Bipolar and Related Disorders
Unless otherwise noted, all of the following information was taken from the Diagnostic and Statistical Manual 5th Edition (American Psychiatric Association, 2013). In general, bipolar disorders are characterized by manic, depressive, and hypomanic episodes. Hypomanic and manic episodes can be characterized by inflated self-esteem, increased motivation, and excessive involvement in activities. Major depressive episodes are characterized by energy loss, depressed mood, weight loss, insomnia, recurrent thoughts of death, and inability to concentrate. Thus, all bipolar disorders are presented by the change in these episodes and can lead to the person’s impairment.
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The specialists distinguish several spectrum disorders, including cyclothymic disorder and bipolar disorders I and II. Bipolar disorder I am characterized by ordinary manic-depressive conditions. However, psychosis or a major depressive episode is not obligatory criteria that allow diagnosing a bipolar disorder. Bipolar disorder II, on the contrary, demands a lifetime experience of a hypomanic episode and a major depressive episode.
A person suffering from this disorder has an unstable mood and spends a lot of time in depression. Such a condition is often followed by social and work impairment. A cyclothymic disorder is diagnosed in adults who have spent at least two years in changing depressive and manic periods without experiencing major depressive, mania, or hypomania episodes. For children, this period is reduced from two to one year.
Cyclothymic Disorder Risk and Prognostic factors
The cyclothymic disorder usually occurs in the period of adolescence. It is characterized by stable (more than 2 years in adults) swings in mood, marked by depressive and manic periods. However, the hypomanic symptoms are not sufficient for diagnostics of a hypomanic episode and depression symptoms are not sufficient for a major depressive episode. The risk of occurrence of the cyclothymic disorder increases due to temperament and other bipolar disorders in the family, especially bipolar disorder I.
The depressive spectrum is mostly characterized by sadness or irritable mood and includes a wide range of disorders. For the most part of, depressive disorders such symptoms are common as anxiety, insomnia or hypersomnia, low energy, poor concentration, and low self-esteem. Such symptoms as suicidal thoughts, feeling of hopelessness, irritability, and decreased interest in social activities can also be present. In general, depressive disorders have a common feature of sad mood but differ in their duration and etiology.
Persistent depressive disorder (or dysthymia), major depressive disorder, premenstrual dysphoric disorder, disruptive mood regulation disorder and some other specified and unspecified depressive disorders constitute this spectrum. The premenstrual dysphoric disorder occurs after ovulation and improves a few days after the beginning of menses. Dysthymia, or persistent depressive disorder, is a more stable condition and is characterized by a depressive mood for more than two years in adults. Major depressive disorder is diagnosed after at least two weeks of nearly every day sadness, anxiety, and suicidal thoughts. Substance or medication-induced depressive disorder occurs due to the intake of such substances as alcohol, opioids, phencyclidine, amphetamine, cocaine, and others. Disruptive mood dysregulation disorder is characterized by frequently and regularly repeated temper outbursts such as verbal and physical aggression.
Premenstrual Dysphoric Disorder Risk and Prognostic Factors
The premenstrual dysphoric disorder is characterized by marked affective liability, depressed mood, increased irritability, marked anxiety, or feeling of tension. The syndrome is diagnosed by specialists if at least one symptom from the abovementioned is present. There also can be additional symptoms such as the sense of swelling, lack of energy, hypersomnia or insomnia, breast tenderness, difficulty in concentration, and decreased interest in activities. The symptoms are especially grave in the period before the onset of menses. Among the risk factors, there are genetic and environmental ones. Stress, seasonal changes, heritability, trauma, and female gender role can be the factors increasing the risk of the occurrence of this disorder. Women taking oral contraceptives experience fewer symptoms of the premenstrual dysphoric disorder.
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Anxiety disorders include conditions characterized by a high extent of anxiety and fear. Fear and anxiety overlap, although fear is related to the imminent threat, while anxiety occurs in anticipation of the future threat. Disorders from the anxiety spectrum differ from each other by the types of situations or objects that the person tries to avoid. Many of these disorders are formed in childhood and persist without any treatment. Thus, this group of disorders is characterized by overestimation of threats that can have different natures.
The anxiety spectrum includes such disorders as selective mutism, agoraphobia, specific phobia, social anxiety disorder, panic disorder, separation anxiety disorder, and generalized anxiety disorder. Besides, an anxiety disorder can be associated with the intake of certain substances or medications. Separation anxiety disorder is related to excessive worry about losing important people. Agoraphobia is characterized by the fear of open spaces and large buildings. Conduct disorder is related to the avoidance of school by the child. Illness anxiety disorder is associated with the fear of illnesses and attempts of self-diagnostics. For panic disorder, regularly occurring panic attacks are common. Individuals experiencing selective mutism keep silent and lose the ability to speak in certain situations.
Selective Mutism Risk and Prognostic Factors
Selective mutism is characterized by losing the ability to speak in certain social situations. The duration of the disorder should be at least 1 month and should not be related to the lack of language skills. The disorder is often accompanied by high social anxiety, as individuals often refuse to speak in public and even with close friends or relatives. There are temperamental, environmental, and genetic factors that increase the risk of selective mutism. Neuroticism can increase the risk of its occurrence, as well as overprotective and controlling parents. There can also be genetic factors relating to selective mutism and social anxiety disorder.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Web.