Introduction

The previous chapters in this book are a testament to the healthy state of developments in research and in clinical practice in the mood disorders. The juxtaposition of the unipolar and bipolar disorders has, it is hoped, provided the opportunity to consider these disorders in a more unified and cross-fertilising fashion than is often the case. The view that psychotic phenomena, whether in depression or in other disorders such as schizophrenia, are something qualitatively different from "everyday experience" can reasonably be questioned in the case of the mood disorders, however controversial this questioning may appear for schizophrenia (e.g., Lavender, 2000). Medicine has advanced through the recognition that the "devils" and "miasmas" of earlier times are in fact a number of disease entities and acute illnesses; this same approach has also benefited psychiatry through, for example, the identification of the organic process in tertiary syphilis, or the identification of the brain's role in the "noble" disease of epilepsy. In parallel, developments in cell and molecular biology have begun to offer up the actual mechanisms by which our genes provide a starting point for the process of development. Fractional differences in starting points can manifest themselves in major differences in outcome, as chaos theory tells us (see Chapter 6); thus, even in twins with the same genotype and with one twin affected by bipolar disorder, there are significant differences in whether or not the second twin will go on to develop bipolar disorder. The issue of the high genetic contribution to bipolar disorders has for too long led to the adoption of simplistic approaches to the bipolar disorders, when it may be more useful to view the unipolar-bipolar distinction as an heuristic one, but in which there is no clear demarcation between different subtypes of depression. As Cavanagh (Chapter 10) quotes memorably, should we consider depression more like a citrus fruit that divides naturally along certain segments, or like an apple that can be divided along any point or direction? One of the major starting points for mood disorders must be still the question of classification and diagnosis; therefore, pointers in this direction will be considered first. We will then briefly review some of the other key developments including epidemiology, theoretical models, and treatment issues, together with one or two additional points, before drawing to a conclusion.

Mood Disorders: A Handbook of Science and Practice. Edited by M. Power. © 2004 John Wiley & Sons, Ltd. ISBN 0-470-84390-X.

BiPolar Explained

BiPolar Explained

Bipolar is a condition that wreaks havoc on those that it affects. If you suffer from Bipolar, chances are that your family suffers right with you. No matter if you are that family member trying to learn to cope or you are the person that has been diagnosed, there is hope out there.

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