Mail box replies

The question was submitted 10/22/2008

Subject: Will depression lead to manic depression?

I've always wanted to know whether depression and manic depression are 2 different/unrelated mood disorders, and whether a patient suffering from depression (non-manic) will evolved into a manic-depressed patient.

In relation to that, how is the "rollercoaster of emotions" a depressed patient goes through (i.e. on somedays the patient is able to function normally and on somedays the patient can't) different from the mood-swings a manic-depressed patient goes through.

Answer from DepNet

Your first question is whether there are differences between depressive disorder (presence of low mood without the highs) and bipolar disorder (characterized by moods that alternate between highs i.e. manic and lows i.e. depression). Most patients with Bipolar Disorder will experience many more depressive than manic episodes throughout the course of their illness.

The SYMPTOMS of depression in bipolar depression are exactly the SAME as for the depressive disorder. These symptoms are present for at least 2 weeks and include the followings:
1) Loss of interest
2) Sleep disturbances
3) Appetite disturbances
4) Prolonged feelings of sadness/depressed mood
5) Poor concentration and attention
6) Guilt feelings or feelings of worthlessness and hopelessness
7) Feeling tired easily
8) Thoughts of death/suicide or suicide attempts
9) Psychomotor agitation and retardation

About 5 to 10% of patients with Depressive Disorder (single episode) subsequently develop a manic episode (the diagnosis is then revised to that of Bipolar Disorder). Some data suggest that acute/sudden onset of severe depression, especially if accompanied by psychotic features and psychomotor retardation in a young person is more likely to predict a bipolar course. Also, a family history of Bipolar Disorder may also suggest subsequent development of Bipolar Disorder.

Mildly depressed patients generally are still able to continue with their daily functioning. However some depressed patients may feel irritable and appear agitated (Agitated Depression). These symptoms are different from the symptoms of mania whereby the patients feel unusually happy, energetic and active but at the same times complain of feeling easily irritated.

Regards,

Depnet

The answer was published on DepNet 10/25/2008