Distinctions between bipolar and depressive disorders


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Distinctions between Bipolar and Depressive Disorders. Want Online Help?

Bipolar and depressive disorders are both mood disorders but differ in key characteristics.

Bipolar Disorders:

Bipolar I Disorder: Characterized by manic episodes lasting at least 7 days or requiring hospital care. Depressive episodes may occur but aren't necessary for diagnosis (American Psychiatric Association, 2022).

Bipolar II Disorder: Involves depressive and hypomanic episodes but not full-blown manic episodes (American Psychiatric Association, 2022).

Cyclothymia Disorder: Features periods of hypomanic and depressive symptoms lasting at least 2 years, but not meeting full criteria for either (American Psychiatric Association, 2022).

Depressive Disorders:

Major Depressive Disorder (MDD): Persistent low mood for at least two weeks, without mania or hypomania (American Psychiatric Association, 2022).

Persistent Depressive Disorder (PDD): Chronic, mild depression lasting at least two years (American Psychiatric Association, 2022).

Disruptive Mood Dysregulation Disorder (DMDD): Severe temper outbursts in children, with a consistently irritable mood (American Psychiatric Association, 2022).

Impact of Misdiagnosis

To the Client:

Misdiagnosis may lead to treatment delays and ineffective coping strategies, potentially exacerbating symptoms (American Psychiatric Association, 2022).

Misunderstanding the condition may cause frustration, confusion, or stigma (American Psychiatric Association, 2022).

To the Agency:

Resources may be misallocated, impacting the quality of care (American Psychiatric Association, 2022).

Lack of appropriate staff training or protocols can hinder effective treatment (American Psychiatric Association, 2022).

To the Insurance Provider:

Increased costs due to inappropriate treatments (American Psychiatric Association, 2022).

Difficulty processing claims for misdiagnosed conditions (American Psychiatric Association, 2022).

Use of "Other Specified" and "Unspecified" Diagnoses

Other Specified Diagnosis: Used when symptoms don't fully match a specific disorder but can be addressed with tailored treatment (American Psychiatric Association, 2022).

Unspecified Diagnosis: Used when there is insufficient information for a specific diagnosis, potentially delaying treatment (American Psychiatric Association, 2022).

Specifier "With Anxious Distress"

Definition: Used when anxiety significantly co-occurs with a mood disorder, impacting treatment decisions (American Psychiatric Association, 2022).

Impact on the Client: Accurate recognition of this specifier allows for better treatment planning, addressing both mood and anxiety symptoms (American Psychiatric Association, 2022).

References:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

American Psychiatric Association. (2022). DSM-5-TR online assessment measures.

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Identify the distinctions between key characteristics for the diagnosis of bipolar and depressive disorders.

Depressive disorders are characterized by a depressive mood (i.e., feeling sad or hopeless) lasting most of the day (American Psychiatric Association, 2022). The individual has little pleasure in daily activities, fatigue, and weight loss or gain (American Psychiatric Association, 2022). The individual also may suffer from insomnia, thoughts of worthlessness and death, and lose their ability to concentrate.  While bipolar disorders can have major depressive episodes, their condition is distinct in the occurrence of a manic episode. A manic episode is a period of abnormally and persistently elevated or irritable mood and an increased level of activity that lasts a minimum of one week. During this period, there is a decreased need for sleep and inflated self-esteem (American Psychiatric Association, 2022). They become more talkative and involved in activities that can have painful consequences (American Psychiatric Association, 2022).

Explain the impact of misdiagnosis from a lack of understanding of these distinctions, including to the client, to the agency, or to an insurance provider.

Misdiagnosis for the client could mean that they are not receiving proper treatment, such as medication, to allow them to lead a functional and healthy lifestyle. Bipolar II can mimic depression since the patient has been in the depression episode for an extensive time, so the misdiagnosis would be the patient beginning to increase their thoughts of hopelessness if their depression medications aren't working (American Psychiatric Association, 2022). They feel the chances of them enjoying life are hopeless. It is this misdiagnosis that could account for the one-third of the population with bipolar II who report a lifetime of suicide attempts because they believe they will forever be stuck in a life of sadness and hopelessness (American Psychiatric Association, 2022).

Explain when you would use "other specified" and "unspecified" when diagnosing mental disorders. Explain the impact to the client.

The use of "unspecified" or "other specified" during diagnostics can fail to provide the patient with an explanation of what is happening to them. When a professional uses unspecified, it's because they do not feel they have received enough history from the patient to make a solid diagnosis (American Psychiatric Association, 2022). In this scenario, it is most likely that the patient would need to speak with a clinician to provide more information so that a diagnosis can be completed. For the "unspecified" diagnosis, the patient is showing signs of the disorders but has not met the full criteria, this could be that perhaps the patient is developing or in the beginning stages of expressing the disorder and has caught it early.

Explain the specifier "with anxious distress and when you would use it."

This specifier is used when two or more anxiety symptoms are present during the majority of the days during a manic or depression episode. This is important to note because higher anxiety levels have been associated with higher risks of suicide (American Psychiatric Association, 2022).  This specifier is associated with both bipolar and depression disorders.

References:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (DSM-5-TR) (5th ed., text rev.).

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