Bipolar Disorder Vs. Depression – Differences Worth Knowing

In this article, we will be talking about bipolar disorder and depression – their differences and their important characteristics. Essential information about mental disorders is a necessity because they help us to take preventive measures against the same and diagnose them in proper time. An in depth study of the causes, triggers, characteristics and symptoms of mental disorders play an effective role in leading a healthy life.

Bipolar Disorder Vs. Depression

A very common question which patients often ask their physician is- “What’s the difference between bipolar disorder (also known as manic depression) and plain old depression?” The answer is very simple. Depression occurs in two instances- one when it occurs as a standalone disorder and secondly when it is a part of another disorder well known as bipolar disorder. It is up to your mental health care giver who will conduct adequate tests to determine whether depression is just depression or is a part of bipolar disorder.

Bipolar Disorder Includes Mania & Depression

Bipolar disorder mainly consists of two cycles in which the patient goes through two alternating cycles. One cycle is depression while the other is mania. The patient oscillates between the two cycles alternatively. It is also known as manic depressive depression.

What is a Mania?

Mania is actually a hyper excited state which can be said to have the following characteristics:

  • It includes a sense of exaggerated self-esteem and a feeling of grandeur.
  • Need for sleep decreases and one feels well rested after a 3 hours’ sleep only.
  • Keeps on talking more than usual.
  • Patients seem to think that they have racing thoughts and hence experience a state known as flight of ideas.
  • Patients draw attention to irrelevant things.
  • Patients show psychomotor agitation and an increase in goal focused activities.
  • There might be an increase in involvement in pleasure filled activities that have a high possibility for painful outcome. For example, engaging in excessive buying activities, foolish business investments or sexual indiscretions, etc…

If more than three of such symptoms are present in a patient for a considerable period of time then he is said to be suffering from episodes known as manic episodes. If the episodes are not as severe as a manic episode then it is known as hypomanic episodes. To be categorized as a manic episode it has to last for at least a week, while to be termed as a hypomanic episode it needs to last for at least four days. If an individual shows signs of suffering from manic episodes and at the same time from alternating cycles of depression then he is said to suffer from bipolar disorder.

Depression has No Mania

However, ordinary depression patients do not suffer from anything even closely resembling mania. Major depression patients have no record of ever suffering from mania and hence they are identified as suffering only from depression. Some characteristics of depressive episodes are as follows-

  • Depressed mood is prevalent for nearly all the day and continues everyday
  • There is no pleasure or interest to be noticed in any activities nearly all the day and continues every day
  • There can also be noticed considerable weight gain or weight loss without dieting, and an increase or decrease in appetite.
  • They also suffer from hypersomnia or insomnia.
  • Psychomotor turmoil or retardation is also noticed on a daily basis
  • Fatigue is a prevalent factor
  • Thoughts of misplaced or excessive guilt or worthlessness
  • Decline in ability to think, concentrate and creativity problems
  • Repetitive thoughts of death and recurrent planning of suicide or lack of plan but still ideation of suicide.

If five or more of these symptoms are present for more than 2 weeks then the person is diagnosed as having depression. Lack of manic episodes qualifies the person as only having major depression.

Subjective report plays a major role in helping a mental health care professional to decide whether the person suffers from just depression or bipolar disorder. This is often referred to as “intake interview” or “initial evaluation” and his stage plays a vital role in gathering as much information as possible by the doctor. The more information a doctor can gather the more they can aid to conduct the correct diagnosis.

For example, if the person attends his first session and complains of depression then the psychologist will looks for hints to know whether he has suffered any manic episodes. If manic or hypomanic episodes were found, then they would be categorized into bipolar otherwise they would be categorized into suffering from major depressive disorder. However, the diagnosis primarily depends on the individuals’ mental health history. There are many factors which will ultimately affect the correct diagnosis. The clinician will ask you the necessary questions to arrive at a proper conclusion.

Differences Between Bipolar Disorder and Depression Based on What an Individual Feels:

In the event of bipolar disorder, there will be alternating mood episodes which will oscillate between over excitement and over sadness, explosive temper and irritability; amid mood episodes.

If it is depression, severe feelings of dejection and despondency that is usually felt over a specific time period and it is generally followed by feelings of inadequacy and hopelessness often combined with suicidal thoughts.

Differences Between Bipolar Disorder and Depression Based on Primary Characterization:

There is a drastic change which varies from usual mood and behavior in bipolar depression.

