Taken from Science News, Vol. 147; 25 Feb 1995, p. 118
For people who display a curious excess of emotional turmoil, physical energy, and self-reflection (signaled by frequent daydreaming), the onset of depression usually triggers a switch to bipolar II within 5 years, assert psychiatrist Hagop S. Akiskal of the University of California School of Medicine in San Diego and his colleagues.
"The emotional storms of these patients might represent attempts for self-cure from depressive inertia, sadness, and self- absorption," Askiskal's team writes in the February Archives of General Psychiatry.
Whatever mental processes underlie bipolar II, it proves difficult to identify, the researchers say. Clinicians often diagnose this condition as borderline personality disorder, which is marked by unstable romantic relationships, manipulativeness, and impulsive acts, but not depression.
However, people suffering from this version of manic depression show the greatest improvement, at least in the short run, when given a certain type of antidepressant medication, Akiskal's team notes. These drugs, which block the action of the chemical messenger monoamine oxidase, differ substantially from the standard class of antidepressants, as well as from newer forms, such as fluoxetine (Prozac).
The scientists studied 559 moderately to severely depressed individuals who first sought treatment nearly 20 years ago at one of five university psychiatric centers. After their depression subsided, participants completed personality scales containing 436 items. Experimenters evaluated the volunteers' condition once or twice a year for the next 11 years.
Personality characteristics of 48 people who during that time converted from major depression to bipolar II were compared with those of 22 who developed full-blown manic depression and with the remainder, who displayed only bouts of depression.
Bipolar II converters cited a personality profile that departed strikingly from those of other two groups, the investigators contend. It revolved around an unstable temperament that featured sharp ups and downs in emotion, relentless pursuit of activities and work, and intense self-absorption fueling a penchant for daydreaming.
