Dysphoric Mania & "Non-depressed Depression"
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Q:  Dysphoric Mania & "Non-depressed Depression"

As I understand it, mania does not need to involve elevated mood.  In fact many people (including me) only experience dysphoric mania.  So then, it seems like the core features of mania are not really the mood symptoms but rather the energy/activation symptoms (increased energy, reduced need for sleep, racing thoughts, impulsivity, etc.)

Okay, so, does the same thing apply to depression? Just like there is non-euphoric mania -- where the features other than mood mostly define the state -- is there such a thing as non-depressed depression?  For example, where someone has low energy, low motivation, slowed thinking, oversleeping, etc, but not depressed mood?  This is not actually a question about me, as I have never experienced anything like that -- I'm just curious.

Dear Tracy --

Your first paragraph here, describing the importance of being able to recognize dysphoric mania, is very precisely put. I wish I could play it as music in primary care physicians' offices (and some psychiatrists as well).

As for "non-depressed depression", which is certainly a strange idea on the face of it, this has actually been described. One can have low energy and yet rapid thought and normal or even elevated mood, according to one recent characterization of mood cycling. (Here is a brief presentation of this
model of rapid cycling as "wave patterns"). I think I have seen a few cases of people who did not have low mood but did indeed have the extremely low level of energy and excessive sleeping which also characterizes depression, but this does not appear to be common, and could have come from some other cause of fatigue, of course.

Good question!

Dr. Phelps


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