Whats the difference between bipolar 1/2 and Severe bipolar depression with psychotic features?
August 26, 2009 by Depression and Anxiety Tips
Filed under Anxiety, Bipolar, OCD & Schizophrenia
Can you answer Gabe’s question about Depression?:
I understand bipolar 1 and 2, but other than psychosis is there anything else that defines the diagnoses “Severe bipolar depression with psychotic features” from the diagnoses bipolar 1 or bipolar 2?
yeah, im diagnosed bipolar 1 with psychotic features. but also read up on this diagnoses of ssevere bipolar depression with psychotic features
Have you claimed your Genesis site?
I understand bipolar 1 and 2, but other than psychosis is there anything else that defines the diagnoses “Severe bipolar depression with psychotic features” from the diagnoses bipolar 1 or bipolar 2?
yeah, im diagnosed bipolar 1 with psychotic features. but also read up on this diagnoses of ssevere bipolar depression with psychotic features
Have you claimed your Genesis site?
Depression Feedback: I thought bipolar I meant you got full mania, and Bipolar II meant you only got hypomania, and in either one, you could get severe depression with psychotic features. It doesn’t matter that much anyway, Bipolar I & II don’t really define bipolar very well anyhow - the picture is much more complicated than that. Apparently there are a great number of combinations of different genes that can cause bipolar disorder, and the combination of genes you get determines what symptoms you will get.
I think when they say you have severe bipolar depression with psychotic features, they are just documenting your current symptoms like when you are going inpatient, rather than commenting on the course of your illness, which Bipolar I, II or NOS would do that.
Depression Feedback: Based on the DSM-IV, “severe bipolar depression with psychotic features” is not an accurate diagnosis. Bipolar is categorized based on the most recent episode (i.e. manic, depressive, or mixed). The diagnosis is further specified using features (i.e. w/ or w/o psychotic features, catatonic, atypical, etc.). The severity also affects the diagnosis; it can be mild, moderate or severe.
Essentially this is the way the diagnosis should look: 296.54 bipolar I, most recent episode depressed, severe with psychotic features.
The psychotic features specifies whether or not the person is experiencing (or has experienced) hallucinations or delusions or both. Either they do or they don’t.
Depression Feedback:
Ok.. i did that wrong…
go here after you read the first part of bipolar 1, then keep clicking next article…
Bipolar I Disorder is not a complete diagnosis in and of itself. When someone is diagnosed with Bipolar I Disorder, the doctor uses what are called specifiers to give more information about the patient’s current condition. Specifiers describe the mood episode and severity of the illness that the patient is experiencing.
If the person most recently experienced a hypomanic episode, often no further specifiers are given. Hypomania is by definition, a mild manic episode with no psychotic features. Therefore, it would be redundant to specify the severity of the symptoms and the presence of psychotic features. This diagnosis can be further specified to give describe if the person is experiencing rapid cycling, if there is a seasonal pattern to their condition, or if there is an absence of symptoms between episodes.
The first specification tells what kind of episode is the person’s most recent episode. The diagnoses with episode specifiers used to describe the person’s most recent mood episode are:
* Bipolar I Disorder, Single Manic Episode
* Bipolar I Disorder, Most Recent Episode Hypomanic
* Bipolar I Disorder, Most Recent Episode Manic
* Bipolar I Disorder, Most Recent Episode Mixed
* Bipolar I Disorder, Most Recent Episode Depressed
* Bipolar I Disorder, Most Recent Episode Unspecified
If the diagnosis is “Bipolar I Disorder, Single Manic Episode,” that means that the person has experienced a manic episode, and they have never had any other manic or depressive episodes. For “Bipolar I Disorder, Most Recent Episode Unspecified,” the person meets the criteria for the symptoms of either a manic, mixed, hypomanic, or depressed episode with the exception of the duration of the symptoms.
If the person’s diagnosis is “Bipolar I Disorder, Single Manic Episode,” the doctor may further specify the patient’s condition according to whether or not the symptoms meet the criteria for a mixed episode. The doctor may specify if the manic episode began postpartum, meaning after the patient gave birth. The specifiers can also describe the severity of the symptoms and whether or not there are psychotic or catatonic features. The doctor can also use a diagnosis specifier to indicate if the patient is in partial remission or full remission.
With the other diagnoses, they are further specified by severity, presence of psychotic features, presence of catatonic features, whether the symptoms began postpartum, whether there is rapid cycling, if there is an absence of symptoms between episodes, or if there is a seasonal pattern. The diagnosis may also specify if the most recent episode meets the criteria for a mixed episode. These diagnoses can also be specified as being in partial remission or full remission.
Taking a look at all the possible specifiers can give you an idea of how varied each patient’s experience with Bipolar I Disorder can be. You need only compare two possible diagnoses to get an impression of how vast the continuum of bipolar disorder can be. Bipolar I Disorder, Most Recent Episode Depressed, Severe with Psychotic Features looks very different from Bipolar I Disorder, Single Manic Episode In Full Remission. Patients with those diagnoses both suffer from the same medical condition of bipolar disorder, but according to the specifiers, their symptoms and experiences with the disorder are extremely different. Without specifiers, the diagnosis of “Bipolar I Disorder” fails to convey the exact nature of the patient’s condition.
Bipolar II Disorder, the more common but by no means less severe type of the disorder is “characterized by one or more Major Depressive Episodes accompanied by one hypomanic episode.” This stipulation is used mainly to differentiate it from unipolar depression.
The key difference between Bipolar I and Bipolar II is that Bipolar II has hypomanic but not manic episodes. Also, while those with Bipolar I disorder may experience additional psychotic symptoms such as delusions and hallucinations, Bipolar II by definition cannot have psychotic features.
The indicators which would lead to a diagnosis of Bipolar II Disorder are:
* One or more Major Depressive Episodes
* At least one Hypomanic Episode
* There has never been a Manic or Mixed Episode
* Another disorder is not responsible for symptoms
* Symptoms cause distress or impair functioning
Symptoms and characteristics of depression include:
* Decreased energy
* Weight loss or gain
* Despair
* Irritability
* Uncontrollable crying
Symptoms and characteristics of hypomania include:
* Grandiosity
* Decreased need for sleep
* Pressured speech
* Racing thoughts
* Distractibility
* Tendency to engage in behavior that could have serious consequences, such as spend