Misdiagnosing depression. Psychiatric disorders with depressive symptoms
Depression is a serious illness that affects millions yearly. Proper therapy and medication can help individuals recover. However, misdiagnosis is possible. Major Depressive Disorder (MDD) called also clinical depression is difficult to diagnose as there are no precise laboratory or neuroimaging tests to confirm suspicion.
Therefore, depression is diagnosed based on symptom criteria. Physical disorders resembling depression, such as diabetes or hypothyroidism, can be ruled out with laboratory tests. However, the other psychiatric disorders can be often misdiagnosed due to the lack of physiological tests available. In a 2009 meta-analysis, general practitioners were only able to correctly identify depression in 47.3 percent of cases. Many doctors diagnose depression in individuals who do not have it.
Bipolar Depression
Bipolar disorder is believed to be genetically inherited and typically develops during adolescence or before age 40. The condition persists throughout one’s lifetime and is characterized by cycles of symptoms. Bipolar depression shares criteria with unipolar depression. However, certain symptoms are more common. In bipolar types 1 and 2, depressive lows last longer than manic or hypomanic episodes (the highs). The bipolar depression is also more commonly accompanied by suicidal thoughts.
Other symptoms of bipolar depression include persistent feelings of sadness, irritability, and anger, a loss of interest in activities previously enjoyed, excessive or inappropriate guilt, hopelessness, disrupted sleep, changes in appetite and weight, fatigue, difficulty concentrating, self-loathing, and thoughts of suicide or death. Typically, the earlier the onset, the more depressive the initial episodes.
A person with bipolar disorder may experience a severe low mood episode, which may follow or precede a feeling of elation. In contrast, those with bipolar II disorder usually experience symptoms of depression or mania during one mood episode. Occasionally, people may experience “mixed” episodes, in which symptoms of depression and mania occur simultaneously. It’s important to note that those with bipolar I disorder may never experience depression.
Diagnosing bipolar disorder
During these episodes, most people seek help and receive a diagnosis, and many are initially diagnosed with unipolar depression. Inappropriately treating bipolar disorder can lead to manic episodes and other complications. For example, antidepressants may trigger a manic episode in those with bipolar disorder. Unlike depression, bipolar disorder requires different medications such as mood stabilizers or antipsychotics. Consequently, it’s vital to monitor the symptoms and follow up with an experienced psychiatrist. A diagnosis of bipolar disorder may take months or years of monitoring. Before making a diagnosis, doctors must rule out other conditions.