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I'm honestly not completely sure how accurate WebMD is regarding their statement about more depression in bipolar patients across the board. Given there are two major subtypes of bipolar disorder, BPI and BPII, there are different features of both.

BPI tends to have more manic highs and the depressive cycles don't meet diagnostic criteria for MDD-grade despressive episodes. The danger in BPI lies in the manic episodes as it can include reckless behavior such as drug use and unprotected sex with random partners, gambling, excessive frivolous spending, and general dangerous behavior due to the delusions of grandeur and elevated self-esteem. Risk of death due to drug overdose, accident, disease, etc. is the concern with BPI; it can also be with psychotic features.

BPII tends to have more depressive cycles, and BPII patients do not experience manic episodes or have experience psychotic features. Both of these are expressly stated as having never to have happened to be classified as BPII. Rather, they experience a lesser form of mania called hypomania. It's typically less dangerous. It can have similar symptoms, but to a lesser degree; however, the depressive episodes for BPII meet MDD criteria. That is where the danger in BPII lies, as the risk of suicide attempt and potentially completion is much higher.

Being diagnosed BPII myself, I can agree that I have experienced far more depressive cycles than hypomanic, and each person's manic and hypomanic cycles are different. For me, hypomania is fantastic. For others, it's hell. They're irritable, have undesired increased libido, do some frivolous spending but not too terribly excessive, etc.

I've had friends that are BPI and that I've seen manic more often than depressed.

Mixed episodes [these are really, really awful] exist in both BPI and II and consist of both depressive and manic/hypomanic symptoms simultaneously [seriously, I'd take straight depressive over mixed; it's THE worst of the three mood cycling options].

And the period in between mood cycles is known as baseline.

September 19, 2016 - 10:26pm


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