Bipolar disorders depressive component

GAD affects about 4 million Americans. It usually manifests after childhood and before a person reaches middle age. ft happens about twice as often in women as in men. Symptoms must persist for at least six months before a diagnosis of GAD may be made. In addition, GAD often occurs along with other psychiatric illnesses, such as depression or bipolar disorder, or with drug abuse, which probably leads to an underestimation of the amount of people affected by this disorder. There is some evidence that the disorder has a genetic component... 

The sequence, number, and intensity of manic and depressive episodes are highly variable. The cause of the mood swings characteristic of bipolar affective disorder is unknown, although a preponderance of catecholamine-related activity may be present. Drugs that increase this activity tend to exacerbate mania, whereas those that reduce activity of dopamine or norepinephrine relieve mania. Acetylcholine or glutamate may also be involved. The nature of the abrupt switch from mania to depression experienced by some patients is uncertain. Bipolar disorder has a strong familial component, and there is abundant evidence that bipolar disorder is genetically determined. 

J. Rosenthal et al. s (1986) dysregulation theory includes (but by definition is not specific to) bipolar disorder. In this model, mood is regulated by several homeostatic mechanisms. The failure of a component part leads to the expression of mood outside of set limits, which are identified as the "symptoms" of mania and depression. R. Post, S. Weiss, and O. Chuang (1992) offer a similar explanahon that overactivity in either of the mediating "circuits" of mania or depression leads to the appearance of associated behavioral manifestations. 

Manic attacks are usually a component of what is called bipolar, or manic-depressive, disorder periodic episodes of depression often arc experienced by these individuals as well. The following case (Spitzer et al., 1989) illustrates the manic component of bipolar disorder. It is an example of the development of manic symptoms late in life. 

The assessment process in diagnosing bipolar disorder is an essential component of the treatment process for this illness. Assessing the client for critical, harmful problems such as suicidal ideation during a depressive episode may require addressing these problems first as a way of securing the client s safety. Assessment also includes the appropriate use of the criteria provided by the DSM-IV manual and the inclusion of medication as the first priority in treatment planning. 

For example, the CB1 gene has been associated with Huntington s age of onset [238], depression in Parkinson s [239], and at least some aspects of multiple sclerosis progression [240, 241]. With respect to schizophrenia, a psychosis that may be elicited by components of cannabis [242, 243], in some [244-248] but not all studies [249-252], implicates the CB1 in certain endo-phenotypes. Similarly, a complex pattern of associations of the CB1 gene with unipolar and bipolar depression, and related disorders, is emerging [253-256] that may involve other genes. 

The role of eiectroconvuisive therapy (ECT) in delusional disorder has not been studied. However, it has proven efficacy in psychotic depression, and is very efficacious in affective disorders (major depressive disorder, bipolar I). Thus, since delusional disorder has psychotic and possibly affective components,... 

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