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Depression Case

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Unipolar depression is described as depression without a history of mania (Comer, 2005). Bipolar disorder is described as a disorder marked by alternating or intermixed periods of mania and depression (Comer, 2005). Both disorders may be the result of genetics or a chemical imbalance in the brain. Both disorders cause abnormal sleep patterns, anxiety, and depression. There are also a number of differences between the two disorders. Both disorders have different symptoms, different characteristics, and different treatments. Both disorders can make living hard, making the smallest tasks seem impossible and both disorders can cause one to lose the desire to live another day.

Symptoms of unipolar depression usually start to develop later in life and affect women more than men whereas bipolar disorder affects men and women equally and symptoms are usually noticeable by early adulthood (NIMH, 2012). Approximately 7% of adults in America suffer from severe unipolar depression with around 5% suffering from milder forms (Comer, 2005). Women are at a minimum twice as likely as men to experience periods of unipolar depression. Around 26% of women may experience periods of unipolar depression compared to 12% of men (Comer, 2005). Approximately 2.6% adults in America suffer from bipolar disorder, with about 2.2% of those being diagnosed with a severe case of bipolar disorder (NIMH, 2012). Children with a parent or sibling who suffers from bipolar disorder are 4-6% more likely to develop the disorder compared to children who have no family with bipolar disorder, though most children with a family history of bipolar disorder will not develop the disorder (NIMH, 2012).

The symptoms of unipolar depression cover five areas of functioning and they often feed upon one another (Comer, 2005). The five areas are emotional, motivational, behavioral, cognitive, and physical (Comer, 2005). Emotional symptoms of unipolar depression are the feelings of sadness, feeling empty, and losing the sense of humor. Motivational symptoms of unipolar depression are the loss of desire to pursue normal activities and a loss of initiative. Behavioral symptoms of unipolar depression are a less active life and a less productive life. Cognitive symptoms of unipolar depression are feelings of inadequacy and lack of acknowledgement for positive achievements. Physical symptoms of unipolar depression are headaches, indigestion, change in appetite, change in sleep, and general pain (Comer, 2005). One might think that symptoms of depression are sadness and constant sleeping but that is not always the case as shown here. The symptoms are clearly vast and more complex than one might think.

Because bipolar disorder is when one experiences both the lows of depression and the highs of mania, this next section will focus on the symptoms of mania as the depression symptoms were stated above. The symptoms of mania in bipolar depression cover the same five areas of functioning as unipolar depressions (Comer, 2005). An emotional symptom of mania is a euphoric joy that does not coincide with the rest of one's life. Motivational symptoms of mania are a constant need for excitement, companionship, and involvement. A common behavioral symptom is when one is very active and move quickly as though they are running out of time constantly as well as talking rapidly and loudly, dressing in flashy clothing, giving large sums of money to complete strangers, and/or getting involved in dangerous activities. Cognitive symptoms of mania are poor judgment, poor planning, and loss of coherence. Physically, symptoms of mania present as an abundance of energy, even after multiple days (comer, 2005). Clearly, the symptoms of mania are wide spread and it is easy to see where mistakes in diagnosing come from. It is easy to notice a few symptoms and chalk the rest up to a bad day, thus making it very hard to be properly diagnosed at first.

Biologically speaking, there seem to be some similarities in the causes of unipolar depression and bipolar disorder, but there are also a number of differences. Genetics suggest that some people inherit a susceptibility to unipolar depression as well as bipolar disorder (comer, 2005). Studies done on identical twins showed a 20% likelihood with unipolar depression and a 40% likelihood with bipolar disorder (Comer, 2005).

While there are some similarities in the biological causes behind these disorders, there are also profound differences. Unipolar depression has been powerfully associated with low activity levels of the neurotransmitter chemicals norepinephrine and serotonin. This theory came to light when it was discovered that high blood pressure medication could cause depression and that those medicines lowered norepinephrine activity or serotonin activity (Comer, 2005). Research has shown that unipolar depression is probably not caused by any one neurotransmitter, but more likely it is caused by norepinephrine, serotonin, and a variety of other neurotransmitters in the brain (Comer, 2005). Biological researchers also believe the endocrine system plays a role in unipolar depression. Those diagnosed with unipolar depression have been found to have high levels of cortisol, which is a hormone the adrenal glands release during stressful times (Comer, 2005). Another hormone linked to unipolar depression is melatonin, a hormone released only at night. It is thought that those who suffer from unipolar depression may secrete more melatonin during long, winter nights (Comer, 2005). Other theories have more to do with the study of what happens within neurons compared to the chemicals that carry messages between neurons (Comer, 2005). Researchers have also been able to start uncovering a brain circuit responsible for unipolar depression. Likely members of this circuit are the prefrontal cortex, the hippocampus,



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