Manic Moments: A Bipolar's World

Bipolar Affective Disorder

is also known as Manic Depressive Disorder or Manic Depression, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Bipolar Disorder causes ups and downs that are different from the normal ups and downs that most people go through, the effects of Bipolar Disorder are severe. The effects of Bipolar Disorder can result in damaged relationships, poor school or job performance, even suicide. There is good news though, Bipolar Disorder can be treated effectively with medication and therapy, and people with this illness can lead full and productive lives. Bipolar Affective Disorder affects about 2.2 million American adults 18 years of age or older during any given year. It typically shows up in late adolescence and early adulthood. Bipolar Affective Disorder can also show up in early childhood or later in life. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person's life.

The Course of Bipolar Disorder

Episodes of mania and depression typically recur throughout a person's lifespan. Between the episodes, most people with Bipolar Disorder are free of symptoms. However, about one-third of the people have some residual symptoms, and about one-percent experience chronic unremitting symptoms despite treatment. People with bipolar disorder can lead healthy and productive lives when the illness is effectively treated. Without treatment, however, the natural course of bipolar disorder tends to worsen. Over time a person may suffer more frequent (more rapid-cycling) and more severe manic and depressive episodes than those experienced when the illness first appeared. But in most cases, proper treatment can help reduce the frequency and severity of episodes and can help people with bipolar disorder maintain good quality of life.

Manic Moments

I started Manic Moments: A Bipolar's World in April of 1999 with the hope of helping others who think or know that they have Bipolar Disorder know, that with the proper medication and therapy, that they can lead full and productive lives. At Manic Moments you can share your experience with this illness with others. You will find links to other sites with information about Bipolar Disorder, you can join our E-Mail support list, you can participate in real-time conversation in the chat room, and post messages to the message board. The primary purpose of this site is to show others who have this illness and their family and friends that having a diagnosis of Bipolar Disorder does not mean that their life is over. In some ways Bipolar Disorder is a blessing, many people who have Bipolar Disorder are creative, have a high level of intelligence, and generally are more sensitive to the feelings of others. While visiting this site I ask that you sign my guestbook as I love to hear from those whom this site has helped in some way.

Manic Moments Bipolar Support List

Manic Moments Bipolar Support List is a LIST SERV for people with Bipolar Affective Disorder, their friends and families, and for anyone who wants to give and receive support and information about this serious illness. The overall atmosphere of this list is that of a large family. Topics range from how certain meds affect us to finding the right therapist to the more serious issues such as job loss and suicidal ideation.

The people on this are real and are here to help out with support when most needed. Sometimes the list has its spats just like any large family, but they usually don't last long and generally bring the group closer together afterwards. Most of those who have signed up to this list have formed some very close relationships with other members of the list. Some of those relationships have even grown to a tangible level with face-to-face meeting, reaching out and touching someone when they are in need.

There are a few rules that are in place to help the list run a little smoother and to protect the privacy of its members. The rules are listed below. For the most part though the list is open for discussion about most any topics. This is a family for those who have lost their friends and families because they don't understand this illness we share called Bipolar Affective Disorder. Welcome to Manic Moments Bipolar Support List.

These Are The List Rules

USE SPOILERS. Place the word SPOILER followed by the spoiler topic, i.e.., Suicide, Rape or other topic you think might disturb someone if they read part of the message, in the Subject line of the E-Mail message before posting it to the List. In the Body of the message, use your Enter/ Return key to place the first line below the first screen-view (about 15 carriage returns). This will help prevent an accidental reading of a topic that would disturb that reader. Also, if the topic is unrelated to Bipolar Disorder, i.e., a joke or other topic not really dealing with Bipolar Disorder, please put OT or Off-Topic in the subject line of the message. This helps those who are only interested in reading about Bipolar Disorder filter their email from this List.

