Depression Recurrent brief depressions

Note. BP = bipolar disorder D/C = discontinue Dep = depression Li = lithium M = mania SA = schizoaffective RBD = recurrent brief depression UP = unipolar. Drug-induced hypomania. 

Anecdotal reports of efficacy in recurrent brief depression... 

For the diagnosis of major depressive disorder, a person must have either symptom 1 or 2, plus five out of nine symptoms, and these symptoms must occur most of the day, nearly every day, for at least two weeks. Major depressive disorder is differentiated from other depressive disorders, including minor depression (dysthymia), recurrent brief depression, and adjustment disorder with depressed mood. 

A typical example of diagnostic splintering provides the group of mood disorders. One reads about major depression, minor depression, double depression, dysthymia, unipolar and bipolar depression, depressive personality, depression not otherwise specified, brief recurrent depression, subsyndromal symptomatic depression, mixed anxiety depression disorder, seasonal depression, and adjustment disorder with depressive mood. 

Recurrent brief episodes e.g. seasonal affective disorder (SAD) Hypomanic, depressed Cyclothymia Persistent mood instability with mild episodes... 

DSM-111, DSM-III-R, and DSM-IV [American Psychiatric Association 1980, 1987, 1994] specified arbitrary time criteria (e.g., 2 weeks duration] before a person qualified for a diagnosis of MDD. Such arbitrariness meant that brief recurrences [e.g., 7-10 days] sometimes were not officially diagnosed as depression, and the relapsing pattern went undetected. 

Bipolar disorder is an episodic illness, with an individually variable course. There is no characterisdc course that defines most padents. Some individuals may experience few manic episodes, but suffer recurrent depression. Others may have frequent, severe manic episodes, with brief and infrequent depressive episodes. Not infrequently, recurrent depression precedes the development of mania or hypomania. The average length of a manic episode, undreatecl, is about 3 months. Depressive episodes in bipolar disorder are usually of 3-6 month dura don. 

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