Hey!
-
deliverance
- Official BleacherCoach
- Posts: 4036
- Joined: August 27th, 2003, 6:23 pm
Re: Hey!
Fantasy Baseball actually takes 180 days of supervision. If you give it less, you'll be lucky to win.
Last edited by deliverance on September 20th, 2011, 12:37 am, edited 1 time in total.
-
The Ancient Enemy
- Official BleacherCoach
- Posts: 7549
- Joined: October 30th, 2004, 2:47 pm
Re: Hey!
I dunno if we have any spots left by now, but send me your email again, Frosty.
Last edited by The Ancient Enemy on September 20th, 2011, 12:37 am, edited 1 time in total.
"I can and will be hard anytime with or without my boyz!!!" - Hollywood
"Their jerseys make me want to run through the desert and tackle a terrorist." - nLions1
"Their jerseys make me want to run through the desert and tackle a terrorist." - nLions1
-
deliverance
- Official BleacherCoach
- Posts: 4036
- Joined: August 27th, 2003, 6:23 pm
Re: Hey!
:lol:
Last edited by deliverance on September 20th, 2011, 12:37 am, edited 2 times in total.
-
The Ancient Enemy
- Official BleacherCoach
- Posts: 7549
- Joined: October 30th, 2004, 2:47 pm
Re: Hey!
Maybe the scoring system isn't set up yet, Freakshow. You should have said you wanted in when I posted the invite hours ago.
Bipolar disorder is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present at the same time. These episodes are usually separated by periods of "normal" mood, but in some individuals, depression and mania may rapidly alternate, known as rapid cycling. Extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations. The disorder has been subdivided into bipolar I, bipolar II, cyclothymia, and other types, based on the nature and severity of mood episodes experienced; the range is often described as the bipolar spectrum.
Data from the United States on lifetime prevalence vary but indicate a rate of around 1 percent for Bipolar I, 0.5 to 1 percent for Bipolar II or cyclothymia, and between 2 and 5 percent for subthreshold cases meeting some but not all criteria. The onset of full symptoms generally occurs in late adolescence or young adulthood. Diagnosis is based on the person's self-reported experiences, as well as observed behavior. Episodes of abnormality are associated with distress and disruption, and an elevated risk of suicide, especially during depressive episodes. In some cases it can be a devastating long-lasting disorder. In some cases, however, it has been associated with creativity, goal striving and positive achievements.[1]
Genetic factors contribute substantially to the likelihood of developing bipolar disorder, and environmental factors are also implicated. Bipolar disorder is often treated with mood stabilizer medications, and sometimes other psychiatric drugs. Psychotherapy also has a role, often when there has been some recovery of stability. In serious cases in which there is a risk of harm to oneself or others involuntary commitment may be used; these cases generally involve severe manic episodes with dangerous behavior or depressive episodes with suicidal ideation. There are widespread problems with social stigma, stereotypes and prejudice against individuals with a diagnosis of bipolar disorder.[2]
Also called manic depression or bipolar affective disorder, the current term "bipolar disorder" is of fairly recent origin and refers to the cycling between high and low episodes (poles). A relationship between mania and melancholia had long been observed, although the basis of the current conceptualisation can be traced back to French psychiatrists in the 1850s. The term "manic-depressive illness" or psychosis was coined by German psychiatrist Emil Kraepelin in the late nineteenth century, originally referring to all kinds of mood disorder. German psychiatrist Karl Leonhard split the classification again in 1957, employing the terms unipolar disorder (Major depressive disorder) and bipolar disorder.
Signs and symptoms
Bipolar disorder is a condition in which people experience abnormally elevated (manic or hypomanic) and abnormally depressed states for a period of time in a way that interferes with functioning. Bipolar disorder has been estimated to affect more than 5 million Americans—about 3 out of every 100 adults.[3] It is equally prevalent in men and women, and is found across all cultures and ethnic groups.[4] Not everyone's symptoms are the same, and there is no blood test to confirm the disorder. Scientists believe that bipolar disorder may be caused by chemical imbalances in the brain. Bipolar disorder can appear to be unipolar depression. Diagnosing bipolar disorder is difficult, even for mental health professionals. What distinguishes bipolar disorder from unipolar depression is that the affected person also experiences the "highs" of a manic phase.