STAY ON TOPIC. This is a Bipolar Disorder Support List, keep general chit chat to a minimum and help those who need help with Bipolar Disorder. If you want to change the topic, create a new message with the new topic in the Subject line. This helps prevent confusion among the readers. Reading the threads that you are interested in is easier if the subject actually reflects the message inside. If you can't do this, go visit the studio harry potter and enjoy yourself there after buying tickets.

POST USING PLAIN TEXT FORMAT. Send all messages in plain text format rather than in HTML formatting since a lot of people's E-Mail clients don't handle HTML formatted messages very well. If you want to show off your HTML skills, make a Web page and tell people about it.

DO NOT PREACH. Don't try to impose your personal religious beliefs on others. By this I mean that if someone says something that offends your particular faith, just delete the message, or if it is too much for you to deal with unsubscribe from the List. Don't preach your particular version of the Bible to the List or to that particular individual. DO NOT GIVE OUT MEDICAL ADVICE. It is not only illegal to do so, but it is also dangerous and could prove fatal. If you are a medical professional and would like to offer your services to this list or this site, contact me at admin@manicmoment.net and we can discuss the possibilities.

DO NOT CROSS POST. Cross posting is sending messages from this List to other lists, visa versa, sending messages from other Lists to this one. Here are several reasons for this rule.
Cross-posting as this is called, causes confusion on the other list since they are reading only one side of the thread.
Cross-posting violates the other members privacy. When you consider the nature of Bipolar Disorder you can understand why this violation WILL NOT be tolerated. If you cross-post you will be removed from this List.

DO NOT SEND SPAM TO THIS LIST. Spamming is the sending of un-solicited E-Mail about your business, Web site, or some other form of advertising. If you have something to share that might be considered spam, send it to me and I will look at it. If I feel that it warrants posting to this List, I will post it for you. Spamming will NOT be tolerated and is grounds for immediate removal and banning from the List.

DO NOT SEND WEBPAGES. Instead, send the link to that Web page and write a brief description of what the page is about.

DO NOT THREATEN, HARASS, OR ATTACK ANOTHER MEMBER. You will receive one warning. After that you will be removed from this List. If you re-subscribe and begin starting trouble again, you will be removed and banned from this List.

DO NOT SEND VIRUSES. Do not in any other way try to breach the security of this mailing List or the associated site or server. Doing so is grounds for immediate banning from the List, and possible investigation or prosecution.

DO NOT SEND FILE ATTACHMENTS LARGER THAN 25Kbytes. If you have something that you want to share with the List, send it to me and I will post it on the site in a special directory. That way those who have an interest in seeing it can go to the Web site to view or download it. Do not send any executable files to the List, they may contain a virus or in some other way pose a security risk to either the server or the recipient.

The Not So Manic Support List

The Not So Manic Support List is a LIST SERV for spouses and loved ones of people with Bipolar Affective Disorder, and for anyone who wants to give and receive support and information about this serious illness. The overall atmosphere of this list is that of a large family.

The people on this are real and are here to help out with support when most needed. Sometimes the list has its spats just like any large family, but they usually don't last long and generally bring the group closer together afterwards. Most of those who have signed up to this list have formed some very close relationships with other members of the list. Some of those relationships have even grown to a tangible level with face-to-face meeting, reaching out and touching someone when they are in need.

There are a few rules that are in place to help the list run a little smoother and to protect the privacy of its members. The rules are listed below. For the most part though the list is open for discussion about most any topics. This is a family for those who have lost their friends and families because they don't understand this illness we share called Bipolar Affective Disorder. Welcome to The Not So Manic Support List.

What is Bipolar Disorder?

Bipolar Disorder is also known as Manic Depression. Bipolar Disorder is a mood disorder that affects approximately 2.2 million Americans. This illness typically begins in adolescence or early adulthood and continues throughout life with approximately 80% of patients experiencing multiple manic episodes and 15% ending their lives in suicide. Bipolar Disorder affects both men and women. Bipolar Disorder is in the same family of illnesses (called "affective disorders") as clinical depression. However, unlike clinical depression, which seems to affect far more women than men, Bipolar Disorder seems to affect men and women in approximately equal numbers.

