Depression: Major Depression & Unipolar Varieties

Formal DSM Diagnoses for Other Depressive Mood Disorders

Rashmi Nemade, Ph.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

As mentioned in our introduction to this article, we are primarily focusing our discussion on Major Depression. However, we also want to take some time to briefly discuss some other disorders that can share symptoms with Major Depression: Bipolar Disorders, Dysthymic Disorder, Depressive Disorder Not Otherwise Specified, Mood Disorder Not Otherwise Specified, Adjustment Disorder With Depressed Mood, and Adjustment Disorder with Mixed Anxiety and Depressed Mood.

As you can tell by the length of the above list of disorders, determining which of these diagnoses best describes a person's particular collection of depression symptoms can be tricky. At times, clinicians must "play detective" as they try to piece together an explanation for why someone feels down in the dumps. You may wonder why a mental health professional spends so much time and effort coming up with a specific label. After all, people who have depressive symptoms feel crummy, and have some degree of impairment that negatively impacts their ability to function in their daily lives.

A correct diagnostic label can help a therapist narrow down the treatment options, and subsequently, get someone on the road to recovery more quickly. A medical analogy may be helpful here. There is a wide array of reasons that someone can develop a fever (e.g., cold, strep throat, cancer, rheumatoid arthritis), so a physician must spend some time determining the exact cause of the symptoms in order to prescribe the appropriate treatment. Obviously, the treatments for a cold and cancer are very different; so pinpointing the diagnosis is important. Similarly, there are a host of reasons why someone develops depressive symptoms. Finding out the cause (and the best treatment) is no less important when it comes to treating a mood disorder. We'll talk about the strategies used to come up with the best diagnosis in a later section of this paper.

Bipolar Disorder

Unlike Unipolar Depression, in Bipolar Disorder, people swing between low and high extreme, severe, and sustained energy levels and moods. Bipolar Disorder, also known as manic-depressive illness, is a serious mood disorder primarily caused by biochemical imbalances in the brain. The low energy phase of Bipolar Disorder consists of Major Depressive Episodes (just as in Unipolar Depression), while the high-energy phase consists of Manic Episodes (Click here to return to our earlier discussion of mood episodes.) The typical person with Bipolar Disorder switches back and forth between episodes of depression and mania every few months, in a process referred to as cycling.

In the United States, about 2 million adults (roughly 1% of the adult population) suffer from some form of bipolar disorder. The disorder typically develops in late adolescence or early adulthood (usually around age 20). Bipolar mood swings can damage relationships, impair job or school performance, and even result in suicide. Bipolar and Unipolar depressive disorders typically require different treatment strategies, therefore, it is important to correctly distinguish between the two disorders. (For more information on Bipolar Disorder, click here to read our article)

 




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