Tanya Battiwalla
While it is said that mood
disorders are diverse in nature, they often have overlapping symptoms. These
overlapping symptoms act as a blurry line between the disorders, making it
difficult to diagnose the patient. This blog will discuss a few types of mood
disorders and some of their symptoms, and will explore the aspect of
overlapping symptoms leading to the difficulty in diagnosing.
Mood disturbances commonly involve
a depressive episode and/or a manic episode. In the former, a person has
markedly low mood and might have negative thoughts or feelings. They experience a loss of interest in pleasurable activities, and possible changes in their
eating and sleeping habits. In manic episodes, an individual may show symptoms
such as elevated and euphoric mood. They may have outbursts of extreme
irritability or violence when someone goes against their plans or desires.
Other symptoms might include inflated self-esteem and high productivity.
(Butcher, 2017)
One of the sub-parts of unipolar
depressive disorder is major depressive disorder. The requirement for this
specific diagnosis is that the patient should have never had a manic,
hypomanic, or mixed episode and must be in a major depressive episode. Other
forms of depression are persistent depressive disorder, loss and grieving, and
postpartum blues. Persistent depressive disorder is when the depressive episode
lasts for more than two years and depressed mood is experienced for most part
of the day on most days. While grieving is a process that takes place when a loved
one dies, postpartum blues may set in when a woman gives birth to a child.
(Butcher, 2017)
Unlike unipolar disorders, bipolar
disorders include the occurrence of manic or hypomanic episodes, usually
preceded or followed by periods of depression. Bipolar disorders are divided
into two categories- Bipolar I Disorder and Bipolar II Disorder. Bipolar I
disorder may include a mixed episode when an individual experiences symptoms on
both extremes (example- depressed mood, anxiety, guilt) intermixed or alternating
rapidly. According to the book Abnormal Psychology (2017), when a patient has only experienced manic
episode, Bipolar I Disorder is assumed and it is understood that the depressive
episode will eventually occur. Bipolar
II Disorder can be distinguished from this in the aspect that it does not
involve a full-blown manic episode. It consists of clear cut hypomanic and
depressive episodes. (Butcher, 2017)
It is found that the symptoms of
the depressive episode of the Bipolar Disorder highly overlap with the symptoms
of Major Depressive Disorder. Studies suggested that some patients
diagnosed with MDD are also found to have symptoms of hypomania (a much milder
form of Bipolar disorder) which may later qualify them to be diagnosed with
bipolar disorder. (Butcher, 2017) Comorbidity is a term used to describe the
presence of two or more disorders in an individual. Therefore, in certain cases
it can be very difficult to know if there is a presence of comorbidity or if
the individual is presenting overlapping symptoms (of different disorders). It
is often also difficult to separate comorbidity from overlapping symptoms; and can
lead to the wrong diagnosis. An example of this could be a study done by Udal
(2014)- To test the high rates reported for comorbidity between bipolar disorder
and attention deficit hyperactivity disorder, they compared questionnaire-based
and neuropsychological measures of inattention and impulsivity/hyperactivity,
in children/adolescents with ADHD. They then performed analysis on bipolar
disorder with and without inattention as a measure. The study’s results showed
that patients with ADHD showed neuropsychological impairment which were not
present in patients with bipolar disorder, suggesting that comorbidity is not present here. According to the book Abnormal Psychology (2017), there is a high
degree of overlap between the measures of symptoms of depression and anxiety as
well, and there is high comorbidity between them. Brenner (2018) says that when
certain symptoms are left unnoticed, a misdiagnosis can take place since
certain disorders have common symptoms and missing out on symptoms which
differentiate the disorders can lead to the wrong decision. He also thinks that
disorders can present themselves in numerous ways which can also lead to a
wrong diagnosis because of the similarity in symptoms (example- cPTSD could be
mistaken for an anxiety disorder).
Therefore, one can observe how
comorbidity and the overlapping of symptoms makes diagnosis of mental illness a
lot more difficult and trickier. While there is a possibility for two or more
disorders to be present, it is also possible that the overlapping symptoms in disorders lead to
a wrong conclusion. A wrong diagnosis will not help the patient and may even
deteriorate their mental health further.
Work Cited:
Brenner, Grant Hillary. 2018. 6
Reasons for Common Psych Diagnostic Mistakes. Psychology Today.
Retrieved from
https://www.psychologytoday.com/us/blog/experimentations/201805/6-reasons-common-psych-diagnostic-mistakes
Butcher, James N. Abnormal Psychology
(2017).
Udal, AH. 2014. Differentiating
between comorbidity and symptom overlap in ADHD and early onset bipolar disorder.
Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24854771
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