you don't take it all at the same time; they try you on one or two and if it doesn't work, switch to something else

Depression and mania. Mania’s a nice word for insanity but that’s at the extreme end. There’s more emphasis on hypomania (the euphoria you’re talking about) these days but in its hard form it’s all the way up there with schizophrenia.

Acute mania’s a bit more than feeling too well.

A psychosis is just a mental illness in the strict sense of the word. I know the DSM likes to limit it more and more to hallucinations and delusions these days (which are even common in bipolar) but it’s been recognised as a type of insanity for centuries. It’s just that medication’s tampered the natural course of bipolar and there’s more emphasis on mild bipolar these days.

The lucid intervals have always been recognised. I don’t think anyone sees it as a chronic form of insanity but acute mania’s used as the stereotype of a mad person. That’s what bipolar’s like in its severe form.

And it should be said that having schizophrenia and bipolar at the same time is close to impssobile. The psychiatrists who love that hybrid schizoaffective label are usually the ones who are only familiar with the watered down version of bipolar and not manic depression in its serious form.

I still think this thread is confused. People talk about bipolar but it sounds like borderline personality disorder or schizophrenia.

That’s because it’s on such a broad spectrum. It just pisses me off the way certain people emphasise the mild end of the bipolar spectrum without being aware of the full range. Like I said the older names hint at the real nature of bipolar much better. And it should also be said that there’s other forms of bipolar psychosis that aren’t manic-depressive but that’s not something people who just memorise the DSM and A-Level psychology books know about.

My ex was bi polar and was on anti psychotic meds.

https://archive.org/details/manicdepressivei00kraeuoftM

I’m leaving this out here for people who really want to know what classic ‘bipolar’ looks like. The new name doesn’t half trivialise the illness.

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https://archive.org/details/manicdepressivei00krae

It’s a long read but worth it if you want to know the full range of unmedicated manic depression.

Antipsychotic meds are used widely these days, including treatment of depression.

Thank you for the link to Kraepelin book. I see you are old school.
could we talk about it further? Pm or here? Or a new thread about mental health?

You don't agree with schizoaffective label? Kraepelin himself, whose book you cite, eventually questioned sharp division between schizophrenia and mood disorders and allowed that some cases may fall in between the two.
I dunno, my gut feeling is to treat disorders of affect separately from psychotic symptoms, like I said earlier.
Then again who really knows? As you say, DSM itself keeps on tinkering with the whole system. Probably we don't know yet how to classify things properly.

That’s where other types of bipolar psychosis and the unsystematic schizophrenias (paraphrenias) come in. A true schizobiopolar mix almost doesn’t exist it’s that rare. 8 time’s out of ten schizoaffective psychosis is a misdiagnosis.

You’ll have to forget all about the DSM and the artificial division between affective and psychotic symptoms. It’s only recently in the DSM that psychosis has been limited to hallucinations and delusions but that’s not the original definition of psychosis or how it works in reality. Like I say a psychosis is just a mental illness in the truest sense of the word. Compared to the neuroses that don’t involve the mental plain directly (just nervous symptoms).

Schizophrenia’s a type of premature dementia. Hallucinations and delusions are just accessory symptoms of a defect syndrome that’s going on in the background and those accessory symptoms are just as common in schizophrenia as they are in other forms of dementia and other psychoses (including bipolar disorder). You’re already going wrong by hyping up the accessory symptoms assuming that hallucinations always point at schizophrenia and nothing else.

Like I say the DSM’s trash. Familiarise yourself with Kraepelin and Leonard.

Dont know but it a good question

I envy your clarity of view and respect your reference to the old greats like Kraepelin and Leonard.
I'm not saying the connections between symptoms that constitute recognized syndromes are incorrect. But I can't help thinking we are still far from certain. It is as if we have a vast tapestry in front of us and are able to see only certain spots on it (syndromes), with some fragments of patterns weaved from different palettes of colours from the spectrums of mood, cognition and behaviour. And we keep on trying to divine the whole tapestry by connecting and reconnecting those spots in different ways. Something which used to be thought of as unipolar depression with brief hypomanic episodes could now be bipolar 2, some ADHD cases may also be reclassified as bipolar 2, schizophrenia could be bipolar 1 with psychotic features, BPD+dysthymia could be bipolar 2.
I know it's not practical or accepted, bofore or now, but I still prefer to separate the visible threads of the pattern if that makes sense.
edit: having said all that, I love when you mention schizophrenia as premature dementia.

Mhm. I get what you're saying but borderline's borderline. Nothing like bipolar manic depression in spite of all the stereotypes.

Depression with even the slightest manic touch is on the manic-depressive spectrum. Some psychotic depressions are closed off by sharp boundaries but there's never any such thing as unipolar depression with "brief" hypomania. That's something that always points at bipolar no matter how brief the abnormal highs are. So long as there's potential for swinging to the other pole it's always bipolar. No matter how mild or brief the reversals are.