Question

15. Carefully distinguish between bipolar I disorder, major depressive disorder and persistent depressive disorder. Highlight the characteristics that they share in common and those that are unique to each. How did the videos shown in class depict the features you describe? What types of medications would you prescribe (if any) for each of these disorders.

Answer 1

Bipolar Disorder I

At least one episode of mania (extreme inappropriate elevated mood, usually alternating with major depressive episodes)

Major depressive disorder

In case of children and adolescents, irritable mood may be observed. 5 or more of 9 symptoms (with at least one of which consists of depressed mood or loss of interest in pleasure) must persist in the same two week period in order to be diagnosed with this disorder.

• Depressed mood (subjective or observed)
• Loss of interest in activities of pleasure
• Change in weight or appetite
• Insomnia or hypersomnia (too little or too much sleep)
• Psychomotor retardation or agitation
• Loss of energy or fatigue
• Feelings of worthlessness or guilt
• Impaired concentration
• Thoughts of death or suicidal ideation

Persistent depressive disorder (in case of children and adolescents mood can be irritable and duration must be one year or longer)

• Depressed mood for most of the day, more often than not for two years or longer

Presence of two or more of the following:

• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self esteem
• Impaired concentration
• Hopelessness

The individual is never without symptoms for more than 2 months.

As mentioned above, bipolar disorder considers of an individual juggling between different states of affect. This consists of either a manic state where inappropriate expression of happiness and elevation without any apparent reason are observed versus a major depressive episode which is marked by feelings of worthlessness, prolonged sadness, loss of interest, etc.). In this manner, the characteristics of the major depressive episode overlap with the other two disorders in terms of the nature of symptoms. However, the distinguishing factor is the fact that in the other two, a manic state (state of elevated mood) may not be observed. Major depressive disorder and Persistent depressive disorder are mostly similar as it can be seen through the symptoms that the two include. However, in case of a persistent depressive disorder, the symptoms need to be more prolonged (2 years) versus a major depressive one wherein the symptoms need to be observable within a 2 week period for a person to be diagnosed. In case of bipolar disorder lithium is suggested to patients. The medicines comprise of mood stabilisers versus in depression they are primarily given anti depressants. SSRIs like Prozac are provided to patients with depression.