The Diagnosis and Treatment of Bipolar Disorder Versus Unipolar Depression

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The Diagnosis and Treatment of Bipolar Disorder Versus Unipolar Depression

Bipolar disorder is a serious mental disorder, but unfortunately our collective knowledge of this mental illness is not extensive. Unlike depression, where patients are strictly sullen and deeply blue, the bipolar patient experiences that same depression only flanked by extreme highs—a hyperactivity and increase in serotonin. It is this inconsistency in mood—a clinical mood swinging, that makes bipolar disorder so difficult to diagnose. Difficulty, as will be discussed in the paper, comes from patients inability to recognize these highs as potentially troublesome, and instead opt to focus only on the depressed moods that follow. Conventional thought, after all, is
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Viewing the serotonin (as well as other neurotransmitters directly responsible for mood such as endorphins, and dopamine) levels of a bipolar patient will often resemble a sine curve—with consistent crests and troughs, and an episode refers to one crest or trough on the curve. Bipolar I disorder is similar to bipolar II, but patients typically alternate between mania and depression, rather than elevated mood (hypomania) of bipolar II. The bipolar patient typically suffers multiple episodes over the course of a year, each usually lasting three to six months (Kessler 1994). If more than four episodes occur within a 12-month period, the patient is said to be in ‘rapid-cycling’ (Coryell 2003).

The manic, episodic nature of bipolar disorder has made difficult for primary care doctors to diagnose and understand. A 2000 study validates this point—69% of respondents with bipolar disorder were considered previously misdiagnosed (Hirschfield 2003). The study would go on to reveal that average bipolar patient receives on average, three and half wrong diagnoses before being correctly identified as bipolar. While as humans we tend to be cognizant of when we are depressed and understand that it is good to go to clinician for this, we are less aware that…