People with bipolar disorder classically have cycles of depression alternating with euphoric/irritable mood states (called mania). There are many disorders of mood in addition to depressive disorders. Some of these mood disorders are:
A manic episode is understood to be a period of euphoric and/or irritable mood that lasts at least 4 days; it's characterized by a decreased need for sleep, racing thoughts, the need to keep speaking, inflated selfesteem or grandiose thinking, and excess goaldirected activities. Exactly the same group of symptoms also defines a hypomanic episode, but the severity is judged to be less. Individuals in the midst of a manic episode can become psychotic and require hospitalization.
In bipolar I disorder, the person must have past a minimum of one manic episode. The number of depressive episodes can be as few as none to any amount. Classically, an afflicted person alternates between episodes with normal mood in between. However, cycles can consist of any frequency of mood states in any order. Bipolar II disorder is composed of depressive episodes alternating with hypomanic episodes only (no mania).
In cyclothymia, no major depressive episode has occurred, but mild depressive episodes alternate with hypomanic states. Mood disorder not otherwise specified is also a condition of exclusion in that a mood disorder is recognized as present, but the criteria have not been met for that other conditions in the DSM-IVTR.
In someone presenting with depression, these conditions are only able to be excluded by a thorough good reputation for symptoms and episodes in the past. Sometimes the patient doesn't recall such episodes, however, such that a bipolar condition is not learned of before treatment for depression is initiated.
Mood swings in many cases are regarded as synonymous with having manic depression. The existence of "mood swings," however, is not enough to determine that a person is manic depressive. Many depressed persons might have ups and downs in their mood. The distinction is essential because manic depression is yet another name for any condition called bipolar disorder, and depression in bipolar disorder is treated differently than in major depression.
Bipolar disorder is less frequent than major despression symptoms, occurring in approximately 1% from the population. It is also more closely related to family background and, in general, is really a more certain illness. Bipolar depression is different from major depression in that the individual has to have experienced a minimum of one manic or hypomanic episode in his / her lifetime.
Although experiencing mania or hypomania is usually referred to as having "mood swings," there are specific criteria to define these mood states. Moodiness can mean many things to many people - from constant crying to installments of irritability or anger. Recent studies have also determined that the symptoms accompanying major despression symptoms may vary dramatically with time. Such variability can be misinterpreted as "mood swings."
Manic or hypomanic episodes are strictly characterized by a low need for sleep (different then insomnia), inflated self-esteem (grandiosity), rapid and pressured speech (the need to keep talking), euphoric mood, and increased activity level. Duration criteria are required to make diagnosing as well.
It is necessary that the strict criteria are used because depression alone could be a cause for irritability and anger management problems, each of which look like moodiness. Once it is determined that a manic or hypomanic episode has occurred in the past, then the diagnosis must reflect that, as the treatment approach may be various and different risks are related to taking antidepressants.
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