Category Archives: ADHD

Subthreshold (Hypo)Mania As A Precursor To Bipolar Disorder

The new Bipolar Spectrum.

“There is growing clinical and epidemiologic evidence that major mood disorders form a spectrum from major depressive disorder to pure mania.”

Subthreshold mania can be seen as a precursor to Bipolar Disorder, subthreshold Bipolar Disorder is defined as “recurrent hypomania without a major depressive episode or with fewer symptoms than required for threshold hypomania” (Merikangas et al, 2007). Bipolar disorder should be suspected if prominent behavior problems, anxiety, and substance abuse were present during childhood in someone with recurrent depression and a family history of affective disorders. For example, the prevalence of anxiety in children may be prominent in early-onset Bipolar Disorder and may predate affective symptoms. Children with a parent with Bipolar Disorder are more likely to be at risk for early-onset Bipolar Disorder, along with anxiety, depression and other disorders.

Studies have shown that offspring of people with Bipolar Disorder are at high risk for developing Bipolar Disorder because they have a parent with the disorder and generally have significantly higher rates of subthreshold mania or hypomania (13.3% versus 1.2%) or what is known as bipolar disorder not otherwise specified (BP-NOS); manic, mixed, or hypomanic episodes (9.2% versus 0.8%); major depressive episodes (32.0% versus 14.9%); and anxiety disorders (39.9% versus 21.8%) than offspring of parents without the disorder. Subthreshold episodes of mania or hypomania (those that resemble but do not meet the full requirements for bipolar disorder in terms of duration) were the best predictor of later manic episodes.

It should be noted that the American Journal of Psychiatry has a multitude of studies that suggest that people who suffer from Major Depressive Disorder (MDD) have a higher susceptibility to Bipolar Disorder and that subthreshold hypomanic symptoms that are found in people suffering from MDD should be taken into consideration when diagnosing. Placing these people instead on a bipolar spectrum, hence altering their treatment plan by incorporating a mood stabiliser which can also assist with the present MDD.

 

 

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The World Is His Oyster: Talking About ADHD

To be perfectly honest I don’t know much about ADHD, one of my close friends was recently diagnosed at 21 years old. He wondered how he got to that age with no one noticing, in a way he was let down by both the schooling system and his family. If he has gotten to where he is today completely on his own he believes that it has made him a stronger person. My friend is now taking Ritalin, feeling clear headed for the first time ever, his anxiety is gone, all he sees now is the potential of the world and how it has become (to a degree) limitless. As he was confessing his mental illness to me, I started to think that I had never seen him so happy, he couldn’t keep the smile off this face, and he even had more confidence when he was speaking then in all the years I’ve known him.

My friend had originally only gone to the doctors for help with his anxiety, the doctor diagnosing him as also depressed when he wasn’t, the antidepressants his doctor prescribed him did nothing. He was later sent to a psychiatrist and diagnosed with ADHD, I’ve never met someone who is so happy to be diagnosed. He just keeps saying “if I got that far without being diagnosed, I wonder what I could do now, considering I can actually focus and pay attention”. He had already completed an IT course at Tafe and was climbing the career ladder at his work but he is now considering psychology. He is a really smart person, no one realised though. My friend’s ADHD was left unrecognised for so long because he didn’t exhibit hyperactivity, it is apparently extremely common for adults to get diagnosed with ADHD without hyperactivity as it wasn’t recognised when they were children and adolescents. The world has truly become his oyster.

the_world_is_your_oyster_by_ghost_hunter666-d4nk1pm