QUESTION:
Dear Dr. Heller,
UNDERSTANDING THE DISEASE TO BE EPISODIC IS IT SUCH THAT:
1. MANIA CAN LAST FOR A FEW DAYS AND THE DEPRESSION FOLLOW IN ABOUT THAT SAME TIME
FRAME?
2. OR IS IT SEVERAL MONTHS IN LENGTH (PERHAPS) EVEN SEASONAL
BEFORE IT CHANGES BACK
3. CAN STRESS TRIGGER THE CHANGE?
4. HOW LONG DOES THE EPISODE LAST BEFORE IT CHANGES TO THE OTHER?
THANK YOU.
ANSWER:
1) By definition hypomanic needs to last 4 days, mania 7 days.
One can have a "mixed episode" where both mania/hypomania and depression have
been present at least 4 times in a week. There are probably some who do not fit that
definition, and the combination of BPD and bipolar can be very confusing at times.
2) The peak incidence of mania is spring and fall, and seasonal winter
depression is also quite common.
3) Stress can trigger the change, and it can happen without stress as
well.
4) There is no predicting how long the episode will last before it
changes to the other.