Unipolar and Bipolar Disorders, Essay Example

Most humans feel sadness, helplessness and are unwilling to do anything at some moments of their lives. These feelings are normal for a human being, but when gloomy mood persists for a prolonged period, and gets in the way with the person’s normal life course, there might be medical reasons for this condition. Depression might be a symptom of different illnesses. Therefore, the patient with the symptoms of depression should be examined by a licensed mental health practitioner in order to determine the type of disorder. For instance, unipolar depression and bipolar disorder in its depressive episode can be mistaken for each other. This paper focuses on exploring the differences between unipolar and bipolar disorders, their courses, causes, and types of treatment.

The main difference between unipolar and bipolar disorder is the presence of manic, hypomanic or mixed episodes; their presence is needed in order to diagnose bipolar disorder (American Psychiatric Association (APA), 2000, p.375). In other words, while unipolar depression is characterized by the prevalence of depressive episodes, any type of bipolar disorder can be diagnosed only provided any episode of maniacal behavior was observed. A person, who suffers from bipolar disorder of any type, has to get through a series of depressive and maniac (or hypomanic, or mixed) episodes. Though the symptoms of depression in the course of unipolar and bipolar disorders might look alike, there are significant differences between these conditions.

Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) provides specific criteria for diagnosing depression. These are:

1. depressive mood most of the day, nearly every day;
2. diminished interest or pleasure in all;
3. insomnia and hypersomnia;
4. significant weight lost or gain when not dieting;
5. psychomotor agitation or retardation nearly every day;
6. fatigue or loss of energy nearly every day;
7. feelings of worthlessness or excessive or inappropriate guilt;
8. diminished ability to think or concentrate, or indecisiveness;
9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation, or a suicide attempt (APA, 2000, p. 356).

Nevertheless, there are differences between the courses of depression episodes in unipolar and bipolar disorders. Unipolar depression tends to affect women more often than men, while bipolar one affects the representatives of both genders with equal frequency. Unipolar depression starts later in life than bipolar. Insomnia, which is a characteristic feature of unipolar depression, makes it difficult for the patient to fall asleep, and makes him walk repeatedly during the night. At the same time, bipolar depression is more frequently characterized with hypersomnia, difficulty waking up and fatigue through the course of the day. Patients, who suffer from unipolar depression, complain that their interest in eating is diminished, while bipolar individuals often suffer from binge eating, which may alternate with the loss of appetite. Unipolar depression is often accompanied with feelings of agitation and restlessness; bipolar disorder is better characterized by psychomotor retardation, somnolence and inactivity. People, diagnosed with unipolar depression often feel hopelessness, sadness, and feel worthless, while bipolar patients feel guilty more often. Specialists observe that bipolar disorder increases the risk of indulging in drug abuse and suicide; it is less responsive to treatment in comparison with unipolar disorder. At the same time, unipolar disorder episodes tend to last longer (“Unipolar vs. bipolar”).

The question about the causes of depression still remains one of the psychiatric mysteries of our times. There are studies that prove that unipolar depression may be caused by stress, by the loss of the loved one, or some tragic incident. Furthermore, sometimes depression might be provoked by biochemical reasons, like the lack of melatonin, low levels of serotonin and norepinephrine, or increase in cortisol level (Stier, 2009). The authors of DSM-IV indicate that unipolar depression is from 1.5 to 3 times more common in people, whose first-degree biological relatives suffered from it, and name substance abuse and divorce as some other factors that may precipitate depression (APA, 2000, p.372).

The biochemistry of depressive episodes in the course of bipolar disorder is basically the same to that of the unipolar depression. Bipolar disorder might also be inherited (American Psychiatric Association, 2000, 386). Depressive episode might be caused by stress, or biochemical imbalance, but in some time depression is usually replaced by maniac or hypermaniac episode, which is characterized by the high amounts of norepinephrine, provoking anxiety and euphoria (Stier, 2009).

The approaches towards treating unipolar and bipolar disorders are different. Unipolar depression is typically treated by antidepressants. There are three groups of these drugs, which are used nowadays. These are Serotonin Reuptake Inhibitors, Tricyclics and Monoamine Oxidase Inhibitors. Unipolar depression is also often responsive to non-substance therapies, such as individual counseling sessions, groupwork, behavioral therapy, different methods of art-therapy etc. Bipolar disorder is harder to treat, as it is most responsive to Lithium therapy and ant-seizure drugs. Stier indicates that treatment is usually inefficient apart from drugs, but their combination might be highly effective. He states that individual, family and group therapy might be helpful in treating bipolar disorder (2009).

It is clear that, though depression caused by unipolar disorder differs from bipolar depression episode, they can easily be mistaken for one another. Therefore, diagnosing a patient requires considerable proficiency, knowledge and experience from the mental health practitioner. Nevertheless, depression, both unipolar and bipolar, is, in most cases treatable; therefore, timely diagnosis and accurate treatment plan may allow an individual return to the normal course of life in comparably short terms.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.

Ketcham, Sandra. Unipolar vs. bipolar depression. Retrieved from: http://www.angelfire.com/home/bphoenix1/uni.html

Stier, A. (2009, Jul.30). Unipolar & bipolar depression. Retrieved from: http://www.associatedcontent.com/article/2005028/unipolar_bipolar_depression_pg3.html?cat=5