Compare/contrast Major Depressive Disorder with Cyclothymic Disorder

Compare/contrast Major Depressive Disorder with Cyclothymic Disorder in terms of the following parameters:

Age-appropriate, culturally responsive, comprehensive assessment.
Description of postulated pathophysiologic mechanisms of the disorder- these should be linked to common symptoms observed in clients who present with this illness.
What behaviors on the part of the client (with either condition) would lead you to believe that they may be experiencing a psychiatric emergency?
Develop a general treatment plan for either disorder- what evidence-based psychotherapies would you plan include? What evidence-based psychopharmacologic approaches (if any) would be appropriate?
Discuss any legal/ethical issues inherent in the care of the individual with either condition (Major Depressive Disorder or Other Specified Depressive Disorder).
How would you know if the care of this client (either in an acute episode or chronic care) exceeded your clinical competence? How would you proceed with the client’s care in this case?
What other professionals would you consider including in the care/treatment of this client, and why?

Major Depressive Disorder (MDD): Assessment should include standardized tools such as the PHQ-9 (Patient Health Questionnaire) or Beck Depression Inventory. Consider cultural expressions of distress (e.g., somatic complaints in some cultures). Developmental stage matters—adolescents may exhibit irritability instead of sadness.
Cyclothymic Disorder (CD): Screening tools like the MDQ (Mood Disorder Questionnaire) and family psychiatric history are crucial, as CD often presents with fluctuating mood symptoms that do not meet full criteria for bipolar disorder. Consider cultural perceptions of mood swings (e.g., viewed as personality traits rather than symptoms).

MDD: Linked to dysfunction in serotonin, norepinephrine, and dopamine pathways. Chronic stress can dysregulate the hypothalamic-pituitary-adrenal (HPA) axis, leading to prolonged cortisol release. Symptoms: persistent sadness, anhedonia, fatigue, sleep/appetite changes, suicidal ideation.
CD: Involves instability in mood regulation, possibly due to dysfunction in limbic structures and neurotransmitter imbalances affecting emotional reactivity. Symptoms: chronic, fluctuating low-level depression and hypomanic episodes (irritability, increased energy, impulsivity).