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How Is Bipolar Depression Different From Other Depression

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Unipolar Depression And Bipolar Depression: Same Symptoms Different Treatments

Bipolar Disorder vs Depression – 5 Signs You’re Likely Bipolar

Unipolar and bipolar depression will look the same on a depression scale. The way a person thinks, talks, and acts will be the same. The main difference is in treatment protocol due to bipolar depressions close association with mania. Unipolar depression can safely utilize the very effective serotonin-based treatments, such as SSRI antidepressants, amino acid supplements, and light box therapy. Bipolar depression treatment needs to be very cautious with the use of serotonin-boosting treatments, as they can cause mania.

Bipolar Disorder And Depression

Bipolar disorder and major depressive disorder are mental health conditions that share some similar features. In some cases, people may confuse the two. However, they are separate disorders that require different treatment approaches.

Some of this misunderstanding may be attributed to the term bipolar depression, which is a name given to the depressive episodes that are a part of bipolar disorder. To understand the difference between bipolar and depression, each disorder must be examined on its own. Once a person understands both disorders separately, it becomes easier to identify differences between bipolar and depression.

Differences Between Unipolar Depression And Bipolar Depression

A detailed explanation of unipolar and bipolar depression plus increased risk of suicide with bipolar depression.

It’s easy to be confused over the differences between unipolar depression and bipolar disorder depression as they often look so similar! They share the symptoms of sadness, hopelessness, pessimism, anxiety and sleep problems, but at some point, unipolar depression and bipolar depression go off in very different directions.

It is important to make this distinction because the treatments for the two depressions are very different. Failure to make an accurate diagnosis can result in treatments that are ineffective or that can even make the condition worse.

This article will cover the sometimes subtle and often not so subtle symptoms of each type of depression and then give management tips that can be used for bipolar depression. For the purpose of this article, I will refer to unipolar depression as depression and bipolar disorder depression as bipolar depression.

Please note that this article is an extension of the articles The Gold Standard of Treating Depression and The Gold Standard of Treating Bipolar Disorder.

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What Are The Symptoms Of Bipolar Depression Or Mania

Individuals with bipolar depression might experience very similar issues during their low emotional states, but they also go through manic periods that are equally painful. Symptoms of mania can include:

  • Intensely euphoric mood
  • Racing thoughts and speaking very quickly
  • Not feeling tired at all for many days at a time
  • Inability to focus or concentrate
  • Restlessness, agitation, irritability
  • Impulsive behavior, such as shopping sprees
  • Increased libido

Manic & Hypomanic Episode Symptoms

How To Tell If Your Depression Is Actually Bipolar II Disorder

Both manic and hypomanic episodes include three or more of the below symptoms:

  • Talking much more than usual;
  • Racing thoughts
  • Feeling the need for less sleep
  • Feeling abnormally upbeat, jumpy or wired
  • Increased activity levels, energy or agitation
  • Inflated sense of well-being and self-confidence;
  • Poor decision-making and increased impulsive behavior

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Its Important To Understand The Major Differences Between Bipolar Depression And Unipolar Depressionand To Help Educate Others About The Distinctions

Most people know what depression looks and feels likea lack of motivation, waking up in the morning with the thought, What is the point of my life?;and asking, Is this all there is?;

Depression can include a lot of anxiety , obsessive-compulsive disorder symptoms, focus problems, irritation, and sometimes psychosis;. Depression symptoms also include crying, catatonic feelings, suicidal thoughts and behaviors, and what I call psychic pain.

This kind of depression can be genetic, called unipolar depression, or situational depression, such as when a person who has always been stable goes into a deep depression after the loss of a loved one.

Bipolar depression is even more complex, in my experience.

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Unipolar And Bipolar Depression: Different Or The Same

Published online by Cambridge University Press:;02 January 2018

Department of Psychological Medicine and Neurology, Medical School, Cardiff University, Cardiff, UK
Nick Craddock
Department of Psychological Medicine and Neurology, Medical School, Cardiff University, Cardiff, UK
Daniel J. Smith, Department of Psychological Medicine, Monmouth House, University Hospital of Wales, Heath Park, Cardiff CF14 4DW, UK. Email:

The Difference Between Unipolar And Bipolar Depression

Bipolar disorder (depression & mania) – causes, symptoms, treatment & pathology

Both bipolar depression and unipolar depression are considered to have genetic and environmental factors and they share many symptoms. So it’s easy to be confused over the differences between unipolar and bipolar depression as they often look similar. They share the symptoms of:

  • sadness
  • sleep problems

But after that, unipolar depression and bipolar depression go off in very different directions.

The biology of these disorders is different, effective treatments are different, and in some respects, the symptoms are also different. Both forms of depression can be very severe and carry a risk of suicide. However, the underlying difference between bipolar depression vs depression is that people with bipolar depression also experience episodes of either mania or hypomania.

It is important to make this distinction because the treatments for the two depressions are very different. Failure to make an accurate diagnosis can result in treatments that are ineffective or that can even make bipolar disorder worse.

