Sunday, 22 April 2018

Mood Disorders- Depression Vs Bipolar Disorder :Symptoms, Neurobiology And Treatment

Depression vs Bipolar Disorder

Mood disorders are also known as 'Affective' disorders the two main mood disorders are DEPRESSION AND BIPOLAR DISORDER. Patient with depression(both Unipolar and Bipolar) and Mixed states of Bipolar disorder are at increased risk of suicide.

   About 5 to 10% of patients with untreated /inadequately treated Unipolar Depression commit suicide and about to 10 to 15% of patients with Bipolar disorder commit suicide.

Mood Disorders- Depression Vs  Bipolar Disorder :Symptoms, Neurobiology And Treatment

In Depression, the patient experiences one or more episodes of low mood which is also called 'Unipolar' disorder. Whereas in bipolar disorder the patient experiences episodes of both low mood(depression) and abnormally elevated mood which could be either Hypomania or Mania, or the patient might experience 2 or more episode of abnormally elevated mood (i.e Hypomania or Mania).  

 Clinical Symptoms of depression- 

  • A depressed mood that is clearly abnormal for a person.

  • Inability to derive pleasure from normally pleasurable activities.

  • Reduced concentration

  • Sleep disturbance.

  • Appetite disturbance(usually decreased or low weight).

  • Increased fatiguability.

  • Retaradtion.

  • Feeling hopeless, helpless, worthless.

  • Suicidal ideation/plans/acts.

Difference between Mania and Hypomania

  • Mania represents a more severe form of abnormally elevated mood than Hypomania. 

  • Patient with Hypomania has insight into their illness.

  • Patient with  Mania tends not to have insight.

  • Patient with Hypomania never has psychotic symptoms.

  • Patient with Mania may or may not have psychotic symptoms.

Clinical Features of Hypomania 
  • An elevated mood that is clearly abnormal for the person.

  • Increased activity or restlessness.

  • Increased energy.

  • Less sleep.

  • Increased sociability.

  • Decreased concentration. 

Clinical Features of Mania
  • Irritable moods that are clearly abnormal.

  • Severe interference with a personal functioning.

  • Grandiosity/increased self-esteem.

  • Restlessness

  • Disinhibition/inappropriate behavior.

  • Increased perceptual sensitivity.  

                            Depression in Bipolar Disorder

Some symptoms that may suggest bipolar depression:
  • Atypical features (increased sleep, and appetite).

  • Psychomotor retardation.

  • More frequent episodes.

  • A family history of bipolar disorder.

  • Male gender(equal gender for prevalence for bipolar).

  • More abrupt onset.

  • Easily destructible and unable to focus.

  • Engage in risky behavior.

                                  Rapid Cycling Of Bipolar disorder

At least four mood  episodes (hypomania/mania/depression) should occur within  a 12-month period and these episodes are demarcated by: 
  •  period of remission.

  • switch to an episode of opposite polarity.

  • switch to an episode of mixed polarity.

The common risk factors that include are alcohol abuse, Thyroid dysfunction, life stressors, relatively less responsive to treatment and a higher risk of suicide.

Neurobiology Of Mood Disorder-

Depression has been studied far more than Bipolar disorder. Depression reduced the volume of  Hippocampus bilaterally (whether a cause of effect or illness) also it reduced the activity of dorsolateral prefrontal cortex. Whereas in Bipolar disorder, studies have shown the inconsistent results in Hippocampal volume. Other systems potentially involved in Mood disorders :

  • Endocrine: e.g HPA axis dysregulation; Oestrogens

  • Immune system 

  • Abnormalities in emotional processing 

  • Role of Neurotrophic factors: e.g. BDNF

Where can a patient get help?

If you also have bipolar disorder and experiencing those symptoms then please do call to your counselor or physician or your therapist or psychiatrist but if you feel suicidal or having suicide ideation then please call at 911

How is Bipolar disorder treated?

Bipolar disorder can be treated now just like other diseases there are psychotherapy and safe medications. So if you are also going through the Bipolar disorder so, please seek help and see your physician or therapist because doing so will help you to get back into your normal life.

*Some other adjunctive treatment options for mood disorders

  • Physcho-education

  • Guided self-help

  • Phototherapy

  • Yoga

  • Acupuncture

  • Sleep Deprivation

  • Exercise Programmes.

1 comment:

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