The complex landscape of mood disorders and schizophrenia

As society grapples with the nuances of mental health, it has become increasingly imperative to unravel the reasons for these conditions. Understanding mental health conditions is essential for effective diagnosis and treatment. At the same time, it is important to foster empathy, promote awareness and extend access to resources.

Many conditions fall under the umbrella of mental health, and sometimes differentiating between them can be confusing. This is especially true for bipolar disorder, schizophrenia, and other mood disorders. While all three can significantly impact a person’s life, they manifest in distinct ways. To differentiate between these conditions, one needs to first understand the emotional rollercoaster of mood swings, the distorted realities of schizophrenia, and the spectrum of other mood disorders that affect millions worldwide.

Bipolar disorders are distinct from mood disorders

While they share common characteristics, there are key differences between mood-related conditions such as major depressive disorder (MDD) and cyclothymic disorder, and bipolar disorders. Bipolar disorders are cyclic and characterised by severe mood episodes, distinct responses to treatment, and genetic predisposition.

Some key distinctions that differentiate bipolar disorder from other mood disorders are:

Cyclic nature

Unlike MDD, which is characterized by prolonged periods of low mood, bipolar disorder involves cyclic mood swings. Individuals experience alternating episodes of mania/hypomania (elevated mood, increased energy) and depression, setting it apart with its hallmark feature of cyclical patterns.

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Severity of mood episodes

Bipolar disorder encompasses extreme mood states not seen in other mood disorders, which makes it important to diagnose. Manic episodes can manifest as excessive euphoria, impulsivity, grandiosity, and risky behaviour, contrasting with the persistent feelings of sadness and hopelessness typically associated with major depressive disorder.

Duration and frequency of mood episodes

Mood episodes in bipolar disorder can last from anywhere between a few days to weeks, significantly impairing functioning. In contrast, other mood disorders may involve less severe symptoms and shorter durations. For instance, cyclothymic disorder presents milder mood fluctuations but persists for longer periods than typical mood swings.

Response to treatment

Bipolar disorder requires a specific treatment approach due to its unique symptomatology. Mood stabilizers, like lithium and anticonvulsants, are commonly prescribed to manage manic episodes, as antidepressants, often effective for MDD, may exacerbate manic symptoms, if not cautiously administered.

Genetic and biological factors

Research indicates a stronger genetic component in bipolar disorder compared to other mood disorders. Those with a family history of bipolar disorder are at higher risk. Furthermore, neuroimaging studies have identified distinct differences in brain structure and function specific to bipolar disorder, further distinguishing it from its counterparts.

Schizophrenia

Schizophrenia, a complex and often misunderstood mental disorder, casts a profound shadow over the lives of approximately 24 million individuals worldwide, equating to roughly 1 in every 300 people, according to WHO. However, among adults, its prevalence intensifies, affecting 1 in 222 individuals. Despite not being as common as some other mental disorders, its impact is substantial, with onset typically occurring during late adolescence and the twenties. Interestingly, onset tends to strike earlier in men than in women, adding another layer of complexity to this enigmatic condition.

Disturbances in thought processes, perceptions, emotions, and behaviour characterize schizophrenia. Diagnosing schizophrenia involves a comprehensive assessment by mental health professionals, including psychiatrists and clinical psychologists.

Here’s how schizophrenia is diagnosed

Clinical evaluation is typically the process of diagnosing schizophrenia that begins with a comprehensive clinical evaluation by healthcare professionals. During this assessment, the healthcare provider gathers pertinent information regarding the individual’s medical history, symptoms, and family history of mental illness.

Symptom assessment plays an important role in the diagnosis of schizophrenia and is based on the presence of specific symptoms, such as hallucinations, characterized by perceiving things that aren’t real, and delusions, which entail false beliefs, disorganized thinking, abnormal motor behaviour, and negative symptoms like reduced emotional expression or lack of motivation.

Duration and impact are crucial considerations, as symptoms must persist for a significant duration, typically at least six months, substantially disrupting the individual’s daily functioning and interpersonal relationships.

To ensure accuracy, healthcare providers meticulously rule out other potential causes of symptoms, such as substance use, medical conditions, or alternative mental health disorders, before arriving at a diagnosis of schizophrenia.

The diagnostic criteria adhere to standardized classification systems, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-10), ensuring consistency and precision in diagnosis.

Leading productive lives with schizophrenia

Treatment and support are essential components in enabling individuals with schizophrenia to lead fulfilling lives. Typically, treatment involves a multifaceted approach tailored to each person’s specific needs.

Adhering to a medication regimen is essential to manage symptoms and prevent relapses. Healthcare providers closely monitor medication effectiveness, adjusting dosages as necessary to optimize symptom control, while minimizing side effects.

Psycho-education about schizophrenia and coping strategies empowers both individuals and their families to better understand the condition and effectively manage symptoms.

Therapeutic support helps promote overall well-being and resilience. Psychotherapy, such as cognitive-behavioral therapy (CBT) or family therapy, is vital in helping individuals develop coping skills, improve social interactions, and enhance problem-solving abilities.

Community integration in the form of supportive housing, vocational rehabilitation programs, and peer support groups, helps individuals with schizophrenia pursue education, employment, and meaningful social connections, fostering a sense of belonging and purpose.

While living with schizophrenia presents its challenges, many individuals can lead productive lives, with the appropriate treatment, support, and resources. Early diagnosis, comprehensive treatment and ongoing support are paramount in achieving optimal outcomes and enhancing the quality of life for those living with schizophrenia.

About the author

Dr Bhagwat Rajput is a well known Psychiatrist & Psychotherapist with over 18 Years of experience. He is a professor in World College Of Medical Sciences and Visiting Senior Consultant at Manipal Hospital and Venkateshwar Hospital. Most Promising Neuropsychiatrist of India – Appreciations/ Awards by Chief Of Army Staff Bipin Rawat, Best Administrator and COVID services by Cabinet Minister Anurag Thakur. He is a specialist for all psychiatric problems in adults like Schizophrenia, Bipolar disorder, Depression, OCD, Anxiety Disorders, Personality disorders, Alcohol and other drug dependence disorders. Dr. Bhagwat Rajput is associated with Sukoon Health as a Partner doctor.