Is Bipolar And Depression The Same Thing

Is Bipolar And Depression The Same Thing – Because the treatment options for major depression in bipolar I disorder and major depression in unipolar disorder are different, this information can help doctors decide what to do. how

As our ability to diagnose mental illness has improved, an important problem remains: the ability to distinguish major depression from bipolar disorder (BDI) in a new patient and a severe depression that meets different criteria of some kind. diagnosis. DSM-5 criteria for major depression. It should be noted that, according to the previous edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5 criteria for a major depressive episode are the same for both unipolar depression and bipolar depression.

Is Bipolar And Depression The Same Thing

Is Bipolar And Depression The Same Thing

Epidemiologically, 17% of people in the United States have experienced at least one episode of major mental illness in their lifetime, 1% have been diagnosed with BDI, and up to 4% have been diagnosed with depression. bipolar disorder II (BDII). (In both bipolar I and II, depression is a more depressive state than mania/hypomania.) The prevalence of the disease is actually 50% of patients diagnosed with BID first had major depression (in transition from mania). or hypomania) and often have recurrences of depression without periods of mania or hypomania up to 5 years after the first episode of depression. This often leads to misdiagnosis, which leads to poor treatment.

How To Diagnose Mixed Features Without Overdiagnosing Bipolar

Of the 600 patients diagnosed with bipolar disorder, 69% were initially misdiagnosed, and the most common misdiagnosis was unipolar depression. More importantly, it takes 10 years or more for a third of patients who are initially misdiagnosed to be diagnosed with bipolar disorder.

A similar poor prognosis was observed in a study of children (mean age = 10.3 years) with prepubertal major depression who participated in a clinical trial of nortriptyline for sad childhood.

During a nearly 10-year follow-up (average age = 20.7), 33.3% were later diagnosed with BDI and 48.6% with Bipolar I or Bipolar II or hypomania. The authors concluded, “The change in mood for mania is important in the treatment of prepubertal major depression because of the concern that antidepressants can cause childhood mania.”

This treatment is difficult because the treatment depends on the initial diagnosis. In addition, self-medication of BDI with antidepressants can be harmful in the long term. Increased anxiety, reduced emotional time, less mental stress that leads to negative emotions, and poor response to treatment can be for no BDI diagnosis.

Unipolar Vs. Bipolar Depression

If a person with bipolar depression is treated with an antidepressant, especially without a mood stabilizer (such as lithium or divalproex), there is a risk of worsening the condition. to the manic state. complex characteristics, or a state of depression with complex symptoms, all can be serious and even fatal. In addition, long-term antidepressant treatment in a patient with bipolar disorder can cause depression.

A recent change in the DSM-5 was the removal of the DSM-IV-TR diagnosis of Bipolar I Disorder, Mixed Episode (the category now also meets criteria for depression major and a manic episode lasting at least one week). This has been replaced by new diagnoses called bipolar disorder and unipolar depression

. If the first state with three characters usually corresponds to the state of the plant attack, the complex attribute determinant is defined. There is evidence that major depressive disorder with complex features can be depressive patients who are at risk of transitioning to hypomania or mania during antidepressant treatment.

Is Bipolar And Depression The Same Thing

In a comparison of antidepressant treatment in depressed patients with bipolar disorder, there was no difference between placebo and the addition of an antidepressant to the patient’s primary mood stabilizer , sparking a health debate about whether antidepressants have a role in treatment. . bipolar depression. Although doctors still argue about this, there is a large consensus that antidepressants should be avoided in the treatment of BID. An expert on bipolar depression. Nassir Ghaemi, MD, goes so far as to say, “To know what to do, you need to know what not to do… Don’t use antidepressants. That’s half the battle.” story.”

Differentiating Between Bipolar And Unipolar Depression In Functional And Structural Mri Studies

In addition, none of the US FDA-approved antidepressants for the treatment of unipolar depression (up to 29) is FDA-approved for the treatment of bipolar depression. (Note to clarify: some argue that fluoxetine is recommended for bipolar disorder in combination with olanzapine. However, this argument is invalid because fluoxetine does not is approved as monotherapy.) The first drug approved by the FDA for the treatment of bipolar disorder was obtained. . Depression in 2003 was olanzapine-fluoxetine. The only other medications currently approved by the FDA for the treatment of bipolar disorder are quetiapine (approved in 2006) and lurasidone (approved in 2013). Over the years, double-blind/placebo-controlled trials of other agents have failed, highlighting the complexities of treating bipolar disorder.

When a new patient presents for treatment for major depression, it is important to take the time for a clinical consultation to obtain a history that can help differentiate between bipolar depression from unipolar depression. It may be easier to distinguish BDI depression from unipolar depression if the patient (or their family/guardian/caregiver) has a clear history or if they can provide detailed medical information about the pain. If the patient has a history of mania or manic episodes with mixed features, a diagnosis of BDI can be made and antidepressants removed. Unfortunately, obtaining a true and accurate psychological history can be difficult for many reasons. In addition, patients do not see episodes of hypomania as a problem (in fact, patients may experience hypomania as a productive and satisfying state). This causes the notifications to disappear.

Although difficult, a psychological evaluation is necessary and should include: family history (especially first-degree relatives), details of past experiences medical history, past medical treatment that may show unmasked symptoms of mania or hypomania, and have previously reported. Drug use, results of previous treatment with antidepressants (eg, for previously treated depression, anxiety, premenstrual dysphoric disorder, obsessive compulsive disorder problems, post-traumatic stress disorder, or other diseases). Similarly, taking an additional history from a friend, family member, or friend can provide more information about what the underlying mental disorder may be and help with clinical trials.

The Mood Disorder Questionnaire (MDQ) developed by Hirschfeld and colleagues 5 can be used as a diagnostic tool and should be given to patients with depression to assess the occurrence of previous events. manic or hypomanic episodes. The MDQ consists of 13 questions derived from the DSM-IV criteria for bipolar disorder and treatment. If the patient answers seven or more “yes”, then there may be a post-manic or hypomanic episode if several “yes” symptoms appear together and cause depression Lungs at least. The MDQ was validated in a study of 198 patients treated in psychiatric hospitals, and analysis showed that patients who answered 7 or more “yes” had a sensitivity of 0.73 and a specificity of 0.90 to identify patients with bipolar disorder.

When Your Loved One Has Bipolar Disorder

Thus, although the MDQ does not diagnose mental disorders, it can help the clinician assess how to conduct clinical interviews.

A new study has found that getting a good family history is important. This study6 was designed to identify factors that predict the transition from unipolar depression to bipolar depression and followed 91,587 Danish patients diagnosed with unipolar depression between 1995 and 2016. Parental history of bipolar disorder is the strongest source of transmission.

If the psychiatric history has previously revealed mania, mania with mixed features, or major hypomania, the current major depression should be treated as BDI depression and antidepressants should be avoided. The BDI is difficult to distinguish from unipolar depression unless the patient has undergone a manic/hypomanic episode.

Is Bipolar And Depression The Same Thing

Over the past two decades, researchers have been trying to identify additional risk factors that may inform more of the criteria for a diagnosis of unipolar depression, or BDI. The table lists risk factors that may support the BDI diagnosis of depression over unipolar depression. However, it is important to remember that one of these risks is not a diagnosis of bipolar disorder.

Bipolar Ii Disorder

Finally, the decision to treat a patient with DSM-5 major depressive disorder as BDI depression versus unipolar depression is made after considering all available information at the outset. treat. It is necessary to consider the severity index, which includes information about the diagnosis of bipolar disorder on the one hand, and BDI depression on the other. Later on

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