Bipolar Disorder.html

Bipolar Disorder

Bipolar and related disorders is an umbrella category in the DSM-5. Under this umbrella, individuals could be diagnosed with disorders such as bipolar I disorder, bipolar II disorder, and cyclothymic disorder. As noted in the last week’s lesson, a defining distinction between depression (i.e., unipolar disorder) and bipolar is the presence of manic episodes. Additionally, individuals with bipolar could also experience hypomanic or mixed mood episodes. The average age of onset for bipolar disorders is twenty-five, but it can also occur earlier. The lifetime prevalence for bipolar disorders in adults in the U.S. is estimated at 4%, which is nearly double the prevalence rate worldwide. Bipolar I disorder has equal prevalence rate in men and women, but bipolar II disorder is slightly more common in women. Bipolar disorders are more common in people who have biological relatives with mood disorders (U.S. Department of Health and Human Services, National Institute of Mental Health, 2016).

Older people with bipolar disorders tend to have increased motor symptoms such as changes in how they walk and exhibit reflexes. However, they are frequently misdiagnosed with dementia. They are also more likely to have mixed mood episodes.

Bipolar I disorder equally affects men and women. The first episode for men, however, is more likely to be manic with subsequent episodes rotating between manic and major depressive. The first episode for women is more likely to be major depressive with subsequent episodes also more frequently being major depressive episodes. Women are more likely to have rapid cycling of episodes.

There is no evidence that there are any differences in prevalence for bipolar disorders based on race and ethnicity. However, people from some ethnic groups are more likely to be misdiagnosed with other disorders such as schizophrenia or schizoaffective disorder.

Reference:

U.S. Department of Health and Human Services, National Institute of Mental Health. (2016). Bipolar disorder. Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

Comorbidity.html

Comorbidity

Comorbidity refers to the coexistence of at least two different disorders in the same individual. Research findings also indicate that 15%–25% of outpatients suffering from an anxiety disorder have a history of alcohol dependence. Research has found that substance dependence is the most common co-occurring disorder in war veterans with Post-Traumatic Stress Disorder (PTSD). It has also been observed that many individuals who experience chronic anxiety often meet many of the criteria for major depression disorder and panic disorder.

Unipolar and bipolar depression are also subject to comorbidity, such as substance use disorder. For example, people with bipolar disorders who use alcohol and other drugs are more likely to be hospitalized and have more difficulty controlling their symptoms. If a person has his or her first manic episode after the age of forty, then substance use or a general medical condition should be suspected first instead of a bipolar disorder.

Comorbidity may complicate the treatment of disorders. For example, a person addicted to drugs might also be suffering with other mental illnesses at the same time; this comorbid presentation can cause problems when developing a treatment plan, as it is imperative to consider the correlation between the substance use disorder and the mental health disorder.

Unipolar Depression.html

Unipolar Depression

Unipolar depression is the umbrella category of depressive disorders. The defining feature of a unipolar disorder, as opposed to a bipolar disorder, is the marked absence of manic episodes. In the DSM-5, unipolar depression falls under the chapter of Depressive Disorders, some of which includes disruptive mood dysregulation disorder, major depressive disorder, and persistent depressive disorder (dysthymia).

Unipolar depression may be accompanied by panic attacks or other anxiety disorder symptoms including separation anxiety in children. Depression can also be influenced or caused by drug/medications as well as a medical condition.

Unipolar depression is also correlated with sleep apnea. Some people have also found that when sleep apnea is treated, their depression goes into remission. Similarly, some people who receive bariatric surgery for obesity also achieve remission of their depression symptoms.

Children with depression are more likely to demonstrate irritability and anger, as well as impulsivity and hyperactivity. Adolescents with depression tend to demonstrate more anger than sadness as well as impulsivity but less hyperactivity.

Elderly adults have higher risks of depressive symptoms related to grief (due to increased frequency of losses) and medical conditions. These symptoms (e.g., memory lapse, diminished problem solving) may be difficult to distinguish from those related to dementia.

Women are diagnosed with depression more often than men. Moreover, men are more likely to express anger or irritability than sadness as well as fatigue and loss of interest in pleasurable activities.

Some cultures describe depressive symptoms in the form of body complaints. For example, Latino and Mediterranean cultures may complain headaches or problems with “nerves.” Fatigue or “imbalance” may be frequent complaints of many Asian cultures.