Depression is one part of bipolar disorder, and it’s not uncommon for patients with bipolar disorder to be misdiagnosed as having unipolar, or “normal,” depression. Not only is depression a different mental health condition from bipolar disorder, but unipolar depression is often different from the type of depression that occurs during a depressive episode of bipolar disorder. If you or your teen have been diagnosed with either depression or bipolar disorder, you might wonder what the differences are. Read on for a guide to both depression and bipolar disorder, as well as what types of treatments can be used for these conditions.
Symptoms of Depression
While everyone has some sadness or “the blues” at times, depression, which is also called clinical depression or major depression, causes difficulties in everyday activities, such as eating, sleeping, and going to school or work. Clinical depression involves sadness and difficulty coping with life, and it lasts all day long (but might be worse in the morning to some people) and for at least two weeks. Episodes of depression can last for just a few weeks or much longer.
In addition to feeling sad, someone with depression might experience overwhelming fatigue and have difficulty getting out of bed. They might feel worthless and guilty and have thoughts of suicide. They might sleep too much or not be able to sleep at all, and they might have an increased or decreased appetite. The person might lose interest in people, places, and things that were once very important to them. Because depression can lead to suicide and because it makes its victims feel miserable, it’s important to seek help if you suspect it in yourself, your teen, or another loved one.
Symptoms of Bipolar Depression
While depression is one component of bipolar disorder, the way that it manifests can be different than it would be in clinical depression. For example, those with bipolar disorder might be less likely to suffer from physical ailments, such as headaches and stomachaches that often plague those with clinical depression. Someone with bipolar depression might be very hostile or angry in addition to feeling sad or worthless. They are also more likely to have unstable moods or a psychotic component to their depression.
Because bipolar disorder includes major fluctuations in behavior and drastic mood swings, the depressive episodes might vary from week to week or from day to day. Someone with clinical depression is less likely to experience these differences than someone with bipolar disorder.
Symptoms of Mania
The hallmark that differentiates bipolar disorder from clinical depression is that it also has a manic component. People with bipolar disorder cycle through depressive and manic episodes. This means that the symptoms of depression will at some point give way to manic symptoms. These include:
- racing thoughts
- a need for less sleep
- grandiose thoughts
- rapid talking
- a high level of distractibility
While the length of time spent in depressive and manic episodes can vary widely depending on the person, the average length of one cycle in people with bipolar disorder is 13 weeks.
It’s important to realize that those with manic symptoms are more likely to get into high-risk situations. For example, a teen in a manic episode might do the following:
- race his or her car
- use dangerous drugs
- engage in unprotected sex
While the major danger with depressive episodes is suicide, the bigger dangers with manic episodes are that the person will have a bad outcome of a risky behavior.
Bipolar I and Bipolar II
There are two types of bipolar disorder. Bipolar I is considered a more severe condition than bipolar II. The ways that the associated depression presents itself can differ between the two conditions. For example, people with bipolar II might struggle with longer periods of depression, but the depression tends to be less severe. Also, while people with bipolar I might be more likely to be hospitalized with psychotic symptoms, those with bipolar II are more likely to struggle with anxiety and substance abuse. Although bipolar I symptoms are often more severe, however, those with bipolar II have a greater incidence of suicide attempts. No matter which type of bipolar disorder you or your teen has, it’s important to be vigilant for symptoms of suicidal thoughts.
As far as mania goes, those with bipolar II have a less severe form of it. In bipolar II, it’s actually called hypomania; true mania does not occur. For example, while someone with bipolar I might react to manic feelings with severely abnormal behaviors, someone with bipolar II might seem to just have more energy than usual, feel more talkative, and need less sleep. Since these types of behaviors can be within normal limits for some people, there is less of an obvious problem to bystanders.
Treatments for Depression and Bipolar Disorder
Bipolar depression is usually more difficult to control than clinical depression, and some treatments that work for the clinically depressed can actually make bipolar depression worse. It’s very important that a correct diagnosis is made; do not try to treat any type of depression on your own without making sure that it’s not bipolar disorder. For example, light therapy and some supplements used with some success in patients with depression can cause worsening of symptoms in those with bipolar disorder. Your doctor will work with you to determine a course of treatment that addresses both depressive and manic symptoms if you have bipolar disorder. With depression, only the depression needs to be treated, unless there is some other issue such as anxiety or substance abuse.
If you or your teen are suffering from depression, it’s important to know what type it is and whether it’s associated with bipolar disorder. Your physician is a good place to start, and he or she will refer you for proper mental health treatment if it’s warranted. If you have concerns that your teenager is struggling with psychosis, suicidal ideation, or any other severe mental health condition, don’t be afraid to call 911 or go to the nearest emergency room for prompt evaluation and treatment.