Posted by floatingbridge on August 2, 2011, at 7:37:55
In reply to Re: Cyclothymia » floatingbridge, posted by Dinah on August 1, 2011, at 11:22:53
Dinah, thanks for typing out this reply. It seems very sober, and after about three years of casting about for a single dx, I am ready to take this in.
> I wonder if it really matters, diagnosis. I mean, it's helpful to have a framework for the problem or ideas for treatment.
>Yes, the proper framewrk. Certainly having the 'wrong' one can be at the very least, psychologically defeating.
> But mental health diagnosis is nebulous at best and often seems to be more of a descriptor than a definition of cause. Even major depression is unlikely to be one illness.
>
> It's not as if you could find a mechanism that causes "cyclothymia" as opposed to "bipolar II". Or that once there is
a definition there is a cure. Psychiatry/neurology just isn't there yet. They just treat symptoms at this point, in a rather hit or miss way.
>Very true I think. The more I have read, I understand even depression, something I have increasingly severe bouts, to remain diffuse at the core. There's the old sense of 'I know it when I see/feel it', but beyond that, the varities and paths to it
seem infinite.> Cyclothymia indicates more rapid mood swings than bipolar II. Which is helpful to know. But surely it's even more helpful to find a descriptor that more closely fits *you* rather than try to fit your symptoms into a diagnostic framework.
After reading about these two conditions, wwho knows? Dx is often based on patient report tona subjective practioner. Somewhere along the line, BP ll seems more likely now then when younger. But recommended treatments largely remain the same. Self knowledge, as you point out, is important. If one rarely, *sigh*, even feels the old hypomania during which I could be at least productive, I'm not even sure there is an apt treatment. Though plenty of treatments to avoid.
>
> For example, while I don't have enough behaviors to meet the diagnosis for borderline personality disorder, I find the theory behind it *fits* very well. So I adopt some of the terminology for myself, even though the whole diagnosis doesn't fit. I say I have OCD, but in some ways it doesn't
precisely fit. I'm likely somewhere on the borderline spectrum, but none of the diagnostic criteria fit me all that well. I even have some attention problems. I guess what fits best is old fashioned "neurosis" but that seriously downplays the physiological causes.
>
> So I say I have easy arousal with slow return to baseline, a *lot* of anxiety and obsessive thinking, and difficulty in mentally switching gears. Under some circumstances, lack of sleep or certain medications or even extreme stress, I can get hypomanic, though never manic. At times I can become
depressed, though that is by no means the major issue. I have health issues associated with the same chemicals that cause emotional/mental issues. IBS, migraines, etc. There's probably some problems caused by excessive stress hormones over an extended length of time.
>This is very helpful for me to read, Dinah. I have those odd health pieces that arevjust beginning to be recognized as running the similar pathways of depression and stress. I, too have borderline features, but as I reread the personality disorders again, wondered if anyone, anywhere, was a pure type. I self-administered the short MMPI2, and finally felt enlightened by (laboriously) studying the generated response charts. It provided not a dx, but rather clusters of difficult or symptom areas that I listed above. To my interest, after trying to fit myself into a borderline spectrum (which fits well enough, mind you) Avoidant had much to 'offer'. It makes complete sense, given sensitive to stimulation and hurt, who wouldn't at least become Avoidant. But rather than take on that particular dx over another, it's just now on a symptom awareness list.
> Personally, I think whatever is wrong with me isn't all that much different from what's wrong with an overexcitable dog. There may be childhood factors, but if I weren't wired like an overly inbred cocker spaniel, my childhood factors would not have caused serious problems.
You might imagine I love the dog analogy. And right now, my new one year old is an English Springer Spaniel. She is overexcitable. If anything, she helps remind myself to practice remaining calm, poor girl. She can get a bit worked up.
>
> I treat symptoms, which is all anyone can do at this point, until they understand more about underlying causes. I think they've finally figured out that correlation does not equal causality. Through trial and error I've found that SSRI's give
surface relief but overall just increase my agitation.This has been the biggest discovery for me to date. I am hoping that Emsam does not recreate this agitation in the long run. I'm not sure yet.
>
> Mood stabilizers are somewhat helpful. Tranquilizers can be occasionally helpful. Antipsychotics, or major tranquilizers, are very helpful on an as needed basis though I can't tolerate
them on a continual basis.
>
> I've grown to be aware of my body and what's going on, and to treat as needed. I know what situations cause
problems and I try to avoid those situations.This sounds very sane. I imagine it took some time to gather this awareness for yourself. I'm glad you have it--and are sharing it with me. Thank you.
>
> I've given up on the psychiatric holy grail, the perfect medication or the "correct" diagnosis. I've given up thinking that the experts are all that expert at all, in comparison with most fields of medicine. Maybe in my lifetime they'll figure it
out. But in the meantime, I'm not going to identify with any diagnosis. They're going to have to treat *me*.:-). I like this.
>
> Does cyclothymic or bipolar II or any other diagnosis really matter, if treatment doesn't change? Can't you just think of yourself as somewhere on the bipolar spectrum?Yes. After reading and reading in my hysterically driven way, I came to a big shrug of my shoulders. What was once perhaps cyclothymic is perhaps BP ll ish because of the greater ratio spent in depression. So yes, the bipolar spectrum. Whatever that is, bipolar. What real mysteries these conditions are. This last fit of reading was good. I keep trying to place all these symptoms into order. The best I came up with were constellations. That's o.k. now for some reason. And what seemed important this time around was taking the MMPI 2 and sitting w/ it myself without the professional interpretation. There would just be, thankfully, few spikes on the charts, but the spikes all seemed to go together upon a little meditation. A term you used earlier, I guess that is just a sketch of *me*.
There is still practice out there to parse out the *merely* psychological from the *merely* physical. I feel that for now, I can't pull myself apart any longer, and to do so, or be expected to or looked at that way would be non-helpful and even cruel.
poster:floatingbridge
thread:992265
URL: http://www.dr-bob.org/babble/20110728/msgs/992552.html