Personality Changes Later in Life: Diagnostic and Treatment Considerations

Topics: Bipolar Disorder | Borderline Personality Disorder | Disinhibition | Frontotemporal dementia | Hypomania | Mania | MOCA | Neuropsychological testing | Personality Disorders | Self-injury | Stimulants | Suicide

CGPR: What is the course of personality disorders as people age? Dr. Tampi: Personality usually doesn’t change much. People with borderline personality disorder (BPD), for example, don’t usually experience significant changes once they reach middle age. Experiences over a person’s lifespan may teach them skills that blunt their sharp edges, but

How to Diagnose Bipolar Disorder

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Diagnosis | DSM | Hypomania | Mania | Mixed Features | Mood

TCPR: When I ask a depressed patient if they’ve ever had manic symptoms, I often run into a problem. They say, “Of course I feel more confident, energetic, and happy ... when I’m not depressed.”Dr. Parker: As it can be hard to tease apart true hypomania from normal happiness, we’ve developed a rating scale to assist, the Sydney Bipolar Screene

How to Diagnose ADHD in Bipolar Disorder

Topics: ADHD | ADHD Rating Scale-5 | Attention Deficit Hyperactivity Disorder | Bipolar Disorder | Bipolar II | Comorbidity | Diagnosis | Diagnostic Testing | Hypomania | Psychiatric interviewing

Hailey is a 24-year-old woman with bipolar II disorder who has recently come out of a mixed episode. Although her mood symptoms have resolved, she is distracted easily, has difficulty organizing her work, and often forgets important tasks. She read about ADHD online and asks if she can have a stimulant to help her focus. ADHD and hypomania share many

How to Use Lamotrigine

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Borderline Personality Disorder | BPD | Hypomania | Lamictal | Lamotrigine | Medication | Mood Stabilizers | OCD | Pharmacology | Psychopharmacology

Lamotrigine is FDA approved as maintenance treatment for bipolar disorder—that is, for delaying episodes of depression, hypomania, or mania. However, it is not approved for active depression or mania—which has given it a reputation as a “light” mood stabilizer. For patients who appreciate tolerability, that’s a good thing, but it isn’t the f

Psychopharmacology in Bipolar II

Topics: Bipolar Disorder | Hypomania | Mania | Mixed Features | Mood Stabilizers

TCPR: You’ve carved out a unique practice with difficult-to-treat bipolar disorders. Tell us about the patients you see. Dr. Kelly: I see a lot of bipolar II and “softer bipolar.” Clinically these patients have chronic depression, often mixed with hypomanic symptoms. Nearly all have tried multiple antidepressants that didn’t work, stopped worki