Unipolar or Bipolar Disorder – What’s all the Fuss About?

Posted on April 23, 2017

One of the most common questions in clinical practice posed by colleagues and patients alike is – Is this Bipolar (Bipolar Disorder) Or Unipolar Disorder (Depression)?”

Differentiating the two poses a clinical challenge. Evidence suggests that misdiagnosis in bipolar disorder is a frequent occurrence.

The absence of biologically-relevant diagnostic markers of BD results in misdiagnosis of the illness as major depressive disorder, or recurrent unipolar disorder (UD) depression, in 60% of bipolar individuals seeking treatment for depression. [1]

In the ANZJP article, the authors Malhi and Porter start the article with the following quote

To the befuddlement of physicists, the universe is expanding; in fact it is accelerating apart at an unbelievable rate ………….While the implications of this are profound, the time frame involved means there is little chance of any direct impact on human kind as we know it. In contrast, another kind of expansion is affecting our lives here and now and also seems to have no end in sight; the diagnostic expansion of bipolarity.” [2]

References

1. Distinguishing between unipolar depression and bipolar depression
de Almeida, J. R. C., & Phillips, M. L. (2013). Distinguishing between unipolar depression and bipolar depression: current and future clinical and neuroimaging perspectives. Biological psychiatry, 73(2), 111-118.
2. Diagnostic Expansion of Bipolarity
Malhi, G. S., & Porter, R. J. (2014). Are ‘buy-polar’forces and ‘try-polar’thinking expanding bipolarity?.
3. Stahl's essential psychopharmacology
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: neuroscientific basis and practical applications. Cambridge university press.
4. Diagnostic Clues for Bipolar Depression
Pies, R. (2007). Is It Bipolar Depression?’WHIPLASHED’Aids Diagnosis. Current Psychiatry, 6(3), 80.