[edit] Major depressive episode
Main article: Major depressive episode
Signs and symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, anxiety, guilt, anger, isolation, or hopelessness; disturbances in sleep and appetite; fatigue and loss of interest in usually enjoyable activities; problems concentrating; loneliness, self-loathing, apathy or indifference; depersonalization; loss of interest in sexual activity; shyness or social anxiety; irritability, chronic pain (with or without a known cause); lack of motivation; and morbid suicidal ideation.[5] In severe cases, the individual may become psychotic, a condition also known as severe bipolar depression with psychotic features.
[edit] Manic episode
Main article: Mania
Mania is generally characterized by a distinct period of an elevated, expansive, or irritable mood state. People commonly experience an increase in energy and a decreased need for sleep. A person's speech may be pressured, with thoughts experienced as racing. Attention span is low and a person in a manic state may be easily distracted. Judgment may become impaired; sufferers may go on spending sprees or engage in behavior that is quite abnormal for them. They may indulge in substance abuse, particularly alcohol or other depressants, cocaine or other stimulants, or sleeping pills. Their behavior may become aggressive, intolerant or intrusive. People may feel out of control or unstoppable. People may feel they have been "chosen", are "on a special mission", or other grandiose or delusional ideas. Sexual drive may increase. At more extreme phases of bipolar I, a person in a manic state can begin to experience psychosis, or a break with reality, where thinking is affected along with mood.[6] Many people in a manic state experience severe anxiety and are very irritable (to the point of rage), while others are euphoric and grandiose.
In order to be diagnosed with mania according to the Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM) a person must experience this state of elevated or irritable mood, as well as other symptoms, for at least one week, less if hospitalization is required. According to the National Institute of Mental Health, "A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present."[7]
[edit] Hypomanic episode
Main article: Hypomanic episode
Hypomania is generally a mild to moderate level of mania, characterized by optimism, pressure of speech and activity, and decreased need for sleep. Some people have increased creativity while others demonstrate poor judgment and irritability. These persons generally have increased energy and tend to become more active than usual. They do not, however, have delusions or hallucinations. Hypomania can be difficult to diagnose because it may masquerade as mere happiness, though it carries the same risks as mania.
Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.[8]
[edit] Mixed affective episode
Main article: Mixed state (psychiatry)
In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously (for example, agitation, anxiety, aggressiveness or belligerence, confusion, fatigue, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, racing thoughts, restlessness, and rage).[9]
[edit] Diagnosis
Manic and depressive episodes, hallmarks of Bipolar Disorder, have been likened to a roller coaster ride.[10]
Diagnosis is based on the self-reported experiences of an individual as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a psychiatrist, nurse, social worker, clinical psychologist or other clinician in a clinical assessment. There are lists of criteria for someone to be so diagnosed. These depend on both the presence and duration of certain signs and symptoms. Assessment is usually done on an outpatient basis; admission to an inpatient facility is considered if there is a risk to oneself or others. The most widely used criteria for diagnosing bipolar disorder are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, the current version being DSM-IV-TR, and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, currently the ICD-10. The latter criteria are typically used in Europe and other regions while the DSM criteria are used in the USA and other regions, as well as prevailing in research studies.
An initial assessment may include a physical exam by a physician. Although there are no biological tests which confirm bipolar disorder, tests may be carried out to exclude medical illnesses such as hypo- or hyperthyroidism, metabolic disturbance, a systemic infection or chronic disease, and syphilis or HIV infection. An EEG may be used to exclude epilepsy, and a CT scan of the head to exclude brain lesions. Investigations are not generally repeated for relapse unless there is a specific medical indication.
