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“Soft” Signs of Bipolar Disorder
Learn about the "soft" symptoms of bipolar disorder and how treatment plays a role in diagnosis.
Bipolar disorder is not one thing.
Much like the manifestations of depression or schizophrenia can differ from person to person, so can bipolar disorder. In fact, sometimes bipolar disorder doesn’t look like bipolar disorder at all. Some research would suggest that there’s a variant of bipolar disorder that can manifest without even official mania or hypomania episodes.
How can this be?
Well, bipolar disorder can be thought of as a spectrum disorder. On one end there is the classic bipolar 1 symptomology of severe depression and manic episodes, and on the other end there is the classic unipolar (major) depression with severe depressive episodes and no mania/hypomania symptomology. And then there is all the space in between. This is where bipolar 2 and bipolar not otherwise specified (NOS) live. This is also where some researchers suggest that “bipolar spectrum disorder” lives. It’s like depression with a dash of bipolar thrown in for added excitement.
“Soft” Signs of Bipolar Disorder
Bipolar spectrum disorder then would find the patient primarily depressed, but with several evidence-based markers for bipolar disorder and without official mania/hypomania symptoms.
markers are suggested by science but are not recognized by everyone.
Soft signs of bipolar disorder include:
- repeated episodes of depression, possibly seasonal
- brief episodes of depression (less than 3 months)
- early-occurring first-onset depression (before the age of 25)
- a first-degree relative with bipolar disorder
- high energy and mood when not depressed
- “atypical” depressive symptoms such as excessive sleep, reactive moods and increased appetite
- experience of psychosis (delusions and / or hallucinations) with depression
- experience of postpartum depression
- experience of mania or hypomania when taking an antidepressant
- loss of response to a previously-working antidepressant
- three or more antidepressants have been tried without effect
Why Does “Soft” Bipolar Disorder Matter?
Well, it wouldn’t, except for the fact that it’s a depression that acts more like bipolar disorder than depression when it comes to treatment; and diagnosis only matters insomuch as it indicates the proper treatment.
Thus the true defining factor of bipolar spectrum disorder is the way in which it reacts to medication. Rather than the typical antidepressant treatment being effective for this type of depression, mood stabilizers, or antipsychotics may work best. This is why, even if no diagnosis of bipolar spectrum disorder exists in the Diagnostic and Statistical Manual of Mental Disorders (DSM), doctors tend to try treatment with these alternative types of medications if multiple antidepressants fail to treat a depression successfully.
What If I Have Soft Signs of Bipolar but I’m On an Antidepressant?
Don’t worry; if an antidepressant is working for you, you’re fine. Presence of one or more of the soft signs doesn’t make you bipolar it’s only suggestive of it.
But if multiple antidepressants haven’t worked and you do have multiple soft signs it might be time to talk to your doctor. I recommend checking out this great resource written by Dr. Jim Phelps to find out more.
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