PsychRounds: The Psychiatry Podcast The Spectrum of Mood Disorders with Dr. Chris Aiken
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Sep 3, 2025 Join Dr. Chris Aiken, Editor-in-Chief of the Carlat Psychiatry Report and Yale-trained psychiatrist, as he explores the intriguing spectrum of mood disorders. He discusses the distinction between bipolar disorder and manic-depressive illness, the impact of individual temperaments on treatment, and innovative non-pharmacological strategies. Dr. Aiken also delves into the potential of the keto diet and the role of nutrition in mental health. Plus, insights on sleep patterns and their effects on mood make for a compelling conversation!
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Bipolar As A Broad Spectrum
- Bipolar features exist on a broad spectrum and many outpatients show subthreshold bipolar signs on screening tools.
- Misunderstanding where to draw diagnostic lines led to under-recognition and inappropriate antidepressant use.
Historical Roots Of Diagnostic Confusion
- Kraepelin saw mood disturbance as continuous and struggled to separate unipolar from bipolar reliably.
- Shrinking bipolar in DSM-III shifted many patients into a broadened depression category, obscuring spectrum cases.
Ask About Family History And Recurrence
- Consider family history and recurrence pattern when distinguishing depressive subtypes versus stress-related depression.
- Use mood stabilizers like low-dose lithium for recurrent affective illness with strong family history rather than defaulting to antidepressants.
