Q:  Daughter Manic or Hypomanic?

Dr.Phelps,
i am just wondering what is the difference between manic and hypomanic?I have a 17 yr old daughter who is bp and not sure if she is manic or hypomanic right now.She is very giddy,cant sit still for 5 minutes.She is talking to herself and is also hearing voices right now.when talking she is making no sense at all.she wanted me to drive her 150 miles from our home so that she can get a job.when i tried telling her that it was to far she became very angry.my daughter is on 600mg of triliptal twice a day.And 80mg of geodon teice a day.she also takes paxil 20 mg in the morning.I am desperate for some kind of answer to her behavior latley.

Thank-you,



Dear Ms. T' -- 
Technically the voices part means BPI, not BPII, because it's a psychosis symptom, and BPII doesn't have psychosis.  But this distinction isn't very important as far as treatment goes (except maybe for insurance reasons in some settings, or something like that).  They're both treated basically the same way.   If she's manic (BPI) or hypomanic (BPII), I'd still be wondering about whether that antidepressant was playing a role in driving the manic-side symptoms.  Although it's controversial, you could ask the doc' about that part.  

Dr. Phelps