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Overlapping Symptoms and the Diagnosis of Mood Disorders


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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