Bipolar Disorder Vs Manic Depression
A critical point in distinguishing bipolar disorder from major depressive disorder is whether the person has had a manic episode. For someone to be diagnosed with bipolar disorder, they must have had a manic episode lasting for at least one week or a hypomanic episode lasting for at least four days.
Manic Depression Vs Bipolar Disorder
When first introduced as a diagnosis, clinicians referred to this disorder as manic depression or manic-depressive disorder. Because of the harm and stigma associated with this label, the American Psychiatric Association changed the name for this disorder to bipolar disorder in 1980.
Without treatment, bipolar disorder can become life-threatening. Its associated with a greater risk for suicide, self-harm, and fatal accidents.
In a psychiatric emergency, call 911 or go to an emergency room near you. If youre having suicidal thoughts, dial the National Suicide Prevention Hotline at 1-800-273-8255 or text 741-741 with the word home.
Distinctions Between Bipolar And Unipolar Depression
This review focuses on depression within bipolar disorder and the evidence concerning whether bipolar depression and unipolar depression appear unique or parallel in their etiology, symptoms, and course. Over the past 100 years, conceptions of depression within bipolar disorder have varied widely, and the changes in conceptualization have been reflected in fundamental changes in the diagnostic nomenclature.
Given the increase in available evidence, it appears wise to question whether this bipolarâunipolar distinction, as it applies to depressive episodes, continues to garner support. That is, do depressions within bipolar disorder reflect unique disease processes compared to depressions within unipolar disorder? Indeed, a recent biological review has suggested that it may be more fruitful to consider conceptualizing bipolar and unipolar depression as the same illness . This review, however, was focused on simply the biological evidence. Here, we broaden the question to include the evidence from studies of course and of psychosocial triggers. We believe that this broader focus is important, given the burgeoning literature on psychosocial antecedents and correlates of episodes of bipolar disorder.
Finally, it is of note that the psychosocial variables that predict bipolar depression are not consistently robust predictors of mania . Instead, a distinct set of biological , personality , and life event variables appear to predict mania.
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Living With Bipolar Disorder
Bipolar disorder is a condition of extremes. A person with bipolar disorder may be unaware they’re in the manic phase.
After the episode is over, they may be shocked at their behaviour. But at the time, they may believe other people are being negative or unhelpful.
Some people with bipolar disorder have more frequent and severe episodes than others.
The extreme nature of the condition means staying in a job may be difficult and relationships may become strained. There’s also an increased risk of suicide.
During episodes of mania and depression, someone with bipolar disorder may experience strange sensations, such as seeing, hearing or smelling things that are not there .
They may also believe things that seem irrational to other people . These types of symptoms are known as psychosis or a psychotic episode.
Loss Of Interest In Everything
People suffering from bipolar depression can experience a loss of interest in life. This lack doesnt mean just the things they usually love to do. This means everything.
Being interested in life is not something they can turn off and on. Its not a choice that theyre making. They dont have the motivation to be interested in anything. This symptom ties into the next symptom on the list.
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Using Symptoms To Diagnose
Depending on your symptoms, your doctor or a mental health professional may give you one of several diagnoses. First, they will need to rule out whether the bipolar symptoms are caused by drug or alcohol use or another medical condition. People who are not receiving treatment for bipolar frequently use drugs or alcohol to cope with symptoms, so you may need medical assistance in detoxing from substances first before an official diagnosis can be made.5
If youve experienced the full criteria for a manic episode, you may get a diagnosis of Bipolar I disorder. If you have manic symptoms but are not seriously impaired by them and have also experienced depression, you may receive a diagnosis of Bipolar II disorder. Finally, if youve experience manic and depressive symptoms without meeting the requirements for a full manic or depressive episode, your doctor may diagnose you with Cyclothymic Disorder.6
If youre not sure whether youre experiencing a typical shift in mood or one that might merit a diagnosis, ask yourself, Have these symptoms interfered with work, school, relationships, or other daily responsibilities? If so, then talk to your doctor or a mental health professional about your concerns.
Mania During Depression: Dimensional Or Categorical
There are two limiting conceptualizations for combinations of depressive and manic symptoms. The first is a dimensional construct in which episodes are viewed as consisting of symptoms combined in different proportions. As shown in and , clinical characteristics of patients in depressive episodes appear to change in a continuous fashion as a function of mania scores. The second is a categorical model, assuming that a critical level of mania severity defines a specific type of episode, as proposed by Benazzi . This approach has the potential to classify patients in a manner that potentially can predict course of illness and treatment response, and is consistent with and . A compromise is to regard manic symptoms as dimensional, but having a threshold level at which clinical consequences are meaningful.
