecdotes of "same day" (ultradian?) fluctuations -- sad to hear that this presentation appears to be (?) common enough to have created language in practice, but I'm glad (if it is prevalent) that folks living with it have helpful language. (Even without a need for diagnosis, just coming across the term "cyclothymia" for the first time some years ago changed my personal experience! 😏)
I heard my mum call it cyclone cycle and wondered what she meant. It sound's similar...
I can attest that mania and depression can be present im the same day. At the same time even. I never understood what I would feel sometimes but it is the only way to describe it. Like high energy emptiness. A raw nerve kind of existential nothing all charged up with an empty kind of sadness. Maybe I am wrong and I don't know anything beyond myself but I can say that for me the construct has validity in describing my experience.
Thank you that was vertical informative
Finding a good doctor like yourself or Dr. Fox who is knowledgeable, cares, & doesnt treat me like a DSM-5 page is nearly impossible. I live in CT. I can talk about symptoms all day. Most doctors dont believe me because of the way i present myself. 💜PLEASE HELP!
Do you have any videos about depressive episode relapse signs?
There is so many about mania but nothing about depression that i can find on youtube.
Such as what may be happening during a period of time before full on depressive episodes.
I have found myself feeling periods of moods that are making me worried im going into a depression again.
I was on such a good streak of good mood and now its changing.
Oh, yeah -- other thought/question. Wondering about your perspective on the following.... Agreed that specificity of diagnosis is critical to clinical work, so "jumping to comorbidities" should be avoided. That said, if I gather correctly, bipolar-type function is thought to be in large part set up and later sustained by brain chemistry (if often initially triggered by a stressor), where as borderline traits often emerge in the wake of trauma. Granted that trauma & brain chemistry are related, it still seems likely that in a reasonable number of cases, two sources of challenge -- likely intermingled -- could produce two comorbid disorders - ? Anecdotally, I am aware of a number of people who have struggled horribly with serial approaches to treatment, only to reach better function when both challenges could be (at least partially) met at once...?
B12, (also B1, B6) and dha deficiencies have a serious impact on bipolar.
What about psychotic features? Im diagnosed bipolar 1 with psychotic features and about the difference between acute mania, mania, and delerious mania?
Than you so much for this information, I have a question about the difference between ultradian cycling and the mixed bipolar disorder, thank you.
Mania and hypomania differ with respect to duration, intensity, and functional impairment: Duration: In mania, an elevated or irritable mood lasts at least one week. In hypomania, symptoms last for at least 4 days. Intensity: In mania, symptoms are severe, and in hypomania, they are mild to moderate.
What about mixed state features? I have bipolar 1 with mix states and psychotic features. Happy to say I’ve been relatively stable for several years with the right medications. I don’t know how many sufferers have the mixed state. So it may not be a topic to discuss. However, its more difficult to understand that part of the disorder. Thanks for the video.
I can make a video about mixed states - I need to read up on them a little first -
@@DrGrande I would be interested in this video as well. It seems the line between ultradian cycling and mixed states can appear to be very blurry at times because two poles are appearing together at once or alongside each other within a day or two. Im curious as to whether these are really two separate entities or rather variations of the same concept.
Mixed states are the wooooorst
@dr. Todd Grande, more about psychosis, please
Just b/c BP1 doesn’t require a depressive episode doesn’t mean that it’s less prevalent than in BP2, but that’s what it sounds like in these videos due to the emphasis on the clinical definition.
-BP1 for 35 years
I had 2 Manic episodes after being put on a 2nd Antidepressant. About a year later I was in ICU for a week due to seizures because of severe serotonin syndrome. 😩 I never had any issues with depression or anything until I was about 28.
My bipolar boyfriend tries to fool the counselor by purposely getting a different diagnosis such as ptsd instead of bipolar when he is manic. He can even intentionally slow down his talking and sound normal with the counselor and then back to rapid talking as soon as the counselor is gone. This is when he is manic. Barely sleeps, rapid talking, gambling, self grandiose, paranoid, irritable, not eating as much, constantly doing different projects, delusional thinking (like being an to agent), constantly moving things in the house like building shelves or replacing the floor, etc.
I did not realize that, in bipolar disorder, it is common to have anxiety/panic issues. Wish I'd known that years ago.
