How can major depressive disorder be distinguished from bipolar depression?

How can major depressive disorder be distinguished from bipolar depression?

• A. Bipolar depression is characterized by mood swings without manic episodes.
• B. Presence of a manic or hypomanic episode distinguishes bipolar from unipolar MDD.
• C. Bipolar depression lacks sadness.
• D. MDD includes psychosis while bipolar does not.

Answer: (B)

The defining idea is that bipolar depression is marked by a history of manic or hypomanic episodes, whereas unipolar major depressive disorder is not. A manic episode involves a distinct period of abnormally elevated or irritable mood with unusually increased energy, lasting at least 7 days (or any duration if hospitalization is needed), plus symptoms like inflated self-esteem, decreased need for sleep, pressured speech, racing thoughts, distractibility, increased goal-directed activity, and risky behaviors. A hypomanic episode has similar features but is less severe and doesn’t cause marked impairment or hospitalization. If a person has never had mania or hypomania, their depressive episodes point to major depressive disorder. Psychotic features can occur in both conditions, so they don’t reliably distinguish them.

The defining idea is that bipolar depression is marked by a history of manic or hypomanic episodes, whereas unipolar major depressive disorder is not. A manic episode involves a distinct period of abnormally elevated or irritable mood with unusually increased energy, lasting at least 7 days (or any duration if hospitalization is needed), plus symptoms like inflated self-esteem, decreased need for sleep, pressured speech, racing thoughts, distractibility, increased goal-directed activity, and risky behaviors. A hypomanic episode has similar features but is less severe and doesn’t cause marked impairment or hospitalization. If a person has never had mania or hypomania, their depressive episodes point to major depressive disorder. Psychotic features can occur in both conditions, so they don’t reliably distinguish them.