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What Can I Do About It

Depression and bipolar disorder can be very challenging. Many people blame themselves for their feelings or wonder why they cant just get over it. Some feel like they have to live with difficult feelings because they worry about what others will think if they ask for help. The symptoms of the illnesses themselves can make it hard to seek help. Depression and bipolar disorder are real illnesses, and they deserve care and support. People can and do recover.

Unexpected Symptoms Of Unipolar And Bipolar Depression

Depression is often described as weepy, sad, and hopeless, but this is only one type of depression. The other depression, irritated depression, is angry, negative, and complaining. People with irritated depression often go untreated as they are considered bitchy, rude, or negative. Irritated depression can manifest in road rage, punching and kicking tires and walls, yelling and statements, such as I hate everyone! Leave me alone! Both unipolar and bipolar depression can either be the typical weepy depression or irritated depression.

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Being An Advocate For Yourself

Over the course of your journey with bipolar depression, you may have experienced setbacks. Those setbacks may have caused frustration. However, now that youre starting treatment, its important to take steps toward better self-care.

After all, setting small, attainable goalsbe it going for a daily walk, taking part in a favorite activity or hobby, or eating healthiercan help you to achieve your larger goals in life. Begin by making a realistic plan to reach your goal.

  • State clearly and positively what your goal is
  • Envision the benefits and how they could improve your life
  • Set up small, attainable steps to reach your larger goal
  • Be aware of challenges that may arise, so your momentum isnt defeated
  • Avoid negative self-talk that may sabotage you
  • Have fun and celebrate small accomplishments along the way

When To Get Help For Depression

What are the Types of Bipolar Disorder and is it Genetic?

Depression is treatable and symptoms can improve with therapy, lifestyle changes, and in some cases medications. If you have been struggling with the symptoms of depressionespecially if they are disrupting your regular habits around sleeping or eatingits a good idea to reach out to a physician or mental health professional for support in figuring out what kind of treatment is right for you. While it may feel overwhelming, its important to seek professional help to manage depression. If left untreated, depression can get worse, and mild cases of depression can become more severe over time.

If you think a friend may be struggling with depression, talk with them about what youve noticed, and remember not to blame them for what they are experiencing. Blame will only increase their negative feelings and worsen their symptoms. Instead, encourage them to seek professional help.

If you or someone you know is having suicidal thoughts or thinking about attempting suicide, reach out for support immediately. You can text START to 741741 or call 1-800-273-TALK to chat with a trained counselor anytime. If you believe you are in immediate danger, call 9-1-1.

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Types Of Bipolar Disorder:

Bipolar disorder consists of basically two conditions bipolar I and bipolar II. Dr Sonal explains, Bipolar I disorder is characterized by major depression and at least one episode of mania. There may be alternate cycles or many cycles of such episodes. Whereas, Bipolar II disorder has at least one episode of major depression and hypomania. There can also be an episode of mixed features of both depression and mania. Sometimes the episodes can be complicated with psychotic features. Whereas, Cyclothymic disorder is cyclic that causes brief episodes of hypomania and depression.

Risk Factors For Depression And Bipolar Disorder

Anyone can have depression. You may be at an increased for it if you have another serious illness or if theres a family history of depression. Environmental and psychological factors may also increase your risk.

The exact cause of bipolar disorder is unknown. However, youre more likely to have it if someone else in you family does. The symptoms usually become noticeable during adolescence or early adulthood, but it can appear later in life.

If you have bipolar disorder, youre at increased risk of:

  • substance abuse

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Studies Of Bipolar Depression And Unipolar Depression

In one large-scale, case-register study including data from 38000 participants internationally, the age of onset for bipolar disorder was 6 years younger than for that of unipolar depression . Nevertheless, the onset of depression was not examined separately.

Evidence from a retrospective study suggests that bipolar disorder is characterized by more depressive episodes than unipolar disorder is . Several studies suggest that bipolar depressions are shorter and quicker to onset than unipolar depression . Nevertheless, findings are not consistent in this area, with two large-scale studies finding no difference between unipolar and bipolar depression in episode length .

Cross-study differences in results might be due to changes in gender or episode length over time. Parallel with the gender ratio in unipolar depression, bipolar depression is more common among women than men . One retrospective study reported that the length of bipolar depressive episodes shortened over a 15-year period .

In sum, compared to unipolar depression, bipolar depression appears associated with a younger age of onset, more frequent episodes, and greater short-term mood variability. No consistent differences have been found between episode length, although some studies suggest a shorter episode length of bipolar depressions compared to unipolar depressions. Depression severity appears comparable between bipolar and unipolar disorders.

Diagnosing Depression And Bipolar Disorder

What Is Bipolar Disorder?

If you have bipolar disorder, getting a diagnosis can be complicated because its difficult to recognize hypomania or mania in yourself. If your doctor is unaware you have those symptoms, your illness will appear to be depression, and you wont get the right treatment.

Accurate analysis of your symptoms is the only way to arrive at the correct diagnosis. Your doctor will need a complete medical history. You should also list all the medications and supplements you take. Its important to tell your doctor if youve had a problem with substance abuse.

