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Q: Does BP I or BP II include Delusions or Psychosis?
On your website PsychEducation.org in speaking about Bipolar II
disorder there is a quote that in general says Bipolar II is "more than plain
depression but not delusional or psychotic." I have been diagnosed with Bipolar
II, but during my depressions experienced delusions and psychosis for a period
of time. Could I have another type of mental illness? Or does this occasionally
happen with Bipolar II, just not very often? Unfortunately I do not have health
insurance, and can't afford it with a Bipolar diagnosis, and am getting free
local health care through a state run agency that does not allow the benefit of
spending much time with the doctor to discuss these types of concerns or issues.
Thanks for your help!
Joy
Dear Joy -
Perhaps the most important part of an answer to your question is that the
distinction between bipolar I and bipolar II really doesn’t matter that much.
It does not really determine the kind of treatment you should get.
In your
case, if the only time you ever get delusions (loss of contact with reality) is
during the depression phases; and when off in the “manic” direction, you only go
as far as “hypomania”, which by definition cannot include delusions, and is not
supposed to dramatically interfere with your ability to function; then you could
indeed have what might rightly be termed Bipolar II (although an unusual version
thereof, in the sense that most people with Bipolar II never have psychosis or
delusions at all).
More
important is to select appropriate treatments for your particular version of
bipolar disorder. We do that by looking at the dominant symptoms which need to
be addressed now, or prevented from returning. In general, the group of
medications usually referred to as “mood stabilizers” are the core ingredients
in the treatment of bipolar disorder. We pick among them by looking at your
particular needs – and their potential risks and side effects. In your setting,
some of the treatment choices may be constrained by cost, but fortunately many
of the best ones are now generic and fairly widely available.
Good luck
with your efforts to learn more and get or stay a symptom free –
Dr. Phelps
Published February, 2009
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