Q: Any Written Tests for Soft Bipolar Disorder? What is the
Treatment for Soft Bipolarity?
My psychiatrist thinks that I may have soft bipolar
disorder. He has been treating me on and off for approx. 5 years. I was
originally diagnosed with depression and anxiety. After seeing my doctor and
taking Effexor, Atenolol and Ativan for 18 to 24 months, I was symptom free. We
both agreed to stop taking the medications. I was symptom free for approx. 3
years. Approx. 8 months ago I had a relapse. I have switched to Cymbalta
(90MG) and back to taking the Atenolol and Ativan as well. I am concerned about
my condition as I am a deputy sheriff and am worried that this condition may get
worse and don't want to lose my job. Is there any written test for soft
bipolar? What is the best medications for soft bipolar? I would appreciate any
help or advice you may have.
Dear Chris --
There is no really reliable test for "soft bipolar disorder". Any
given result could be interpreted as a true positive, or a false positive; or as
a true negative, or a false negative, if the test said "no, you don't have it".
However, to answer your question, there are two paper-and-pencil tests that are
available, if interpreted carefully in discussion with your psychiatrist (not on
your own). One is the
Bipolar Spectrum Diagnostic Scale. The other is the
HCL-32. In both cases, I think the best way to use these tests is to look
at the items which really strike you as applicable to you, and discuss those
with your psychiatrist.
In general, "soft bipolarity" is treated in the following way,
because of circumstances: the patient is already on an antidepressant. When the
diagnosis is considered (i.e. some degree of bipolarity), particularly if
several antidepressants have been tried and did not work, or are no longer
working, one then turns to the treatment approaches used in bipolar disorder.
In practice, this means adding a "mood stabilizer" to the antidepressant. If
there is a dramatic improvement, I generally then try to taper the
antidepressant, very slowly (e.g. 4 months, 25% per month), to keep things as
simple as possible and find out whether the mood stabilizer alone can produce a
solid stable result.
Which mood stabilizer? There are quite a few choices. You'll find
them discussed in the
treatment section (start with that link, take the version for patients and
families, and navigate to the treatment page) of my website, with a more
comprehensive list on my
mood stabilizer options page. This may help you participate more fully in a
discussion with your psychiatrist about which one to use, and how.
Good luck with that --
Published May, 2008