There are several other mental disorders which may involve similar symptoms to bipolar disorder. These include schizophrenia,[11] schizoaffective disorder, drug intoxication, brief drug-induced psychosis, schizophreniform disorder and borderline personality disorder. Both borderline personality and bipolar disorder can involve what are referred to as "mood swings". In bipolar disorder, the term refers to the cyclic episodes of elevated and depressed mood which generally last weeks or months. The term in borderline personality refers to the marked lability and reactivity of mood, known as emotional dysregulation, due to response to external psychosocial and intrapsychic stressors; these may arise or subside suddenly and dramatically and last for seconds, minutes, hours or days. A bipolar depression is generally more pervasive with sleep, appetite disturbance and nonreactive mood, whereas the mood in dysthymia of borderline personality remains markedly reactive and sleep disturbance not acute.[12] Some hold that borderline personality disorder represents a subthreshold form of mood disorder,[13][14] while others maintain the distinctness, though noting they often coexist.[15][16]
[edit] Clinical Scales
The Bipolar Spectrum Diagnostic Scale (BSDS)[17] was developed by Ronald Pies, MD and was later refined and tested by S. Nassir Ghaemi, MD, MPH and colleagues. The BSDS arose from Pies's experience as a psychopharmacology consultant, where he was frequently called on to manage cases of "treatment-resistant depression." There are 19 question items and 2 sections on the English version of the BSDS. The scale was validated in its original version and demostrated a high sensitivity.[18]
[edit] Criteria and subtypes
Main article: Current diagnostic criteria for bipolar disorder
There is no clear consensus as to how many types of bipolar disorder exist.[19] In DSM-IV-TR and ICD-10, bipolar disorder is conceptualized as a spectrum of disorders occurring on a continuum. The DSM-IV-TR lists four types of mood disorders which fit into the bipolar categories: Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder NOS (Not Otherwise Specified).
[edit] Bipolar I
In Bipolar I disorder, an individual has experienced one or more manic episodes with or without major depressive episodes. For a diagnosis of Bipolar I disorder according to the DSM-IV-TR, one or more manic or mixed episodes are required. A depressive episode is not required for the diagnosis of Bipolar I disorder but it frequently occurs.
[edit] Bipolar II
Bipolar II disorder is characterized by hypomanic episodes rather than actual manic episodes, as well as at least one major depressive episode. Patients with a Bipolar II diagnosis under the DSM IV criteria cannot, by definition, ever have had a manic episode prior to their diagnosis. However, a Bipolar II diagnosis is not a guarantee that they will not eventually suffer from such an episode in the future.[citation needed]
Hypomanic episodes do not go to the full extremes of mania (i.e. do not usually cause severe social or occupational impairment, and without psychosis), and this can make Bipolar II more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing, crippling depression. For both Bipolar I and II, there are a number of specifiers that indicate the presentation and course of the disorder, including "chronic", "rapid cycling", "catatonic" and "melancholic".
[edit] Cyclothymia
Cyclothymia involves a presence or history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes. A diagnosis of Cyclothymic Disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that do not meet full criteria for major depressive episodes. The main idea here is that there is a low-grade cycling of mood which appears to the observer as a personality trait, but interferes with functioning.
[edit] Bipolar NOS
"Bipolar Disorder Not Otherwise Specified" is a catch-all diagnosis that is used to indicate bipolar illness that does not fit into the other diagnostic categories. If an individual clearly seems to be suffering from some type of bipolar disorder but does not meet the criteria for one of the subtypes above, he or she receives a diagnosis of Bipolar Disorder NOS (Not Otherwise Specified).
[edit] Rapid cycling
Most people who meet criteria for bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months.[20][21]
Rapid cycling, however, is a course specifier that may be applied to any of the above subtypes. It is defined as having four or more episodes per year and is found in a significant fraction of individuals with bipolar disorder. The definition of rapid cycling most frequently cited in the literature (including the DSM) is that of Dunner and Fieve: at least four major depressive, manic, hypomanic or mixed episodes are required to have occurred during a 12-month period.[22] There are references that describe very rapid (ultra-rapid) or extremely rapid[23] (ultra-ultra or ultradian) cycling. One definition of ultra-ultra rapid cycling is defining distinct shifts in mood within a 24–48-hour period.
[edit] Challenges
The experiences and behaviors involved in bipolar disorder are often not understood by individuals or recognized by mental health professionals, so diagnosis may sometimes be delayed for 10 years or more.[24
Bipolar disorder is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present at the same time. These episodes are usually separated by periods of "normal" mood, but in some individuals, depression and mania may rapidly alternate, known as rapid cycling. Extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations. The disorder has been subdivided into bipolar I, bipolar II, cyclothymia, and other types, based on the nature and severity of mood episodes experienced; the range is often described as the bipolar spectrum.
