Recurrent brief depressive disorder: symptoms, causes and treatment

This mood disorder expresses its symptoms differently from major depression.

Depression is one of the most common types of disorders in the population and one of the most widely known.. It can involve a high degree of affectation in the life of the individual, having both inactivity and high irritability.

Traditionally, it was noted that a person was truly depressed if the depressive episode in question lasted more than 14 days. If this was not the case, it was usual for the person not to receive a diagnosis for this disorder.

However, in recent years, extensive research has been done which, while it may still seem tentative, has indicated that true depression can occur in short episodes of time. These episodes are not a mild version of what has been called major depression, since the degree of affectation in the individual's life can be such that he or she may even commit suicide.

We are going to talk about a disorder whose duration has generated a wide debate: recurrent brief depressive disorder. We will explain what it is, which are its historical antecedents, what the WHO and the APA think about it besides differentiating it from other affective disorders.

What is recurrent brief depressive disorder?

The recurrent brief depressive disorder, also called recurrent brief depressionis a psychological disorder characterized by intermittent depressive episodes. These episodes are not linked to the menstrual cycle in women, and have a short duration, between 2 and 14 days, usually lasting between 5 and 7 days. Episodes occur between 6 and 12 times a year. After a year, the sum of the days of depression can add up to about a month.

Although the episodes are brief, the degree of depression that is reached is so severe that they can affect the functionality of the person, in addition to carrying out self-harming attempts.The symptoms of depression are so severe that they can affect the person's functionality, as well as lead to self-harming attempts and suicide. In addition, sufferers often have anxiety and irritability.

Due to the characteristics of the disorder it can be confused with major depression and other associated disorders, being differentiated not by the severity of the symptoms, but by the duration of the depressive episode.

Background of the diagnostic label

Already since the 19th century some disorders have been seen whose onset is occasional and for brief episodes, ranging from hours to days. In the past, these types of mood problems, especially if they took the form of depression, were called by various names, such as 'periodic melancholia' or 'intermittent depression'.such as 'periodic melancholia' or 'intermittent depression'.

When the DSM-III (Diagnostic and Statistical Manual of Mental Disorders), developed from a large body of psychiatric research, was published, among the criteria for depression it was explicitly specified that the depressive episode had a duration of more than two weeks. Thus, there was no diagnostic label in which the same symptoms of major depression were contemplated but with a shorter duration.

Jules Angst, a Swiss psychiatrist, coined the term 'recurrent brief depression' in 1985 on the basis of epidemiological data. based on epidemiological data and proposed a set of criteria for diagnosing this type of mood disorder. As a result of this, and thanks to several studies at the European level, the World Health Organization did include it in the tenth version of the ICD (International Classification of Diseases) in 1992, while the APA opted to provide provisional diagnostic criteria for this disorder in the fourth edition of the DSM.

Symptoms

Generally, people with recurrent brief depressive disorder suffer from the same symptoms as in major depression. They exhibit anxiety and irritability, as well as hypersomnia..

Depression, in general terms, is a symptom and set of disorders that can produce a high degree of deterioration in the functioning and adaptation of the person. In addition, the life of patients may be disturbed because of this, and the schedules and routines that the person may have acquired while not suffering from the episode may be altered.

Differential diagnosis

In the ICD-10 (ICD-10), recurrent brief depressive disorder is defined as a disorder that meets criteria for mild, moderate and severe depressive episodes. The particularity that makes this disorder different from major depression is that it it lasts less time, with depressive episodes lasting less than two weeks..

Thus, recurrent brief depression does not differ from major depression in the severity of symptoms, nor should it be seen as a mild form of this type of disorder. Depressive episodes, although brief, are particularly dangerous because of the risk of suicide. This is why major depression and recurrent brief depressive disorder are considered two related but different disorders.

Also differs from major depression with seasonal pattern of recurrence by the fact that depressive episodes in recurrent by the fact that the depressive episodes in recurrent brief depressive disorder occur every month and are of shorter duration.

As for bipolar disorder with rapid cycling, recurrent brief depression does not have hypomanic or manic episodes. As for premenstrual dysphoric disorder, it differs from it because it is not associated with the menstrual cycle.

It should be noted that this disorder has a high comorbidity with anxiety disorders, such as generalized anxiety, as well as being able to initiate the abusive consumption of certain substances and lead to addiction.

Causes

The cause of relapsing brief depression is still unknown, and it is most likely a multicausal phenomenon, with many variables influencing its onset. However, it has been suggested that there may be some relationship between this disorder and bipolar disorder.It is also related to possible genetic factors.

It has been seen that a small group of patients diagnosed with this disorder present temporal lobe epilepsy.

Prevalence

Although research on this disorder has so far yielded rather few data, it is estimated that about 5% of the population may suffer at some point in their lives from an episode that meets the above-mentioned characteristics. This frequency reaches 10% in young adults between 20 and 30 years of age..

Treatment

People who are going through an episode of these characteristics can acquire a greater degree of wellbeing by by attending psychotherapy. In this way, it is facilitated the adoption of habits that weaken the presence of the disorder, until its effects fade or have much less power over people.

In addition, psychotropic drugs, namely SSRIs, mood stabilizers such as lithium, and antiepileptic drugs are prescribed in clinical practice. However, drugs alone do not make the disorder go away, and their aim is to mitigate the symptoms in the medium term.

Bibliographic references:

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