You are so correct I’m bipolar 1 and I have had severe full blown manic lots of hypomania and rapid cycles and mixed and I’ve had some counselors say I can control it
Weird question and since this video is older not sure if I’ll get a response. So I was diagnosed with depression when I was about 13/14. I only saw the psychologist 2-3 times. He referred me to a doctor to get on antidepressants. I hated them. They worsened my suicidal thoughts and just didn’t help at all. I stopped taking them. Later in my life I started getting seizures. Common seizure medicine is antidepressant or mood stabilizers. They originally put me on keppra. Same thing happened. It messed with my sleep schedule and it was just terrible. I asked for a new medication so I could not have seizures. They put me on lamictal. Once on lamictal everything got better. I still get depressed at times but not as bad. My question is sometimes with depression do mood stabilizers work better than antidepressants. I always wondered if I am actually bipolar but I don’t want to self diagnosed. Is it worth it to go to the doctor. My symptoms are being taken care of for the most part. I think I’ve had possible mania at times but it’s hard to say and I was only formerly diagnosed with depression. I want to go back to therapy but I’ve been working a ton lately so I just haven’t found the time. My main question I guess is does a diagnosis really matter if the symptoms are being taken care of? Although I take it for seizures it has still helped me immensely mentally.
Can you do a video on being diagnosed with bipolar disorder, then becoming addicted to amphetamines/amphetamine induced psychosis & how it effects the bipolar disorder: rapid daily cycling between depression & mania or hypomania? A therapist could state there is no bipolar disorder present, but rather an addiction, however the person had every symptom of bipolar disorder prior to ever taking amphetamines & it changed the way a person is diagnosed. If you how share your thoughts & feelings in would be greatly appreciated!
I have scitzophrenia and bipolar. And I have found out the hard way that amphetamine can cure psychosis and scitzophrenia. Amphetamine lifts me out of the suicidal depression so I can get out of bed and helps me be able to keep up with the rapid cyclone cycles that I go through each day. I do not use it to party but use it to get through my day alive. Psychiatrists I think should prescribe amphetamine urgently as a cure. If they don't, that is murder by suicide. Illegal behaviour so help me to petition now... Truth...
It can be very difficult to not only live with bipolar 2 disorder, it can be difficult for me to articulate to a professional counselor what's going on in my head. I get so frustrated with myself. Sometimes I really hate and punish myself for being this way. It's so embarrassing really to reveal to a counselor. I try my best to hide my disorder but I know I'm not on the right medication yet, I'm still manic and then fall into and seemingly endless and deep depression, almost becoming agoraphobic.
You're looking a bit tired/stressed, Dr. G. I hope everything's alright. Please make sure you're taking care of yourself!
I detect sarcasm. Doctors are not suppose to help anyone. Blackmail.
You might have mentioned the effect substances like coffee can have worsening or even creating a mood disorder.
Can you do more videos about bipolar with borderline traits or borderpolar I been diagnosed with both also what about bipolar with ADHD I also been diagnosed with both
You're the best! :)
Abilify helps my thoughts but makes me antsy physically. Will this go away over time? I've been on it for almost 3 weeks now, went from 5 up to 10 mg. My NP insists I take it before bed, which I do, and I have much trouble sleeping, which is unusual for me.
I am loving reading the comments here from bipolar patients. 😍
It's helping me see my wife's bipolar from her perspective.
One thing that I have learned with 20+ years of mental disorder and anguish, is go to as many counseling sessions as possible and talk. I mean share everything! Even if uncomfortable, embarrassing, shameful, what have you. If they don't know your behaviors, patterns, tendencies, traumas, abuses, and so forth, they have a worse chance of diagnosing and even more detrimental is getting misdiagnosed
When I was diagnosed with bipolar disorder I asked if it was bipolar 1 or 2. They told me, "Just bipolar disorder". In the U.K. they don't seem to understand it enough. The U.S. has a better understanding of it.
Living with someone who is bipolar 1 who refuses to take medication. I am trying so hard to be understanding and supportive but I feel like the only one making a compromise. I am so afraid that one day it might be that I’ve waited too long to do something. Although what are my options? I am the only one employed, I pay the bills I can’t leave because I have no where to go and my husband would be homeless. Is there anywhere I can go for help or just talk to someone (cannot afford to see a therapist for myself as all monies go to just keeping a roof over my head)
i'm bipolar 2, but i learned how to control my self during maniac disorders. i learned when i am in maniac face. and take control of that conduct, first i do recognize when it started some time at the begin and some time when it begun. more difficult to me is deal with depression periods , lot of time when i recognize them is already in this period. it happens suddenly and the only thing i can do is telling my self I will be gone quickly ,,,, and star doing mechanical things cleaning, repairing something,,,, but try never stop doing tasks. being this way is how i can live my live with happiness
If you are bipolar ll and experience mania as opposed to hypomania then technically you are Bipolar l...no longer Bipolar ll if I understand Dr Grande correctly. I've had to listen to this several times bc it's a lot of into to take in.