No specific diagnostic test is available to help your doctor determine if you have bipolar disorder or depression. But your doctor may want to order tests to rule out other conditions that can mimic depression. These tests might include physical and neurological exams, lab tests, or brain imaging.

Treatment will be more effective if you start early and stick to it.

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Identification Of Clinical Features That Can Help Identify Pre

In the above sections we discussed the features of depressive episodes that, in retrospect, preceded a confirmed diagnosis of bipolar disorder or differentiated those with established diagnoses of BD versus unipolar depression. Clinicians, however, face a different task. They need to decide whether a patient presenting with depression might be suffering from bipolar depression and if so, what implications this has for clinical management.

There are no definitive criteria or biomarkers for depression preceding first episode hypo/mania and some would argue that it is unipolar depression until it converts. In this view, antidepressant induced switch is a helpful hint to alter course of treatment. The alternative view is that our goal is to better identify probable bipolar disorder at first/early episode depression, particularly in high risk families, cause no harm, and positively impact the long-term course of illness. In this latter approach, a staging strategy to enrich the data collected at a research level and a clinically useful cost/benefit strategy at a clinical level is imperative. One approach to depression at least in youth is to assign no polarity until several episodes have occurred but this will not do justice to those who convert late or not at all.

Table 1 provides a summary of clinical variables helpful in distinguishing unipolar and bipolar depression, using a triad of family history, course of illness, and symptoms.

Depression: Symptoms & Causes

Often referred to as depression, major depressive disorder is characterized by persistent low mood, feelings of sadness and loss of interest or pleasure in most areas of life. Some of the most common depression symptoms include:

  • Feelings of hopelessness, helplessness or worthlessness
  • Inappropriate feelings of guilt
  • Social isolation

Understanding these key signs of depression can make identifying the disorder easier. However, its still important to bear in mind that the symptoms of a depressive episode in bipolar disorder are the same as many of the symptoms of major depressive disorder.

Like bipolar disorder, the exact causes of depression are unknown. However, most people agree that chemical imbalances in the brain play a significant role. Like bipolar disorder, depression tends to run in families.

Feelings of depression or anxiety can lead to suicidal thinking. If you or a loved one is experiencing suicidal thoughts or tendencies, call the National Suicide Prevention Hotline at .

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Polarity At Onset And Interval From First Depression To First Mania

Depressive episodes are common at the onset of bipolar disorder as shown in both retrospective and prospective studies. The proportion of those with a depressive index episode varies between different studies, but consistently is over 50% . Family data suggest that the polarity at onset is possibly a heritable trait and may identify separate genetic subtypes of bipolar disorder .

Some studies suggest that there is also a difference in the manifestation of early depression depending on the family history. In the Pittsburgh high-risk study, those at risk of bipolar disorder had depression that was more severe with more prominent atypical symptoms, especially hypersomnia, fatigue, psychomotor retardation, and sense of hopelessness .

A related variable describing the early course of BD is the interval from first depression to mania or hypomania. This also tends to vary considerably both within and between studies. Thus, Berk et al. reported an average of 7.6 ± 8.7 years and Cha et al. 5.6 ± 6.1 years . In both cases the interval is not only lengthy, but also highly variable between individuals. Murru et al. found the duration of untreated illness over 6 years on average and those with a longer untreated interval had more typically younger onset, predominantly depressive polarity, more chronic course, and more frequent comorbid conditions .

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In trying to explain the measurable differences in neural activation they observed, the researchers theorized that individuals with bipolar disorder may block anticipation of negative stimuli to avoid negative emotions prior to performing a task. They suggested such blocking out could be a defensive mechanism that depressed individuals with bipolar disorder use to remain functional.

Overall, they said their results bring anticipatory processing into focus and suggests that anticipatory brain activation preceding performance on working memory tasks may be an important biological marker of major depression and bipolar disorder, and suggest the possibility that targeting anticipatory processing could be a promising direction in developing future therapies for both conditions. They acknowledge that their results need to be replicated in larger cohorts, including in more people with a bipolar I diagnosis. Of the 18 bipolar patients in the current study, 80% were diagnosed with bipolar II.


Holly A. Swartz, M.D., a 2006 BBRF Young Investigator.

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What Are Your Treatment Options

Treatment will depend on which type of bipolar disorder you have, and what your symptoms are. Most of the time, youll need medication to manage your symptoms, along with therapy. Medications that may be used include:

Antidepressants Antipsychotics Mood stabilizers Anti-anxiety medications

Sometimes traditional medication therapy isnt enough. At Boston MindCare, our doctors offer a unique treatment option when nothing else has worked. Ketamine infusion therapy can help the symptoms of depressive episodes associated with bipolar disorder. It works by inhibiting glutamate in your brain to stabilize your mood.

Like many of the other medications used to treat this disorder, ketamine comes with some side effects, so its important to talk to our doctors to see if this treatment is right for you.

You dont need to deal with bipolar disorder on your own. If youre looking for help, call our office at 701-207-9841 or book an appointment online today.

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