Bipolar Disorder characterized by mood swings. Although there is no known cure as of this writing, most forms of bipolar disorder show signs of improvement with the proper medication often coupled with therapy and support groups and most people with bipolar disorders are able to lead normal, productive lives.

The textbook definition of Bipolar Disorder is: "One or more Manic or Hypomanic Episodes, accompanied by one or more Major Depressive Episodes. These episodes typically happen in cycles."

In simpler terms, Bipolars have moodswings ranging from grand elation, to devastating lows, with some realatively normal periods mixed in between. Now you may say that everyone feels highs and lows, does that mean that we are all Bipolar? No, most "normal" people feel the emotional highs and lows that accompany happy times or sad times. For people with Bipolar Disorder those highs and lows are like the highs of winning the lottery and the lows of losing a loved one, but Bipolars ride those high and lows every day of every week, of every month.

Bipolar Disorder is distinguished from Major Depressive Disorder by the presence of manic or hypomanic episodes. It is distinguished from Schizoaffective Disorder by the absence of psychotic symtoms (such as delusions, halucinations) during periods of stable mood.

Bipolar Disorder is really a spectrum of disorders. Bipolar I disorder is characterized by a history of at least one manic episode, and (usually) depressive episodes. Bipolar II disorder is characterized by hypomanic episodes alternating with depressive episodes. Cyclothymia is characterized by highs which fulfil some but not all criteria for hypomania and lows which fulfil some but not all criteria for depression.

The Manic Episode

Criteria for Manic Episode (American Psychiatric Association DSM-IV) Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either; A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting for at least one week (or any duration if hospitalization is necessary). During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

The symptoms do not meet criteria for a Mixed Episode
The mood disturbance is sufficiently severe to cause marked impairement in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.

The Hypomanic Episode

Criteria for Hypomanic Episode (American Psychiatric Association DSM-IV) Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either; A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
The disturbance in mood and the change in functioning are observable by others.
The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

The Major Depressive Episode

Criteria for Major Depressive Episode (American Psychiatric Association DSM-IV) Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person's normal mood; social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. A major depressive episode is also characterized by the presence of a majority of these symptoms:

The symptoms do not meet criteria for a Mixed Episode
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

The Mixed Episode

Criteria for Mixed Episode (American Psychiatric Association DSM-IV)
The criteria are met for a Manic episode and for a Major Depressive Episode (except for the duration) nearly every day during at least a 1-week period.
The mood disturbance is sufficiently severe to cause marked impairement in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
The symptoms are not due to the direct physiological effects of a sub- stance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Mixed-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.

Cyclothymic Disorder

Criteria for Cyclothymic Disorder (American Psychiatric Association DSM-IV)
For at least 2 years, the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a Major Depressive Episode. Note: In children and adolescents, the duration must be at least 1 year.
During the above 2-year period (1 year in children and adolescents), the person has not been without the symptoms in Criterion A for more than 2 months at a time. No Major Depressive Episode, Manic Episode, or Mixed Episode has been present during the first 2 years of the disturbance.
Note: After the initial 2 years (1 year in children and adolescents) of Cyclothymic Disorder, there may be superimposed Manic or Mixed Episodes (in which case both Bipolar I disorder and Cyclothymic Disorder may be diagnosed) or Major Depressive Episodes (in which case both Bipolar II Disorder and Cyclothymic Disorder may be diagnosed).

The symptoms in Criterion A are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Schizophrenia

Diagnostic Criteria (American Psychiatric Association DSM-IV) Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).
Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.
Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
Relationship to a Pervasive Developmental Disorder: If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

Diagnostic Criteria of Schizophrenia Subtypes

Paranoid Type

A type of Schizophrenia in which the following criteria are met:

Preoccupation with one or more delusions or frequent auditory hallucinations. None of the following is prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect.

Catatonic Type

A type of Schizophrenia in which the clinical picture is dominated by at least two of the following:

Disorganized Type

A type of Schizophrenia in which the following criteria are met:

All of the following are prominent:

The criteria are not met for Catatonic Type.