@@violatrujillo thanks. 1 or 2. My best achievement is to learn how to deal with my illness. Even though I am taking my daily dose.
Could you do a video explaining the difference between symptoms of depression and depression? Because i was diagnosed with cyclothymia but im not sure i agree because for me my depression was really bad, like i had suicidal ideation quite often, i had absolutely lost interest in all my favourite activities, i didnt see a point of getting out of bed, i missed work just a few times, normally i was going to work but as soon as i would get home i would be just lying down, i felt my body was so heavy i couldnt get up, i stopped taking care of my self like not brushing my teeth, i wasnt even hungry like food didnt have taste for me. So im confused, was my depression just symptoms of depression just because i didnt miss work as much? I had no social life, not even wanted to text people, i just wanted to be alone. I started a treatment with excitalopram, and after 3 weeks i went to a euphoric state that my psycologist even said to calm down, then i got into depression again, and then i had this super weird moment of a brilliant idea, i focused so much in projects, i i had a lot of energy but i only wanted to focus on my projects, i engaged with a lot of things... and then i went to a really bad depression where i couldnt get up and would cry the whole time. So i went to the doctor and i got lamotrigine as well, and then i felt more stable. So in my head i have bipolar 2. Anyway, could you do a video about the difference between major depression and symptoms of depression? Thank you
I didn't know it until a psychiatrist that took over my previous psychiatrist read off my disgnoses, but I was given several of them and two were BPD and Bipolar 2. It's embarrassing to me.
I'm so sorry. And, as well as, overwhelming!. ... Hopefully, this new shrink is good and gets you on the right meds and in to DBT.
i have severe manic and depressive rapid cycling traits that are unpredictably erratic long duration or very short duration its all over the place i also have comorbidities with autism and ptsd that ranges from ultrainian ultra to type 2 bi polar disorder they actually could not pin down type one or 2 for me because of this so its something that is being closely monitored
How do you differentiate between having Disruptive Mood Dysregulation Disorder and Bipolar Disorder with irritable/agitated mania?
I am a Therapist (No degree in Psych) and have a client whose husband possibly has Bipolar Disorder with Narcissistic tendencies...( I have seen him for a business consult where I noted some very interesting and red flag behaviours) He appears to be very resistant to any form of help (so his wife tells me) and his behaviour/habits cause a lot of problems for their family. How do you/the wife get help for them when they don't think they have a problem.? Depression, Hypomania, some alcoholic binges for weeks, no sleeping, obsessive behaviour, some paranoia... Suggestions of a pathway.. he is now in his 60's.
I saw a friend of mine with bipolar disorder went from depressed to manic to depressed all in one day. It took all day for me to convince her to take her meds.
I have bipolar one. I was bipolar "non specific" or "otherwise not specified"... since I was 14. I was diagnosed bipolar one after being involved in a covert narcissistic abusive relationship. So basically my I didn't fit the complete diagnostic requirements for one or two until my first manic episode which landed me in jail on a DWI charge and a year later I had another DWI charge. Little did I know, my drinking increased due to an inability to basically calm my mania... that I'd never had before so didn't understand what was going on till it was too late. By this time I was 39... so wow... 14 to 39 and here we are. Wondering if the narcissist had anything to do with that. He does meet 7 of 9 traits according to the DSM-V on one way of diagnosing NPD... on the second scale he meets it all criteria. Anyway (and I am a psychology degree holder as well), what about the one you briefly mentioned... cyclomythic and drug induced bipolar disorder? Also, I am curious as to how you explained the rapid cycler as having 2 parts to it. I am a rapid cycler. I swing directly from mania to depression but never in a day... that to me would signify a mixed episode... correct? And as far as I was taught, that would signify cyclomythic? Correct? I'm genuinely curious.
One of my daughters was diagnosed bipolar one ... or borderline.... and the other bipolar two. Their father was paranoid schizophrenic and as I was taught, bipolar and schizophrenia are created by the same genome from the father. My father is bipolar two. Borderline is a personality disorder which has a high cure success rate after approximately 10 years after diagnosis, in which... bipolar being a neurological disorder at a neurochemical level... often first being migraines and stomach issues, which I've had both since age 4, until trauma... is non curable. So basically if they run comorbid, wouldn't one be able to be successfully cured and the other wouldn't, meaning they are still presenting the same issues regardless of diagnosis. I find it hard to believe they are comorid. Like narcissistic personality disorder and bipolar disorder. I find it difficult to believe they are similar as I actually feel terrible and apologize and know what I've done in mania, that in depression make me suicidal. I'm not mourning my own grief, I'm mourning grief I caused others. Or in my depressed delusional state, I feel I failed others. Sam Valknin, who I'm not a huge fan of for obvious reasons, touched on the two. Hate to say it, but he actually explained it well.
