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Re:Loving Someone with Depression by r_hoods_ghost on Monday January 03, 2022 @04:02AM (#29778759)
Because it's not just cyclical major depression (and there's no "just" to major depression either, but that's another rant). The diagnostic criteria for bipolar is that you have had at least one extended episode of mania or hypomania alongside a depressive episode, so you're not going to have the diagnosis unless you've been manic or hypomanic at some point. Although it may not be a major or dominant part of someone's presentation, mania or hypomania is nevertheless there and it effects what treatments are appropriate. Certain SSRI's may trigger off hypomania or mania in a bipolar patient, or simply be utterly ineffective, whereas in someone with cyclical major depression their response would be different. I'm bipolar II and spend roughly 1/4 to 1/3rd of my life meeting the criteria for major depression but very rarely have hypomanic episodes, and this was the case even before I was on lithium. Indeed I've gone for years in between major hypomanic episodes. But hoo boy! When they hit there is no mistaking them.

The other thing is that unlike with depression where you have to squint really hard to see much of an effect from most treatments, there are reasonably effective treatments for mania and hypomania, including good old lithium. So if you're being treated, while you might still suffer from regular bouts of depression, you'll likely have much reduced or even eliminated hypomanic or manic symptoms. So it's not unusual to see manic depressives who are treated showing very few manic symptoms for years on end.

Re:Loving Someone with Depression by R0b0t1 on Monday January 03, 2022 @10:12PM (#29790836)
It seems very dangerous to diagnose as such. Perhaps someone gets depressed every three months near end of quarter when their hours get cut?

Once someone demonstrably has issues with mania, yes, sure, I understand wanting to prevent it, but in a lot of cases I see very little separation from actual mania and "I felt good one day" (which if someone were depressed may feel very weird).

There's also strong arguments that one or two manic or hypomanic episodes are not enough evidence for a bipolar diagnosis.

Re:Loving Someone with Depression by etripe on Friday January 07, 2022 @08:01AM (#29838595)
> Perhaps someone gets depressed every three months near end of quarter when their hours get cut?

As someone who's been clinically depressed, your examples seem contrived to me. Are they based on any specific evidence, and if so, would you please share with the group?

Re:Loving Someone with Depression by asveikau on Monday January 03, 2022 @10:45AM (#29781873)
Just a small thing, I believe you don't need a depressive episode for a bipolar I diagnosis. For bipolar 2 I think yes.