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For prognostic and treatment purposes, it is increasingly important to be able to distinguish unipolar depression from bipolar spectrum depression

For prognostic and treatment purposes, it is increasingly important to be able to distinguish unipolar depression from bipolar spectrum depression

This chapter has described the mood disorders, including those across the bipolar spectrum. For prognostic and treatment purposes, it is increasingly important to be able to distinguish unipolar depression from bipolar spectrum depression. Although mood disorders are indeed disorders of mood, they are much more, and several different symptoms in addition to a mood symptom are required to make a diagnosis of a major depressive episode or a manic episode. Each symptom can be matched to a hypothetically malfunctioning neuronal circuit. The monoamine hypothesis of depression suggests that dysfunction, generally due to underactivity, of one or more of the three monoamines DA, NE, or 5HT may be linked to symptoms in major depression. Boosting one or more of the monoamines in specific brain regions may improve the efficiency of information processing there, and reduce the symptom caused by that area’s malfunctioning. Other brain areas associated with the symptoms of a manic episode can similarly be mapped to various hypothetically malfunctioning brain circuits. Understanding the localization of symptoms in circuits, as well as the neurotransmitters that regulate these circuits in different brain regions, can set the stage for choosing and combining treatments for each individual symptom of a mood disorder, with the goal being to reduce all symptoms and lead to remission.

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