I love your videos, and think you are amazing for doing as thorough a job as you do. Bipolar is a huge topic to cover as well as Antisocial Personality Disorder. You do an excellent job. Question though... there is not a lot of research on what happens to someone with bipolar disorder that goes through a narcissistic abusive relationship. My family and myself struggle. I became bipolar one as mentioned, and now have been diagnosed with severe CPTSD, GAD, and social phobia as well as agoraphobic tendencies. Help?
I have bipolar Type 2, and am talking to my dr's about psychopathic traits(type 1). Is scored 33 on the hare test, and high on levenson. I feel like my bipolar helps the psychopathy, and my high IQ helped me adapt so well I didn't find this out until I was 33. Side note I have a TBI,(psychopathic trendies seemed to be there before that), and I think the physical abnormalities of bipolor helped me recover from that very fast. I feel that BPD is over diagnosed, and have seen that in my friends. perhaps bipolar and psychopathy should be on a spectrum,
Good point
Agree about comorbid with BPD. Isn't it reasonable to assume that living with one could produce the other? That last thing. Where is the line between impulsivity and poor impulse control?
doubleplus good video
If someone has only one ever full manic episode, and that episode was caused by abnormal circumstances (in my case, recovery from brain surgery) would they still remain in the bipolar 1 diagnosis?
Alanna McGrane I believe the DSM5 specifies it has to be without a “physical” cause.
@@IonIsFalling7217 I think that's true. Also, clinicians need to be sure psychosis or manic appearing behavior is not caused by recreational drugs or drug interaction.
Delirium can look a lot like psychosis, but it is not a mental disorder. it's very interesting, i suggest looking into it :)
another interesting thing I learned from being wrongly diagnosed with Adult ADHD is that if someone does not have ADHD symptoms in thier childhood, then the ADHD-like symptoms are usually from another disorder or physical illness. In my case, I had untreated undiagnosed hypothyroidism
Full mania due to physical complications, or substance abuses, rules out the BD 1 diagnosis.
A good one is that many women with autism and bipolar disorder are mistakenly diagnosed with borderline personality disorder!
If someone with a long history of bipolarII has a mixed episode, or dysphoric mania, do they then get diagnosed with bipolar I?
I have always wondered WHY I continue continue to have the Major Depressive Disorder label in my records.
I can tell you that medical practitioners will see that a patient being treated for bipolar disorder is on antipsychotic medication. Often, antipsychotic medications are used strictly as mood stabilizers, with the person having no history of psychosis. This is lost on many in the medical field where they often assume this person has bipolar I or bipolar II with psychotic features. Atypical APs like Latuda, Vraylar, and aripiprazole are all used with great frequency and efficacy as mood stabilizers and are actually quite poor at addressing psychosis, if present.
Really interesting facts. Why is bipolar disorder different in terms of a one way street? I have to be honest. I'm really bad at diagnosing bipolar disorder. I think it's because 1) I haven't had a lot of clients who are bipolar and 2) I haven't seen a lot of unmedicated bipolar clients so I never really get to see mania.
I believe this one way street concept is mostly used for categorizing and labeling symptoms diagnostically. When someone has a history of MDD and they develop manic/hypomanic symptoms, it is no longer useful to use the MDD label on them even if they never go on to have another manic episode. The reason for this is that we cannot really predict whether a person will or will not have another mania in their lifespan so categorizing this occurrence as under the umbrella of bipolar can help clinicians note that manic symptoms are present in a patient's history and they should be treated in a way that is conscious of the potential for them to reoccur. In the context of medication, it is important to categorize someone with a history of mania into bipolar diagnosis because certain medications used for major depression are well known to potentially trigger mania in bipolar people (and not MDD ppl). Even if their symptoms appear qualitatively identical to someone with MDD during a depressive episode, the fact that there have been past mania episodes means they could respond to antidepressants completely differently than someone with true MDD. If clinicians were to downgrade a bipolar diagnosis to MDD, there could be potential for medication to be administered that could be detrimental to their condition rather than beneficial. This is why you can upgrade to bipolar if new symptoms appear, but you cannot downgrade later on.
The medication for manic depression and bipolar is the same thing. There is no difference. Stop lying now...
Is it true that persistent depressive disorder is often comorbid with borderline personality disorder and childhood trauma?