The main difference between bipolar disorder and depression are the mania symptoms characterized by excessive excitement or irritability, extreme elation, and delusions of grandeur that are associated with the bipolar condition. In fact, until fairly recently, bipolar disorder was often called manic depression, a term that highlights both poles of the illness mania and depression. To clarify the differences between straightforward depression and bipolar disorder, it's helpful to understand the specific symptoms of each.
While mood swings, or cycling back and forth between manic and depressed states, are a component of bipolar disorder, depression is unipolar meaning that there is no "up," or manic, part of the condition. Instead, depression is characterized by an intense, prolonged "down" state of mind that interferes with a person's daily life, as well as his or her ability and desire to engage in relationships and regular activities. Symptoms of depression include:
- Pervasive sadness
- Extreme fatigue or loss of energy
- Inability to make a decision
- Lack of interest in activities that are normally enjoyable
- Appetite changes
- Sleep problems
- Feelings of worthlessness or guilt
- Thoughts of death or suicide
Bipolar Disorder Symptoms
Although bipolar disorder includes the depressive symptoms described above, it also includes manic symptoms. Bipolar disorder is characterized by uncontrollable dramatic mood swings that fluctuate between depressive lows and manic highs. Manic symptoms may include:
- Excessively high energy; rapid speech and thoughts
- Decreased need for sleep
- Overinflated sense of self-importance
- Difficulty concentrating
- Disturbed judgment
- Increased recklessness (usually involving money, drugs, alcohol, or sex)
Bipolar Disorder: Understanding Different Types
Knowing about the different types of bipolar disorder can also help you distinguish between this condition and depression. There are two types of bipolar disorder: Bipolar I disorder is diagnosed when a person has experienced at least one manic episode, regardless of whether or not the individual has also had a previous bout or bouts of depression. Bipolar II disorder is the diagnosis given 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. Sometimes people also experience rapid-cycling bipolar disorder, which means that a person reports four or more dramatic mood swings throughout the course of a year, and the shifts can occur in as little time as just a few hours or multiple times a week. It is also possible for the manic and depressive symptoms of bipolar disorder to occur simultaneously; this is called mixed-state bipolar. In some cases, people experience a milder form of bipolar disorder, known as cyclothymia, which is characterized by minor mood swings that don't significantly interfere with a person's ability to function but may significantly interfere with his or her ability to enjoy life and maintain significant relationships.
Making the Correct Diagnosis
Everyday Health's Emotional Health Expert, Ruth Wolever, PhD, a clinical health psychologist and the research director at the Duke Center for Integrative Medicine, Duke University School of Medicine, explains that an accurate medical history is the most important tool for distinguishing between depression and bipolar disorder. "The cyclical pattern of bipolar is distinct from depression, and the chemical signatures, or profiles, of the brain are different as well." However, adds Dr. Wolever, "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."
If left untreated, both bipolar disorder and depression can have serious consequences in people's personal and professional lives and can even result in suicide. For this reason, it is crucial to remember that these mood disorders are treatable. Both "talk" therapy and medication or a combination of the two can go a long way in managing symptoms of depression and mania, stabilizing mood swings, and helping people with these conditions deal with related problems, such as addiction, poor performance at school or work, and difficulty with relationships. If you think you may have bipolar disorder or depression, a professional diagnosis is the first step toward getting help.
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