In case of depression, there is noticed feelings of prolonged sadness that might interfere with daily activities can be noticed.

Differences Between Bipolar Disorder and Depression Based on Causes:

Bipolar disorder– is caused by an imbalance in brain-chemical, genetics or environmental factors.

Depression– is caused by low serotonin levels in the brain, chemical changes in the brain; change in levels of dopamine and epinephrine.

Differences Between Bipolar Disorder and Depression Based on Mental Symptoms:

When it comes to bipolar disorder, there are prolonged periods of extreme high and extreme low.

In case of depression, hopelessness,prolonged sadness, indifference, suicidal feelings can be noticed.

Differences Between Bipolar Disorder and Depression Based on Physical Symptoms:

There are many physical symptoms also involved in bipolar disorder which includes talking very quick, patients can be easily distracted, increase in number of activities, sleeping very little and insomnia, having unrealistic beliefs in one’s abilities, impulsive behavior, concentration problems, change in eating habits, sleeping patterns, or other habits, even attempting suicide.

Taking depression into account, there can also be noticed lack of energy, lack of emotion, insomnia and sleep pattern changes, change in desire for food (appetite), slow responses and thinking, continuous headaches, early-morning wakefulness or hypersomnia, digestive problems that do not go away with continuous treatment and cramps.

Differences Between Bipolar Disorder and Depression Based on Names:

The other names of bipolar disorder are manic depression or manic depressive illness.

Depression is also called as major depressive disorder or Dysthymia -long term (less severe symptoms) or unipolar disorder.

Differences Between Bipolar Disorder and Depression Based on Treatment Options:

There is also differentiation on the basis of treatment patterns, for example- Bipolar disorder treatment includes electroconvulsive therapy (ECT), long-term and continuous – control of symptoms, medication & psychotherapy.

Treatment for depression includes psychotherapy, CBT (Cognitive Behavioral Therapy), medications, Electroconvulsive Therapy (ECT), RTMS (Repetitive Transcranial Magnetic Stimulation) and some times, even a need for hospitalization.

Differences Between Bipolar Disorder and Depression Based on Medication:

There are also differences based on the given medications. Bipolar sufferers are prescribed medications such as those of atypical antipsychotics, mood stabilizers and antidepressants.

Depression sufferers are mostly prescribed with antidepressants.

Differences Between Bipolar Disorder and Depression Based on Therapy:

Therapy differences that can be noticed are as follows-

Therapies suggested for Bipolar Disorder includes- Interpersonal therapy, Family-focused therapy, Psychoeducation.

Therapies suggested for Depression includes- CBT (Cognitive Behavioral Therapy) and interpersonal therapy.

Differences Between Bipolar Disorder and Depression Based on Risk Factors:

Risk factor differentiations can be observed as follows-

Bipolar disorder often develops in late teenage years or in early adulthood years – half of the cases begin before the age 25. Some suffer from symptoms in childhood while some suffer later in life.

On the other hand, depression is the most common mental disorder in United States. The Average onset time period is 32 years old Women (70% more likely). 3.3% of 13 to18 year olds have experienced it.

Differences Between Bipolar Disorder and Depression Based on Diagnosis:

Diagnostic criteria for bipolar disorder includes physical exam, conducting patient interviews, lab tests. Symptoms must be radically changed from usual behavior.

Diagnostic criteria for depression includes physical exam, interview, lab tests. Medical conditions must also be ruled out such as that of thyroid disease.

What is the Next Step After the Diagnosis?

First requirement for treatment is diagnosis. Once you have been diagnosed, you will be given a course of treatment to be followed. The treatment varies on the basis of the patient’s own individualistic needs, background and the severity of his or her condition. A course of medication and psychotherapy is the basic necessity in both bipolar and depressive disorders. A combination of both the methods is effective for effective results.

While bipolar medications usually begin working within a few weeks, medications for depression generally takes longer to expert full therapeutic effects. Studies have shown that the span of time can range from 6 to 8 weeks for people who take anti-depressants. Cognitive-behavioral therapy and techniques along with psychotherapy are noticed to be effective in dealing with depression in the meantime.

Most of the people who have been diagnosed with either bipolar disorder or depression generally feel way better within a few months and they can even think of discontinuing their treatment with their doctor’s permission. The length of treatment varies widely from person to person and is usually based upon the severity of the disorders, the effectiveness of the treatment methods, and various other factors.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:April 22, 2019

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