3
$\begingroup$

I was looking for a term which describes a bipolar disorder of lesser severity.

I know from experience from someone I know well, what a very severe case of the bipolar disorder looks like, when an otherwise very intelligent and very sane person can become completely unstable in both directions, and requires medication to basically survive it. I'm searching for a term which has indeed the symptoms of the bipolar disorder, but is not as severe as to require medication to basically survive the mood swings. I'm not talking about being just sad for something or craving attention. I'm talking about the very real symptoms of mania, followed by depression, just not as severe to be fatally dangerous without medical intervention. A severity which I would describe of being able to cope with by learning about it and a good degree of self-control, exercise, and good eating habits.

I thought the term was clinical versus non-clinical depression, but a search of the Internet made me doubt it. They talked about it as if the clinical was a case where there is a "disorder of the brain" and the non-clinical was "just sad because of a sad event", so either were those forums wrong (I guess so, because of their apparent unprofessional writing style, and they never seemed to know about bipolar, they thought manic depression was just about being very very sad), or there is another term which best answers my question.

$\endgroup$
  • $\begingroup$ I found a serious-looking article which uses the term "nonclinical", but in the context of borderline and not bipolar> ncbi.nlm.nih.gov/pmc/articles/PMC3772134 $\endgroup$ – vsz Sep 17 '14 at 16:25
  • $\begingroup$ vsv - bipolar and borderline are different (mostly unrelated) disorders, but the notion of "non-clinical" is widely used. I updated my answer to include this. (Sorry, I had mis-read it as "subclinical" the first time around.) $\endgroup$ – Susan Sep 17 '14 at 19:31
5
$\begingroup$

I think the main question here is:

Is there a term…which describes a bipolar disorder of lesser severity[?]

Yes. There are a couple ways to think about this, but you’re clearly accustomed to differentiating the manic and depressive phases of bipolar disorder, so I’ll start with that.

There is mania (excerpted from DSM 5*):

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day...

B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:

  • Inflated self-esteem or grandiosity.
  • Decreased need for sleep
  • More talkative than usual or pressure to keep talking.
  • Flight of ideas or subjective experience that thoughts are racing.
  • Distractibility
  • Increase in goal-directed activity
  • Excessive involvement in activities that have a high potential for painful consequences

C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning....

And there is hypomania:

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. ….

B. [This criteria is the same as for mania.]
....
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization.

I have bolded the main differences between the two definitions. You can see that hypomania is the term for the less severe form of the manic phase of bipolar depression.

Neither mania nor hypomania is likely to occur in the absence of depressive symptoms, however. Thus, there are two basic phenotypes of bipolar disorder (summarized from DSM 5*):

Bipolar I disorder: Patient experiences mania; depressive periods may not qualify as Major Depressive Disorder.

Bipolar II disorder: Major Depressive episodes are required; manic phase may be hypomanic. (This is classically considered a less severe syndrome, but this notion has been challenged in recent years.)

And finally, one more term for you:

Cyclothymic disorder: patient experiences both hypomanic and depressive periods without ever fulfilling the criteria for an episode of mania, hypomania, or major depression.

(Your other question you seem to already know the answer to, but since it's in the title..... Nonclinical depression refers to something on the spectrum of normal (i.e. not pathological), such as situational mood disturbance. A related concept, subclinical depression is a loose term to describe depressive symptoms that don't meet criteria for Major Depressive Disorder..)


*American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

$\endgroup$
  • $\begingroup$ I appreciate your effort put into this answer, it made most of the terms a bit more clear. Just so I know I understood it correctly, even though there are a lot of differences between them besides severity, if we tried to arrange them from the most severe to the least severe, we would end up with Bipolar I, Bipolar II, hypomania, cyclothymia, subclinical, non-clinical? $\endgroup$ – vsz Sep 23 '14 at 13:36
  • 1
    $\begingroup$ @vsz - I'm glad it was helpful. Mania/hypomania are phases of bipolar d/o, so conceptually it doesn't work to make a hierarchy this way. Bipolar I includes full-blown mania +/- MDD; bipolar II includes hypomania but full-blown MDD; cyclothymia includes only the milder forms of both. Subclinical and non-clinical are not strict DSM terms and can be applied to any disorder. For bipolar, "subclinical" is basically the same as cyclothymia, and there isn't really "non-clinical" bipolar d/o. Hope that's clearer. $\endgroup$ – Susan Sep 23 '14 at 13:48
  • $\begingroup$ (Sorry, MDD = Major Depressive Disorder) $\endgroup$ – Susan Sep 23 '14 at 13:50
1
$\begingroup$

Nonclinical depression is a popular term for the natural reactions to the external factors, such as loss, seasonal changes, emotional stress http://www.depressionfree.com/non-clinical.html

while the major types of clinical depression are as follows: Major Depressive Disorder

Major depression is a severe mental disorder that deeply affects an individual’s way of life and characterized by the inability to enjoy life fully and be satisfied.

Dysthymia

Dysthymia is a type of chronic mild depression.

Bipolar Disorder

Bipolar disorder, also known as manic depression, is characterized by constant mood changes.

Cyclothymic Disorder

Cyclothymic disorder is often described as a milder form of bipolar disorder.

Seasonal Affective Disorder Severe mood change according to the season. Aka SAD

Melancholia

Antenatal And Postnatal Depression

$\endgroup$
  • $\begingroup$ can you add some links to each of those terms (preferably from a non commercial web site)? $\endgroup$ – Vance L Albaugh Apr 11 '16 at 15:46

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy

Not the answer you're looking for? Browse other questions tagged or ask your own question.