Mental Depression

Bipolar Disorder—Depressed Phase
The presentation of a depressive episode in a bipolar (manic-depressive) patient is identical to that of major depression, except there is a history of prior manic or hypomanic episodes. Mania is manifested by periods of elation or expansive mood, increased energy, decreased need for sleep, inflated self-esteem, and over-involvement in activities with a decreased concern for the consequences. Its diagnosis requires adequate severity to substantially impair the patient's level of functioning. If the hallmark symptoms of mania exist, but the patient shows no decrement in functioning, the patient is described as hypomanic. It is important to identify patients who have bipolar disorder or who have had past manic or hypomanic episodes because antidepressants alone may precipitate a manic episode.

The following is a sample question about a past manic episode: Have you ever experienced a period of 4 - 5 days where you felt euphoric or elated with too much energy and didn't need any sleep?

Patients with this diagnosis should be referred to a psychiatrist for management.