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Written by Coy Stoker
University of Phoenix
August, 2008

Depression

Introduction

In the United States some form of depression affects upwards of 10 percent of the population in any given year; whereas, only about 1 percent of adults worldwide are affected by bipolar disorders in the same timeframe (Nevid & Rathus, 2005). Unipolar depression and bipolar disorder affect people from all socioeconomic, religious, and ethnic backgrounds, from all corners of the globe. Both disorders are indiscriminate obstructions to normal psychological wellbeing and given the prevalence of the disorders in the world, a more thorough understanding of the causes, symptoms, treatments, and differences between unipolar and bipolar disorders would logically be advantageous.

Unipolar Depression According to the DSM-IV handbook depression is characterized as, ".a period marked by at least five symptoms of depression and lasting for two weeks or more" (Nevid & Rathus, 2005, 197). The symptoms related to depression are usually grouped into five areas of human operation: behavioral, cognitive, motivational, and emotional. The motivational aspects of unipolar depression include suicidal thoughts and a lack of drive to pursue normal, everyday activities; while, the cognitive and behavioral facets of depression are exhibited as a tendency to hold extremely negative views about oneself and a propensity towards less active, less productive lives. Lastly, the emotional component of depression plays itself out as feelings of sadness, dejection, and crying spells. Furthermore, during extreme forms of depression a person might hallucinate, have delusions, or lose touch with reality. Even though the symptoms of depression are pretty straightforward, discovering the underlying causes in the aftermath of the disorder is not so clear-cut. However, the causal factors of childhood sexual abuse, stressful life events, negative automatic thinking, chemical imbalances in the brain, an inherited genetic predisposition, instances of imagined loss, a persistent lack of positive rewards, and a lack of social support are implicated in the development of unipolar depression (Nevid & Rathus, 2005; Abramson et al., 2006). Moreover, several studies have concluded that an "affectionless control" parenting style and negative inferential feedback (global, stable attributes, and negative consequences) contribute significantly to the development of depression later on in life (Abramson et al., 2006). As it turns out, the most effective treatments for unipolar depression are cognitive therapy, drug therapy, electroconvulsive therapy (ECT), and interpersonal psychotherapy (IPT). Yet, due to excessive side-effects ECT is only used in extreme cases of depression and non-adherence to antidepressant medication ranges from 10 to 60% (Lingam & Scott, 2002). In a nutshell, depression develops through a complex interaction between nature and nurture, and can be adequately treated through therapy, antidepressants, or ECT.

Bipolar Disorder

Bipolar disorder is characterized by bouts of major depression coupled with manic episodes of unusually high or irritable moods that last more than a week (Nevid & Rathus, 2005). The symptoms of the manic stage of bipolar disorder range from the mildly disruptive to life-threatening and include: active, powerful emotions, irritability, anger, euphoric joy, and talking rapidly and loudly. In extreme cases of mania a person can even lose touch with reality or have trouble remaining coherent. What's more, it is believed that mania is caused by an inherent genetic predisposition coupled with a chemical imbalance in the brain. Those that suffer from bipolar disorders have been shown to possess an abnormality in the proteins that aid in the transport of ions through the neuronal membrane. Additionally, the use of lithium as a mood stabilizer has greatly improved the treatment options for those that suffer from bipolar disorders. Lithium works through some yet unknown inter-neuronal mechanism that may remedy the abnormality that is thought to lead to this disorder. However, lithium does carry quite a few side-effects if the dosage prescribe by the clinician is too much or not enough. In fact, the side-effects are so severe that sometimes the effectiveness of the drug itself is inhibited by the client's fear of the side-effects (Lingam & Scott, 2002). Psychotherapy is sometimes used in conjunction with the lithium therapy in order to address problems related to their disorder. All told, bipolar disorder is characterized by extended bouts with depression and mania and in most cases can be effectively managed through the use of lithium and therapy.

Differences and Conclusion

The differences between unipolar depression and bipolar disorder are varied and complex, surprisingly enough considering that depression is actually one stage of bipolar disorder. For example, the antidepressant drugs that helped those suffering from unipolar depression are of little help to those afflicted with bipolar disorders. In fact, there is some evidence that antidepressants can actually cause manic episodes in cases of bipolar disorder (Nevid & Rathus, 2005). In conclusion, both unipolar depression and bipolar disorders have the potential to be life-threatening and life-changing but with the proper drug treatment and therapy in place both disorders can be manage with some level of success, notwithstanding the aforementioned obstacles.

Sources

Abramson, L. Y., Alloy, L. B., Gibb, B. E., & Neeren, A. M. Smith, J. M. (2006). Role of parenting and maltreatment histories in unipolar and bipolar mood disorders: Mediation by cognitive vulnerability to depression. Clinical Child & Family Psychology Review, 9(1), 23-64.
      Retrieved August 21, 2008, from EBSCOhost database.

Lingam, R., & Scott, J. (2002). Treatment non-adherence in affective disorders. Acta Psychiatrica Scandinavica, 105(3), 164-172.
      Retrieved August 21, 2008, from EBSCOhost database.

Nevid, J.S., & Rathus, S.A. (2005). Psychology and the challenges of life: Adjustment in the new millennium (9th ed.). Hoboken, NJ: John Wiley & Sons.


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