Bipolar Disorder vs. Major Depressive Disorder

Bipolar Disorder vs. Major Depressive Disorder

Nicole Higginbotham

Abstract

Though there are different disorders with depressive symptoms, the treatments for all of these disorders are not the same.

Bipolar Disorder vs. Major Depressive Disorder

Rapid thoughts, mood swings, and problems concentrating are all symptoms of bipolar disorder. Individuals with this order have to learn to adjust to life in a completely different way. Depending on the intensity of their disorder, many individuals may have trouble communicating with others and holding professional conversations. It may be an even more demanding task for these individuals to maintain a successful lifestyle and become financially independent. It is not an impossible task, but it takes strong will and sometimes the proper medical care in order to accomplish this sense of independence.

There have been many different studies done focusing on bipolar disorder, but a study performed on bipolar patients that utilize the drug lithium seemed most interesting and proactive. Researchers Carrie Bearden and Paul Thompson decided to test the effects of the drug lithium on bipolar patients and compare their brain matter with that of those individuals that were bipolar and not taking lithium. Lithium has been used to reduce bipolar characteristics that may hold individuals back from maintaining a successful life. This drug is said to stabilize mood swings and make it easier for patients to focus.

Bearden and Thompson decided to take two groups of individuals, all bipolar, and have half of the group take lithium and keep the other half of the group unmedicated. After having the medicated group take lithium for a liable amount of time, Bearden and Thompson took the two groups and gave all of the individuals an MRI. After the MRI results were returned, the two researchers compared the unmedicated group to the medicated group and found that the group that was taking lithium had more gray matter in the areas of their brains that focused on mood swings, motivation, and attentiveness. They theorized that this gray matter was necessary to maintain these parts of a human brain and also predicted that the gray matter in the medicated individuals brains must have been damaged and malfunctioning before taking the lithium.

This is an amazing discovery due to the fact that it may be able to tell us the deficiencies that hold people back from living content lives. These researchers tested the validity by comparing two groups of people with the same disorder and medicating only half of their subjects. However, the trade-off was that the researchers did not test the effects on the gray matter after the medication was stopped. This is a problem, because the subjects with an increased amount of gray matter could have gotten that matter in their brains another way, and by testing the subjects off of the medication as well, researchers would have been able to see if the gray matter went away with the lithium intake. This could also be bad, because it could mean that if a patient misses a dose more than once, the gray matter in their brains may deplete.

Major Depressive Disorder is a disorder in which a person experiences changes in their sleeping patterns and appetite, decreased energy or fatigue, thoughts of guilt or worthlessness, poor concentration and indecisiveness, and thoughts of death or suicide. The symptoms of this disorder impair the person so much that he or she begins to have issues in his or her social and/or occupational life. After a person is diagnosed with this type of disorder, he or she may have to go to counseling and will probably be prescribed antidepressants.

One type of antidepressant that he or she may be prescribed is a selective serotonin reuptake inhibitor (SSRI). “When the brain does not make enough serotonin, or it cannot use existing serotonin correctly, the balance of chemicals in the brain may become uneven” (Holland, 2012). The SSRIs help adjust the serotonin levels in the brain by blocking the reabsorption of serotonin in the brain, and by doing this, neurotransmitters will send and receive chemical messages more effectively. The goal is to boost a person’s mood, which in turn will relieve depressive symptoms.  The side effects that a person should be warned about when taking this type of medication are: digestive issues, nausea, restlessness, headaches, insomnia or drowsiness, decreased sexual desire, erectile dysfunctions, and agitation.

Another type of drug that may be given to  a person with major depressive disorder is a serotonin and norepinephrine reuptake inhibitor (SNRI). These types of drugs block the reabsorption on serotonin and nor epinephrine. “With additional serotonin and nor epinephrine circulating in the brain, the brain’s chemical balance is reset, and the neurotransmitters are thought to communicate more effectively” (Holland, 2012). This type of drug is also meant to improve a person’s mood and relieve depression. A couple well-known SNRIs are Cymbalta and venlafaxine. The side effects of this type of medication include: increased sweating, increased blood pressure, heart palpitations, dry mouth, a fast heart rate, digestive problems, changes in one’s appetite, nausea and dizziness, restlessness, headaches, insomnia or drowsiness, decreased sexual desire, and agitation.

Tricyclic Antidepressants (TCAs) are another type of drug used to help with major depressive disorder. These drugs have been around for a long time. “TCAs work by blocking the reabsorption of noradrenaline and serotonin, and this helps the body prolong the mood-boosting benefits of the noradrenalin and serotonin it releases naturally, which improves mood and reduces the effects of depression” (Holland, 2012). Side effects of this type of drug include: weight gain, dry mouth, blurred vision, drowsiness, fast heart beat, confusion, bladder problems, constipation, and loss of sexual desire.

Norephinephrine and dopamine reuptake inhibitors (NDRIs) are also drugs used to treat major depressive disorder and bipolar disorder. Wellbutrin is one of the most common types of this drugs. “These medicines block the reabsorption of norepinephrine and dopamine, which helps reset the balance of these chemicals in the brain. These types of drugs are also used for seasonal depression issues and to help people stop smoking. The side effects of this type of drug include: seizures, anxiety, hyperventilation, nervousness, agitation, irritability, shaking, trouble sleeping, and restlessness.

Monoamine Oxidase Inhibitors (MAOs) are also medications given to people with major depressive disorder. “MAOs prevent the brain from breaking down the chemicals norepinephrine, serotonin, and dopamine, which allows the brain to maintain higher circulating levels of these chemicals, which boosts mood and improves neurotransmitter communication” (Holland, 2012). Side effects of this type of drug are: daytime sleepiness, insomnia, dizziness, low blood pressure, dry mouth, nervousness, weight gain, reduced sex drive, erectile dysfunction, and bladder problems.

It is important that a client is monitored during the first few months of taking these drugs. It is also important that each client’s medical history is reviewed before giving them medication to prevent adverse side effects before they happen. There is a possibility that bipolar clients may have issues with both depression and manic episodes if the drugs have a negative effect. There is also a possibility that clients with major depressive disorder may have issues with suicide. It is important to have information about a client’s past before he or she is put on prescriptions and for him or her to be advised about possible side effects.
Resources

Anonymous. Lithium Builds Gray Matter in Bipolar Brains, Study Shows.   Researched July 11, 2011 from PhysOrg.com and UCLA:      http://www.physorg.com/news95351363.html.

Anonymous. Lithium. Researched July 11, 2011 from PubMed Health, National Center     for Biotechnology Information, and the U.S. National Library of Medicine:             http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000531.

Bipolar Disorder. (2008). In National Institute of Mental Health. Retrieved October 17,      2011, from http://www.nimh.nih.gov/health/publications/bipolar-           disorder/complete-index.shtml

Holland, K. (2012). Depression Medications and Side Effects. Healthline. Retrieved July   20, 2014, from http://www.healthline.com/health-slideshow/depression–      medications-and-side-effects#11

Winans, E. A., & Bettinger, T. L. (2005). Major Depressive Disorders. Pharmacotherapy   Self-Assessment Program, 1-44.

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