Bipolar disorder was once known as “manic depression,” and that term is perhaps a better descriptor for the condition, as it identifies the two poles of the condition – mania and depression.
Depression is unipolar, which refers to the presence of one pole. A person with depression doesn’t experience the manic phases that are characteristic of bipolar disorder.
People with bipolar disorder experience a combination of symptoms of mania and depression that alternate in cycles. In many cases, there are periods of normal moods between the manic and depressive phases.
To better understand the difference between bipolar disorder and depression, let’s take a look at the symptoms of each condition.
Symptoms of Depression
- Prolonged sadness
- Weariness, feelings of worthlessness or guilt
- Changes in appetite
- Changes in sleep patterns
- Aches and pains
- Problems focusing or making decisions
- Loss of interest in activities that were once enjoyed
- Suicidal thoughts or tendencies
As mentioned above, periods of mania are what differentiate bipolar disorder from depression.
Symptoms of Mania
- Increased energy, activity, and restlessness
- Excessively “high,” euphoric mood
- Subjective experience of racing thoughts, jumping quickly from one idea to another
- Noticeable increase in talkativeness, rapid speech, and feeling pressure to keep talking
- Easily distracted
- Decreased need for sleep, feeling rested and energetic after just a few hours of sleep
- Grandiose thinking and unrealistic beliefs in one’s own abilities
- Impulsive behavior, taking risks without thought of the consequences
- Increased sex drive
- Provocative, intrusive, or aggressive behavior
- Increase in goal-oriented activities
There are two types of bipolar disorder: Bipolar I and bipolar II.
Bipolar I is diagnosed when a person experiences at least one manic episode. The manic episode may be preceded by or followed by hypomanic or major depressive episodes. Mania symptoms cause significant impairment in your life and may require hospitalization or trigger a break from reality (psychosis).
Bipolar II disorder is diagnosed when a person has experienced at least one bout of depression and an episode of elevated mood that is called hypomania. Episodes of hypomania are not as intense or extreme as actual mania and are shorter-lived. People with bipolar II usually experience longer periods of depression and relatively shorter states of hypomania.
A person with bipolar I disorder may also have hypomanic episodes, but someone with bipolar II cannot ever have had a manic episode. If a manic episode occurs in someone with bipolar II, usually the diagnosis will be changed to bipolar I.
An accurate diagnosis is critical, because treatment options for bipolar disorder and depression are different. While antidepressants are commonly prescribed for depression, people with bipolar disorder are given a different type of medication – mood stabilizers.
Dr. Andrea Fagiolini, a psychiatrist and medical director of the Bipolar Center at the University of Pittsburgh School of Medicine, explains why getting the diagnosis and medication right is so important:
“Giving an antidepressant to someone with bipolar disorder could trigger a manic episode. Manic episodes can be dangerous, because you have very poor judgment, tend to use more drugs, drive recklessly, spend a lot of money, have much more sex – and have it completely unprotected. There’s a higher risk of high-risk behaviors because there is poor judgment.”
Diagnosing bipolar disorder can be tricky, because people are more likely to seek help when they are in the depressive phase. Dr. Mary Phillips, professor of psychiatry and director of functional neuroimaging in emotional disorders at the University of Pittsburgh School of Medicine, explains why this can lead to an incorrect diagnosis:
“A lot of individuals like being high — it’s the depression that bothers people. They talk about the depression but not the highs.”
Ruth Wolever, PhD, a clinical health psychologist and the research director at the Duke Center for Integrative Medicine, told Everyday Health that taking an accurate medical history is the key to distinguishing between bipolar disorder and depression:
“The cyclical pattern of bipolar is distinct from depression, and the chemical signatures, or profiles, of the brain are different as well. Clinically, the depression phase of bipolar disorder and of major depression look the same. Therefore, unless the person with bipolar disorder is in a manic phase at the time he or she seeks medical help — or a hypomanic state, in the case of bipolar II — it’s through the medical history that a clinician will be able to distinguish between the two mood disorders.”
Proper diagnosis is important for any mental health issue, because it can impact your quality of life – and that of those around you. Finding a healthcare practitioner who will take the time to listen and work with you to figure out the best treatment plan can help you get back to enjoying life.