Major Depression and Manic Depression ? Any Difference?

Countless number of patients and their family members have asked me about manic?depression and major depression. "Is there any difference?" "Are they one and the same?" "Is the treatment the same?" And so on. Each time I encounter a chorus of questions like these, I am enthused to provide answers.

You know why? Because the difference between these two disorders is enormous. The difference does not lie on clinical presentation alone. The treatment of these two disorders is significantly distinct.

Let me begin by describing major depression (officially called major depressive disorder). Major depression is a primary psychiatric disorder characterized by the presence of either a depressed mood or lack of interest to do usual activities occurring on a daily basis for at least two weeks. Just like other disorders, this illness has associated features such as impairment in energy, appetite, sleep, concentration, and desire to have sex.

In addition, patients afflicted with this disorder also suffer from feelings of hopelessness and worthlessness. Tearfulness or crying episodes and irritability are not uncommon. If left untreated, patients get worse. They become socially withdrawn and can't go to work. Moreover, about 15% of depressed patients become suicidal and occasionally, homicidal. Other patients develop psychosis-hearing voices (hallucinations) or having false beliefs (delusions) that people are out to get them.

What about manic-depression or bipolar disorder?

Manic-depression is a type of primary psychiatric disorder characterized by the presence of major depression (as described above) and episodes of mania that last for at least a week. When mania is present, patients show signs opposite of clinical depression. During the episode, patients show significant euphoria or extreme irritability. In addition, patients become talkative and loud.

Moreover, this type of patients doesn't need a lot of sleep. At night, they are very busy making phone calls, cleaning the house, and starting new projects. Despite apparent lack of sleep, they are still very energetic in the morning - ready to establish new business endeavors. Because they believe that they have special powers, they involve in unreasonable business deals and unrealistic personal projects.

They also become hypersexual - wanting to have sex several times a day. One?night stands can happen resulting in marital conflict. Like depressed patients, manic patients develop delusions (false beliefs). I know a manic patient who thinks that he is the "Chosen One." Another patient claims that the President of USA and the Prime Minister of Canada ask for her advice.

So the big difference between the two is the presence of mania. This manic episode has treatment implications. In fact the treatment of these disorders is completely different. While major depression needs antidepressant, manic-depression requires a mood stabilizer such as lithium and valproic acid. Recently, new antipsychotics, for example risperidone, olanzapine, and quetiapine, have been shown to be effective for acute mania.

In general, giving an antidepressant to manic?depressed patients can make their condition worse because this medication can precipitate a switch to manic episode. Although there are some exceptions to the rule (extreme depression, lack of response to mood stabilizers, among others), it is preferable to avoid antidepressants among bipolar patients.

When considering the use of antidepressant in a depressed bipolar patient, clinicians should combine the medication with a mood stabilizer and should use an antidepressant (e.g. bupropion) that has a low tendency to cause a switch to mania.

About The Author

Copyright © 2004. All rights reserved. Dr. Michael G. Rayel ? author (First Aid to Mental Illness?Finalist, Reader's Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.

mike@drrayel.com

---

Are you suffering from Depression?

Millions of people sufferaround the world from a depressive illness.... Read More

First Thing You Should Do to Get Out of Depression

Depression, in psychiatry, is a symptom of mood disorder characterized... Read More

Depression: Escape Your Mental Prison

There is an illness all around me in modern society... Read More

Omega 3 EPA: Natures Very Own Anti-depressant

Since Dr Malcolm Peet, a consultant psychiatrist at Sheffield swallow... Read More

Psychiatrist Begin Training About Vagus Nerve Stimulation for Depression

The manufacturer of the vagus nerve stimulator has begun face-to... Read More

Depression: What It Is and What You Can Do About It

There are three basic ways to treat depression: psychotherapy, self-help,... Read More

Fighting Depression by Restoring Your Routines

When we have depression, one of the things we drop... Read More

Efficacy and Safety of Vagus Nerve Stimulation for Depression Published in Journal

On September 1st, the efficacy and safety of vagus nerve... Read More

Senate Finance Committee Delays FDA Approval of Vagus Nerve Stimulation Therapy for Depression

On June 15th, 2004, FDA's Medical Devices Panel recommended that... Read More

When Your Fears and Depression Have the Best of You

What do you do when your fears and depression are... Read More

Depression and EPA Fish Oil - Does It Really Work?

It is now no secret that people all over the... Read More

Recognizing Depression

Depression is a serious issue. There are simply hundreds of... Read More

Aspartame and Your Mental Health

In 1965, a chemist working to develop an ulcer drug... Read More

How To Help A Stressed Or Depressed Loved One

Having lived with a depressed partner for 3 years and... Read More

Aromatherapy and Depression

When artiste Leslie Cheung committed suicide, he left behind a... Read More

Chronic Fatigue Syndrome And Depression Are Not The Same Thing!

Chronic Fatigue Syndrome is a... Read More

When Your Mind Develops A Mind Of Its Own

We've all been there? One minute your listening intently as... Read More

Adult Men and Women Who Suffer From Chronic Depression

Market surveys on women, men and depression suggest an estimated... Read More

Andropause and Depression

Andropause correlates directly with depression ? a major player in... Read More

Hurricane Recovery: Steps to Start Putting Your Life Back in Order

It seems unreal, another major storm hitting Florida after experiencing... Read More

Get Rid Of Depression Once And For All

Depression is something that will occur in many people's lives,... Read More

The Patients Guide to Vagus Nerve Stimulation and Depression

INTRODUCTION Everybody has a story. My... Read More

Vagus Nerve Stimulation: What are the Benefits and How Does It Relieve Depression?

Vagus nerve stimulation is more effective than antidepressants and is... Read More

Can You Overcome Depression?

There are many things that happen within the body when... Read More

5 Ways to Transform Your Struggles Into Victories

Have you read the famous quote, "Every struggle is a... Read More

Anxiety and Depression Treatment - 5 Tips for Beating Depression

Everyone has days when they are down, worn out and... Read More

Depression: One Womans Story

Sharon was talking to a friend on the phone one... Read More

What is Neurotransmitter Deficiency Disorder and How Can It Cause Depression, Anxiety, and...

Neurotransmitters (NTs) are essential chemical messengers that regulate brain, muscle,... Read More

Antidepressants 101- What You Absolutely Need to Know

IntroductionChange in social and economical states throughout the world although... Read More

So You?ve Been Diagnosed with Bipolar Disorder?

If you've been diagnosed with bipolar disorder (also known as... Read More

Mental Health Stigma ? What Can We Do About It?

What is Stigma? Stigma is the use of stereotypes and... Read More

What?s Causing My Depression and Fatigue?

Chronic Fatigue and Chronic Depression are absolutely systemic in our... Read More

Manic Depressive Episodes And Scientology

Scientologists believe that chemical imbalances do not exist. In their... Read More