Not What it Sounds Like – Bipolar NOS – Bipolar Disorder NOS (Not Otherwise Specified)

Bipolar NOS May Not Be Specified, But it’s Not Specifically Good!

Bipolar Disorder NOS (Not Otherwise Specified) is also called Bipolar NOS. The NOS means that it’s a category of bipolar disorder which doesn’t fit into the other categories. At first glance I figured it just meant it was bipolar disorder that didn’t “make the cut.” Like it wasn’t quite that bad.

This is true and not true. I’ve seen different info on the internet about this topic, but it seemed incomplete. So I got myself my own copy of the DSM-IV. The DSM-IV has five different reasons to give this diagnosis. In fact, two of those are kind of what you would think from the name Bipolar NOS. They aren’t as bad as the others.

The “Easy” Ones

The first of these two types of Bipolar NOS is when there are hypomanic episodes along with chronic depressive symptoms that are too infrequent to make for a diagnosis of Cyclothymic Disorder. Sounds like they get hypomania, but not as much depression as a regular cyclothymic. Well if you read my page on Cyclothymic Disorder you’ll know what I think of that. And this isn’t even as bad as that. It’s still not normalcy though, and hypomania is not always that fun either, at least not for the people living with the person.

The second type of Bipolar NOS is when a person will get repeated hypomanic episodes, but with absolutely no episodes of depression. Wow. Hard for me to feel any sympathy for that one. What do you call this, very successful, ambitious people? How did they even diagnose this? Who’s going to his doctor for this one? Well… maybe his family his. Especially if he’s aggressive or irritable.

I Don’t Want These

The next three types of Bipolar Disorder NOS are as Bad or Worse than the standard three categories of bipolar disorder.

The first of these (I’m listing everything out of the DSM-IV’s order in order to make things clearer), is when the mental health professional knows or thinks it might be bipolar disorder, but can’t tell if it’s one of the standard types of bipolar disorder, or if it is the result of a medical condition (I guess a brain tumor or hormonal problem), or the substance abuse (Drugs, as in a bad trip.) Yes, taking drugs is a cause of permanent mental illness. Think about that before you think about tripping.

The second is when the sufferer alternates between manic and depressive symptoms so fast that they don’t have the minimum time limits to fit into the category of having had a manic, hypomanic or major depressive episode. Obviously something is very wrong, so this is the box they put it in. What a hellish rollercoaster to be in!!

The last of these is when a manic or mixed episode is superimposed on a delusional disorder (what you and I would call “crazy”), residual schizophrenia (I guess that means it’s not full on, because mania can be a symptom of schizophrenia, it includes delusions and hallucinations too. May God help them.), or Psychotic Disorder Not Otherwise Specified.

So if a person has mania, and is also really psychotic, they get the tag of Bipolar NOS. (Whoah. Makes me almost happy I’m only Bipolar 1.)

I thought my brother fell into the last category of Bipolar NOS, but he has OCD besides Bipolar I. That doesn’t seem to fall in any category listed here, so I think that a person can get a double diagnosis, Bipolar I with OCD, or another anxiety disorder. The symptoms are so different, after all.

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