Data from the United States on lifetime prevalence vary but indicate a rate of around 1 percent for Bipolar I, 0.5 to 1 percent for Bipolar II or cyclothymia, and between 2 and 5 percent for subthreshold cases meeting some but not all criteria. The onset of full symptoms generally occurs in late adolescence or young adulthood. Diagnosis is based on the person's self-reported experiences, as well as observed behavior. Episodes of abnormality are associated with distress and disruption, and an elevated risk of suicide, especially during depressive episodes. In some cases it can be a devastating long-lasting disorder. In some cases, however, it has been associated with creativity, goal striving and positive achievements.[1]
Genetic factors contribute substantially to the likelihood of developing bipolar disorder, and environmental factors are also implicated. Bipolar disorder is often treated with mood stabilizer medications, and sometimes other psychiatric drugs. Psychotherapy also has a role, often when there has been some recovery of stability. In serious cases in which there is a risk of harm to oneself or others involuntary commitment may be used; these cases generally involve severe manic episodes with dangerous behavior or depressive episodes with suicidal ideation. There are widespread problems with social stigma, stereotypes and prejudice against individuals with a diagnosis of bipolar disorder.[2]
Also called manic depression or bipolar affective disorder, the current term "bipolar disorder" is of fairly recent origin and refers to the cycling between high and low episodes (poles). A relationship between mania and melancholia had long been observed, although the basis of the current conceptualisation can be traced back to French psychiatrists in the 1850s. The term "manic-depressive illness" or psychosis was coined by German psychiatrist Emil Kraepelin in the late nineteenth century, originally referring to all kinds of mood disorder. German psychiatrist Karl Leonhard split the classification again in 1957, employing the terms unipolar disorder (Major depressive disorder) and bipolar disorder.
Signs and symptoms
Bipolar disorder is a condition in which people experience abnormally elevated (manic or hypomanic) and abnormally depressed states for a period of time in a way that interferes with functioning. Bipolar disorder has been estimated to affect more than 5 million Americans—about 3 out of every 100 adults.[3] It is equally prevalent in men and women, and is found across all cultures and ethnic groups.[4] Not everyone's symptoms are the same, and there is no blood test to confirm the disorder. Scientists believe that bipolar disorder may be caused by chemical imbalances in the brain. Bipolar disorder can appear to be unipolar depression. Diagnosing bipolar disorder is difficult, even for mental health professionals. What distinguishes bipolar disorder from unipolar depression is that the affected person also experiences the "highs" of a manic phase.
[edit] Major depressive episode
Main article: Major depressive episode
Signs and symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, anxiety, guilt, anger, isolation, or hopelessness; disturbances in sleep and appetite; fatigue and loss of interest in usually enjoyable activities; problems concentrating; loneliness, self-loathing, apathy or indifference; depersonalization; loss of interest in sexual activity; shyness or social anxiety; irritability, chronic pain (with or without a known cause); lack of motivation; and morbid suicidal ideation.[5] In severe cases, the individual may become psychotic, a condition also known as severe bipolar depression with psychotic features.
[edit] Manic episode
Main article: Mania
Mania is generally characterized by a distinct period of an elevated, expansive, or irritable mood state. People commonly experience an increase in energy and a decreased need for sleep. A person's speech may be pressured, with thoughts experienced as racing. Attention span is low and a person in a manic state may be easily distracted. Judgment may become impaired; sufferers may go on spending sprees or engage in behavior that is quite abnormal for them. They may indulge in substance abuse, particularly alcohol or other depressants, cocaine or other stimulants, or sleeping pills. Their behavior may become aggressive, intolerant or intrusive. People may feel out of control or unstoppable. People may feel they have been "chosen", are "on a special mission", or other grandiose or delusional ideas. Sexual drive may increase. At more extreme phases of bipolar I, a person in a manic state can begin to experience psychosis, or a break with reality, where thinking is affected along with mood.[6] Many people in a manic state experience severe anxiety and are very irritable (to the point of rage), while others are euphoric and grandiose.
In order to be diagnosed with mania according to the Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM) a person must experience this state of elevated or irritable mood, as well as other symptoms, for at least one week, less if hospitalization is required. According to the National Institute of Mental Health, "A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present."[7]
[edit] Hypomanic episode
Main article: Hypomanic episode
Hypomania is generally a mild to moderate level of mania, characterized by optimism, pressure of speech and activity, and decreased need for sleep. Some people have increased creativity while others demonstrate poor judgment and irritability. These persons generally have increased energy and tend to become more active than usual. They do not, however, have delusions or hallucinations. Hypomania can be difficult to diagnose because it may masquerade as mere happiness, though it carries the same risks as mania.
Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.[8]
[edit] Mixed affective episode
Main article: Mixed state (psychiatry)
In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously (for example, agitation, anxiety, aggressiveness or belligerence, confusion, fatigue, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, racing thoughts, restlessness, and rage).[9]
[edit] Diagnosis
Manic and depressive episodes, hallmarks of Bipolar Disorder, have been likened to a roller coaster ride.[10]
Diagnosis is based on the self-reported experiences of an individual as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a psychiatrist, nurse, social worker, clinical psychologist or other clinician in a clinical assessment. There are lists of criteria for someone to be so diagnosed. These depend on both the presence and duration of certain signs and symptoms. Assessment is usually done on an outpatient basis; admission to an inpatient facility is considered if there is a risk to oneself or others. The most widely used criteria for diagnosing bipolar disorder are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, the current version being DSM-IV-TR, and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, currently the ICD-10. The latter criteria are typically used in Europe and other regions while the DSM criteria are used in the USA and other regions, as well as prevailing in research studies.
An initial assessment may include a physical exam by a physician. Although there are no biological tests which confirm bipolar disorder, tests may be carried out to exclude medical illnesses such as hypo- or hyperthyroidism, metabolic disturbance, a systemic infection or chronic disease, and syphilis or HIV infection. An EEG may be used to exclude epilepsy, and a CT scan of the head to exclude brain lesions. Investigations are not generally repeated for relapse unless there is a specific medical indication.
There are several other mental disorders which may involve similar symptoms to bipolar disorder. These include schizophrenia,[11] schizoaffective disorder, drug intoxication, brief drug-induced psychosis, schizophreniform disorder and borderline personality disorder. Both borderline personality and bipolar disorder can involve what are referred to as "mood swings". In bipolar disorder, the term refers to the cyclic episodes of elevated and depressed mood which generally last weeks or months. The term in borderline personality refers to the marked lability and reactivity of mood, known as emotional dysregulation, due to response to external psychosocial and intrapsychic stressors; these may arise or subside suddenly and dramatically and last for seconds, minutes, hours or days. A bipolar depression is generally more pervasive with sleep, appetite disturbance and nonreactive mood, whereas the mood in dysthymia of borderline personality remains markedly reactive and sleep disturbance not acute.[12] Some hold that borderline personality disorder represents a subthreshold form of mood disorder,[13][14] while others maintain the distinctness, though noting they often coexist.[15][16]
[edit] Clinical Scales
The Bipolar Spectrum Diagnostic Scale (BSDS)[17] was developed by Ronald Pies, MD and was later refined and tested by S. Nassir Ghaemi, MD, MPH and colleagues. The BSDS arose from Pies's experience as a psychopharmacology consultant, where he was frequently called on to manage cases of "treatment-resistant depression." There are 19 question items and 2 sections on the English version of the BSDS. The scale was validated in its original version and demostrated a high sensitivity.[18]
[edit] Criteria and subtypes
Main article: Current diagnostic criteria for bipolar disorder
There is no clear consensus as to how many types of bipolar disorder exist.[19] In DSM-IV-TR and ICD-10, bipolar disorder is conceptualized as a spectrum of disorders occurring on a continuum. The DSM-IV-TR lists four types of mood disorders which fit into the bipolar categories: Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder NOS (Not Otherwise Specified).
[edit] Bipolar I
In Bipolar I disorder, an individual has experienced one or more manic episodes with or without major depressive episodes. For a diagnosis of Bipolar I disorder according to the DSM-IV-TR, one or more manic or mixed episodes are required. A depressive episode is not required for the diagnosis of Bipolar I disorder but it frequently occurs.
[edit] Bipolar II
Bipolar II disorder is characterized by hypomanic episodes rather than actual manic episodes, as well as at least one major depressive episode. Patients with a Bipolar II diagnosis under the DSM IV criteria cannot, by definition, ever have had a manic episode prior to their diagnosis. However, a Bipolar II diagnosis is not a guarantee that they will not eventually suffer from such an episode in the future.[citation needed]
Hypomanic episodes do not go to the full extremes of mania (i.e. do not usually cause severe social or occupational impairment, and without psychosis), and this can make Bipolar II more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity and is reported less frequently than a distressing, crippling depression. For both Bipolar I and II, there are a number of specifiers that indicate the presentation and course of the disorder, including "chronic", "rapid cycling", "catatonic" and "melancholic".
