An example of a case of bipolar disorder is that of Spitzer et al (1981). For four months a women had spent most of her time confined to her bed, appearing to be sad and also deep in thought she mad remarks such as ‘Iam no good to anyone’ and ‘I’m going to be dead soon’. She expressed feelings of hopelessness and listlessness and also had difficulties in concentrating. Suddenly one day her mood seemed to be remarkably better, she appeared pleasant, communicated more and seemed cheerful. The following day however she her speech rate increased her movement became extremely rapid and she demonstrated a flight of ideas whilst intruding in on everyone’s activities. Over a couple of days, this activity increases to the point where she is unable to control her actions and attempts to break the furniture.
This case shows the symptoms that a bipolar sufferer experiences. It demonstrates the manic side of the disorder and also the depressive side.
Unipolar depression differs from bipolar depression because the symptoms consist of intense feelings of guilt, lack of enjoyment or pleasure in activities or company, frequent negative thoughts, low self -esteem difficulty in initiating action and making decisions, loss of energy and disturbance of weight, sleep and appetite. These symptoms come and go in cycles and during episodes symptoms can be extremely severe. Unlike bipolar which sees the patient experiencing both depressive and manic moods, unipolar sees the patient experiencing severe depressive symptoms with no high.
A case of unipolar is that of Spitzer et al (1981). A 55 yr old man has suffered from decreased appetite and a 23 kg weight loss over the past six months. He is withdrawn and isolated, unable to work, uninterested in friends and family, and unresponsive to their attempts to make him feel better. He wakes at 4 a.m. and is unable to fall back asleep. He claims to feel worse in the mornings and to improve slightly as the day wears on. He is markedly agitated and speaks of feelings of extreme unworthiness. He says that he would feel better off dead and that he welcomes his impending demise from cancer.
Looking at both cases you can clearly identify the difference between the two disorders. The young women suffering from bipolar experienced depressive symptoms just like the man suffering from unipolar the difference between them is that the women also experiences peaks of mania and these alternates.
There are different explanations of the causes of depression. One of the main explanations is that of the psychological theory. The Behavioral Model focuses on the role played by reinforcement. Ferster (1965) stated that depression is a result of a reduction in reinforcement. It is presumed that certain events, such as death of a loved one induce depression because they reduce positive reinforcement. Depressed individuals are less socially active which leads to concern so their symptoms are noticed and receive attention it is argued that this reinforces the depressed behavior. The Cognitive Model focuses on the theory that people become depressed when they believe that nothing they do will improve their situation. Learned helplessness enables the depressive to see that they are to blame and not the situation and that they have failed on not just one specific thing but various things. Aaron Beck (1976) described irrational thinking as the cause of depression and proposed three factors that contribute to a persons vulnerability to depression. Theses three factors are the cognitive triad
Negative view of self
Negative view of the world Negative view of the future
This cognitve triad consists of negative thoughts that depressed individuals have about themselves, the world and the future. Depressed patients usually regard themselves as helpless, worthless and inadequate.