Our results show that, while it is possible to classify bipolar depressed subjects according to their MRS scores, a definitive criterion remains to be established. The ROC analysis was only modestly significant, and the choice of alcoholism and suicide attempt history, while clinically relevant characteristics, is an indirect measure of membership in any mixed depressive class. Choice of a different dependent variable, such as BIS score or head trauma, would have produced a ROC curve with a different inflection point. More definitive efforts at classification will require a larger group of subjects.
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Sherri’s Bipolar Depression Story
I asked Sherri, a 40-year-old woman with bipolar disorder, to describe the difference between depression and bipolar depression symptoms:
For me, bipolar depression comes with not only depression but psychosis. I start to see things that aren’t there and hear things that aren’t heard, like my name called over-and-over-again. I see mice running across the floor. I hear my name projected over the loudspeaker at the grocery store. I smell burning rubber in my apartment. With bipolar depression, I suffer these hallucinations and extreme paranoia. I feel like someone out there is trying to get me. I often have to cross the street if I see someone suspicious. With clinical depression, it’s different. Those who experience usually only feel really down and hopeless. I feel bipolar is much worse because of the psychosis. I was diagnosed with depression before I ever had mania, so I’ve lived with this a long time.
Its Important To Keep Talking
Initially, your loved one may not understand completely. Thats OK. Give them time.
Explain to them that youre working to manage your condition and get the help you need. And that their encouragement and support is needed as well. Let them know the conversations you share help build a strong foundation from which you can hopefully move forward.
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What Are The Signs Of Bipolar Disorder In Teens And Children
Generally, people are diagnosed with bipolar disorder as teens or adults, but children can also develop symptoms. Teens and children with bipolar disorder can have manic, depressive, or mixed episodes, and the symptoms in adults and adolescents are very similar. However, it can be hard to tell whether your child has bipolar disorder or another condition affecting younger people, like an anxiety disorder or attention-deficit/hyperactivity disorder, because they have some common symptoms, according to the National Institute of Mental Health9. Bipolar disorder can be complicated and requires a careful and thorough evaluation by a trained, experienced mental health professional. If you think your kid might have bipolar disorder, its a good idea to talk to a trained child psychologist who is familiar with the subtleties of these mental health conditions and can accurately diagnose your loved one.
Symptoms Of A Mixed Episode
A mixed episode of bipolar disorder features symptoms of both mania or hypomania and depression. Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts. This combination of high energy and low mood makes for a particularly high risk of suicide.
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Distribution Of Manic Symptoms In Bipolar Depressed Subjects
Schedule for Affective Disorders and Schizophrenia Mania Rating Scale scores in patients with bipolar depressive episodes ranged from 0 to 29, as shown in . The mean ± SD was 8.75 ± 6.5, median was 8, and the 25th75th percentile range was 413. Only three subjects had scores of 0. The distribution did not depart significantly from normal .
Distribution of Schedule for Affective Disorders and Schizophrenia Mania Rating Scale scores in subjects with bipolar depression.
Who Experiences Bipolar Disorder
Bipolar disorder usually begins in older teens and young adults, with at least half of all cases appearing before age 25. Children and adolescents, however, can develop this disease in more severe forms and often in combination with attention deficit hyperactivity disorder . Some studies have indicated that bipolar depression is genetically inherited, occurring more commonly within families.
While bipolar disorder occurs equally in women and men, women are more likely to meet criteria for bipolar II disorder. Women with bipolar disorder may switch moods more quickly this is called “rapid cycling.” Varying levels of sex hormones and activity of the thyroid gland in the neck, together with the tendency to be prescribed antidepressants, may contribute to the more rapid cycling seen in women. Women may also experience more periods of depression than men.
An estimated 60 percent of all people with bipolar disorder have drug or alcohol dependence. It has also been shown to occur frequently in people with seasonal depression and certain anxiety disorders, like post-traumatic stress disorder .
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The Positive Impact Of Exercise
You dont have to go to the gym to gain the benefits of being active. In fact, aerobic activity, such as taking a long walk, hiking, going for a bike ride, or gardening may be enough to have a positive impact.
And, the time commitment is minimal. Just 3 days a week, for 30 minutes a dayeven in three 10-minute blocksmay help you to feel better.
Signs Of A Bipolar Disorder Depressive Episode
Its important to note the difference between depression as a mental illness and a depressive episode as part of bipolar disorder.
Depressive episodes in bipolar oftentimes coincide with manic episodes. However, there are a variety of forms of bipolar disorder in which the levels and balance between manic and depressive episodes are different.