[edit] Cyclothymia
Cyclothymia involves a presence or history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes. A diagnosis of Cyclothymic Disorder requires the presence of numerous hypomanic episodes, intermingled with depressive episodes that do not meet full criteria for major depressive episodes. The main idea here is that there is a low-grade cycling of mood which appears to the observer as a personality trait, but interferes with functioning.
[edit] Bipolar NOS
"Bipolar Disorder Not Otherwise Specified" is a catch-all diagnosis that is used to indicate bipolar illness that does not fit into the other diagnostic categories. If an individual clearly seems to be suffering from some type of bipolar disorder but does not meet the criteria for one of the subtypes above, he or she receives a diagnosis of Bipolar Disorder NOS (Not Otherwise Specified).
[edit] Rapid cycling
Most people who meet criteria for bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months.[20][21]
Rapid cycling, however, is a course specifier that may be applied to any of the above subtypes. It is defined as having four or more episodes per year and is found in a significant fraction of individuals with bipolar disorder. The definition of rapid cycling most frequently cited in the literature (including the DSM) is that of Dunner and Fieve: at least four major depressive, manic, hypomanic or mixed episodes are required to have occurred during a 12-month period.[22] There are references that describe very rapid (ultra-rapid) or extremely rapid[23] (ultra-ultra or ultradian) cycling. One definition of ultra-ultra rapid cycling is defining distinct shifts in mood within a 24–48-hour period.
[edit] Challenges
The experiences and behaviors involved in bipolar disorder are often not understood by individuals or recognized by mental health professionals, so diagnosis may sometimes be delayed for 10 years or more.[24
Last edited by The Ancient Enemy on September 20th, 2011, 12:37 am, edited 1 time in total.
"I can and will be hard anytime with or without my boyz!!!" - Hollywood
"Their jerseys make me want to run through the desert and tackle a terrorist." - nLions1
"Their jerseys make me want to run through the desert and tackle a terrorist." - nLions1
-
deliverance
- Official BleacherCoach
- Posts: 4036
- Joined: August 27th, 2003, 6:23 pm
Re: Hey!
Before you invite people to a draft, don't you have to have the scoring set up? That's been the case in every league I have ever been in. You always complain about me begging to get into your Fantasy leagues and then you put out an open invite and I ask you for more details and you respond with nothing. It's cool, though. I would have felt bad taking your money anyway.
Last edited by deliverance on September 20th, 2011, 12:37 am, edited 1 time in total.
-
deliverance
- Official BleacherCoach
- Posts: 4036
- Joined: August 27th, 2003, 6:23 pm
Re: Hey!
woman – noun
1. the female human being (distinguished from man).
2. an adult female person.
3. a female attendant to a lady of rank.
4. a wife.
5. the nature, characteristics, or feelings often attributed to women; womanliness.
6. a sweetheart or paramour; mistress.
7. a female employee or representative: A woman from the real estate agency called.
8. a female person who cleans house, cooks, etc.; housekeeper: The woman will be in to clean today.
9. women collectively: Woman is no longer subordinate to man.
1. the female human being (distinguished from man).
2. an adult female person.
3. a female attendant to a lady of rank.
4. a wife.
5. the nature, characteristics, or feelings often attributed to women; womanliness.
6. a sweetheart or paramour; mistress.
7. a female employee or representative: A woman from the real estate agency called.
8. a female person who cleans house, cooks, etc.; housekeeper: The woman will be in to clean today.
9. women collectively: Woman is no longer subordinate to man.
Last edited by deliverance on September 20th, 2011, 12:37 am, edited 1 time in total.
-
The Ancient Enemy
- Official BleacherCoach
- Posts: 7549
- Joined: October 30th, 2004, 2:47 pm
Re: Hey!
We were looking to get 12 guys so we could hash-out the scoring prior to setting it in stone. It's not just one guy's league, it's 12 guy's league. That's why we wanted people first.
Last edited by The Ancient Enemy on September 20th, 2011, 12:37 am, edited 1 time in total.
"I can and will be hard anytime with or without my boyz!!!" - Hollywood
"Their jerseys make me want to run through the desert and tackle a terrorist." - nLions1
"Their jerseys make me want to run through the desert and tackle a terrorist." - nLions1
-
deliverance
- Official BleacherCoach
- Posts: 4036
- Joined: August 27th, 2003, 6:23 pm
Re: Hey!
Understandable. It's all good, TAE.
Last edited by deliverance on September 20th, 2011, 12:37 am, edited 1 time in total.