Undifferentiated Type

A type of Schizophrenia in which symptoms that meet Criterion A are present, but the criteria are not met for the Paranoid, Disorganized, or Catatonic Type.

Residual Type

A type of Schizophrenia in which the following criteria are met:

Absence of prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior. There is continuing evidence of the disturbance, as indicated by the presence of negative symptoms or two or more symptoms listed in Criterion A for Schizophrenia, present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

Associated Features

Differential Diagnosis

Schizoaffective Disorder

Criteria for Schizoaffective Disorder (American Psychiatric Association DSM-IV) An uninterrupted period of illness during which, at some time, there is either (1) a Major Depressive Episode, (2) a Manic Episode, or (3) a Mixed Episode concurrent with symptoms that meet (4) Criterion A for Schizophrenia. Note: The Major Depressive Episode must include depressed mood.

During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms. Symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Specify type:

Bipolar Type: if the disturbance includes a Manic or a Mixed Episode (or a Manic or a Mixed Episode and Major Depressive Episodes). Depressive Type: if the disturbance only includes Major Depressive Episodes.

Associated Features

Differential Diagnosis

Psychotic Disorder Due to a General Medical Condition, a delirium, or a dementia; Substance-Induced Psychotic Disorder; Substance-Induced Delirium; Delusional Disorder; Psychotic Disorder Not Otherwise Specified.

Schizophreniform Disorder

Diagnostic Criteria (American Psychiatric Association DSM-IV) Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated): delusions hallucinations disorganized speech (e.g., frequent derailment or incoherence) grossly disorganized or catatonic behavior negative symptoms, i.e., affective flattening, alogia, or avolition

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. An episode of the disorder (including prodromal, active, and residual phases) lasts at least 1 month but less than 6 months. (When the diagnosis must be made without waiting for recovery, it should be qualified as "Provisional.")

Specify if:

Associated Features

Differential Diagnosis

Schizophrenia; Brief Psychotic Disorder.

Delusional Disorder

Diagnostic Criteria (American Psychiatric Association DSM-IV) Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month's duration. Criterion A for Schizophrenia has never been met. Note: Tactile and olfactory hallucinations may be present in Delusional Disorder if they are related to the delusional theme. Criterion A of Schizophrenia requires two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

delusions hallucinations disorganized speech (e.g., frequent derailment or incoherence) grossly disorganized or catatonic behavior negative symptoms, i.e., affective flattening, alogia, or avolition

Note: Criteria A of Schizophrenia requires only one symptom if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Specify type (the following types are assigned based on the predominant delusional theme):

Associated Features

Differential Diagnosis

A delirium, a dementia, or Psychotic Disorder Due to a General Medical Condition; Substance-Induced Psychotic Disorder; Schizophrenia; Schizophreniform Disorder; Mood Disorders With Psychotic Features; Psychotic Disorder Not Otherwise Specified; Depressive Disorder Not Otherwise Specified; Bipolar Disorder Not Otherwise Specified; Shared Psychotic Disorder; Brief Psychotic Disorder; Psychotic Disorder Not Otherwise Specified; Hypochondriasis; Body Dysmorphic Disorder; Obsessive-Compulsive Disorder; Paranoid Personality Disorder.

Personal Journal of Gregory S. Kuhn

Welcome to my personal journal. I have decided once again to keep a "hopefully" daily journal of how I am feeling, how things are going in my life, and just my thoughts in general. I have done this in the past, but then stop after several months...perhaps out of boredom, or possibly just because I got busy doing another thing...typical of someone with Bipolar Disorder. We have the uncanny capicity for starting many new and exciting projects, only to later abandon them. I feel that I am getting better at following through to the end now that I am getting older, but I still do sometimes stop after a short period of doing something. I hope that you find something of interest in my day-to-day ramblings. Thank you for taking a minute or two out of your busy life to read some of my life. Enjoy!