DSM Differential for Mood Disorders — Clinical Reference
Missing bipolar disorder — treating it as unipolar depression — is one of the most consequential diagnostic errors in outpatient practice. This reference gives you the clinical signals that distinguish mood disorders from each other, with the screening questions that catch what standard depression screening misses.
What is in this cheat sheet
Major Depressive Disorder — criteria, episode specifiers, the presentations that are most commonly missed (masked depression, somatic presentation, irritable depression in men), and when medication evaluation is clearly indicated.
Persistent Depressive Disorder (Dysthymia) — the long, low-level depression that clients often do not identify as depression because it is their baseline. Why this presentation is frequently undertreated.
Bipolar I vs. Bipolar II — the clinical distinction between manic and hypomanic episodes, the symptoms that clients and therapists most commonly miss, and why antidepressant monotherapy in bipolar disorder is contraindicated.
Bipolar screening questions — the specific questions that surface hypomanic history when clients present only with depression. What to ask and how to ask it without the client dismissing it.
Cyclothymia — the subclinical but impairing cycling pattern that is frequently missed, and its treatment implications.
PMDD — the premenstrual mood disorder that requires cycle tracking to identify, its relationship to bipolar, and the treatment options including first-line approaches.
The differentials that matter most — unipolar vs. bipolar, primary depression vs. depression secondary to substance use or medical condition, MDD vs. grief, MDD vs. burnout.