A depressive episode, according to the DSM-5, includes being in a depressed mood and loss of interest, alongside symptoms that occur nearly every day for about 2 weeks, such as:
These signs of bipolar disorder should be documented so that you can present them to your doctor when trying to diagnose whats going on with you.
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Understand Sexual Health Issues
Understanding what can happen as a result of sexual activities is important, as it relates to events that may be unintended, such as an unplanned pregnancy.
Having clarity about your sexual actions can also help to reduce your chances of contracting STIs, such as HIV.
This is especially important during periods of hypersexuality.
When Should I Call My Teens Healthcare Provider
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Feels extreme depression, fear, anxiety, or anger toward him or herself or others
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Feels out of control
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Hears voices that others dont hear
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Sees things that others dont see
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Cant sleep or eat for 3 days in a row
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Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help
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What To Do When Youre Depressed
The most important step you can take is to start and stay on a bipolar treatment plan. Most include a mix of medicine and talk therapy.
Your doctor might prescribe a few different kinds of medication, including mood stabilizers, antidepressants, and antipsychotic drugs. Talk therapy can also help you control stress and recognize your symptoms sooner. Another type of therapy, called cognitive behavioral therapy, teaches you good ways to handle the negative thoughts that come with depression.
You can take other steps to fight depression, too:
- Donât drink alcohol or use drugs. They can make your mood worse and keep your medications from working.
- Stick to a routine. Try to go to bed, wake up, exercise, and take your medicines at the same time every day.
- Donât make major life changes while youâre depressed. Your doctor or therapist may be able to help you schedule absences from work if you need them.
- Ask a family member or friend for support. They can help you keep up with your appointments and medications.
If you are thinking about suicide or hurting yourself:
- Tell someone who can help you right now
Balanced Meals May Help Balance Your Mood
Much like being active, making healthy food choices may help your physical well-being. Remember to include fresh fruits and vegetables, whole grains, and lean proteins in your diet.
Try including a daily walk or add a healthy meal to your routine once or twice a week and build on that change. Ask yourself, Do I feel a difference? If you have more energy and feel more alert, you may want to continue on this healthy path.
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Bipolar Disorder Vs Major Depression
You may have heard of people who were first diagnosed with depression but later diagnosed with bipolar disorder, and this can be confusing. How can you tell the difference? Keep in mind that the hallmark of bipolar disorder is the presence of episodes of mania or hypomania. These are not present in major depression.
Another common question that’s asked is “Can depression turn into bipolar disorder?” The answer to that question is no, depression doesn’t transition into bipolar disorder later on.
However, it is possible for someone to be diagnosed while they are in the depressive phase, which may result in a diagnosis of depression. At the time, they may not recall or be asked about symptoms of mania or hypomania that would lead to a bipolar diagnosis. Later on, with more careful questioning, or with the occurrence of a manic or hypomanic episode, the diagnosis of bipolar may become clear.
Can You Have A Good Life With Bipolar Disorder
Absolutely. People with well-managed bipolar disorders have jobs, families, and are productive members of our society. Bipolar disorder, while a chronic condition, doesnt define you. Just like people who manage their diabetes or heart condition, you can learn to manage and control bipolar disorders with medications, therapies, and good lifestyle habits that sets you up for a successful life.
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Learning To Recognise Triggers
If you have bipolar disorder, you can learn to recognise the warning signs of an approaching episode of mania or depression.
A community mental health worker, such as a psychiatric nurse, may be able to help you identify your early signs of relapse from your history.
This won’t prevent the episode occurring, but it will allow you to get help in time.
This may mean making some changes to your treatment, perhaps by adding an antidepressant or antipsychotic medicine to the mood-stabilising medication you’re already taking. Your GP or specialist can advise you on this.
Mania And Mixed Depressive Episodes
Any antidepressant should be stopped. Haloperidol, olanzapine, quetiapine or risperidone can be used to treat a manic episode. If these do not work well, Lithium can be added.
Once the treatment has started, symptoms usually improve within a few days, but it may take several weeks for a full recovery. You should check with your doctor if you want to drive while taking this sort of medication.
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Getting Support From Loved Ones
Ideally, once youre diagnosed with bipolar depression, your loved ones would understand and rally around you with encouragement and support. However, not all of your loved ones will completely understand your diagnosis and what would be helpful. Its OK.
This is your chance to help them understand your experiences and forge a stronger relationship.
When To Start A Mood Stabiliser
After just one episode, its difficult to predict how likely you are to have another. Some people dont want to start a mood stabiliser at this stage, but episodes of mania can be severe and very disruptive.
If you have a second episode, there is a strong chance of further episodes. So, at this point, a mood stabiliser would be more strongly recommended.
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