June 29, 2005

Is Unipolar Part Bipolar?

Unipolar depression has long been looked at as a separate form of depression than bipolar disorder. But recent studies have shown that those who have unipolar depression often have symptoms that are more than just unipolar. Depending on the criteria used, some of those who have unipolar depression could be considered to have bipolar symptoms.

"Dr Angst and colleagues used three criteria for bipolar II, the DSM-IV (which mandates at least three hypomanic symptoms, four if irritable, over at lest four days), a "strict" Zurich criteria (which lowered the symptom threshold to three over one day) and a "broad" criteria which dropped the symptom requirement to two over one day. Using the DSM criteria yielded a finding of 7.4 percent bipolar IIs in a depressed population. On the Zurich strict criteria, the figure shot up to 23.7, and for the broad criteria – get ready – 49.2 percent. In other words, nearly half of a so-called unipolar population exhibited symptoms that were more than just unipolar" (McManamy, 2005).

Emil Kraepelin described mixed states and hypomania almost a century ago. Kraepelin also did not distinguish between unipolar and bipolar depression. At the Sixth International Conference on Bipolar Disorder this question was discussed and the validity of separating unipolar from bipolar was mentioned.

Different studies have confirmed that many people with unipolar depression have symptoms of bipolar disorder, which makes one wonder, how different are the two? Unipolar and bipolar depression are often "misdiagnosed." People who are diagnosed with bipolar disorder have in the past been misdiagnosed as unipolar, and those with unipolar depression were at one point thought to be bipolar. Despite these findings the next DSM will probably tighten the definition of bipolar disorder rather than broaden it. But who knows, we might see a Bipolar III disorder in the future.

The source of this article was McMan's Depression and Bipolar Web which you can reach at: http://www.mcmanweb.com/


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