Bipolar Vs Major Depressive Disorder

Suicide And Depression In Bipolar Disorder

Some people with bipolar depression feel so overwhelmed that they think suicide is the only option. Its not. There are some practical measures you can take to prevent it, including:

• Keeping a list of important contacts handy

• Removing any means of suicide

• Staying away from alcohol and recreational drug use

• Avoiding websites that encourage negativity and suicide

• Joining a support group

If your depression is so severe that youre thinking about suicide or engaging in self-injury, call any of the following hotlines:

American Psychological Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, American Psychiatric Publishing, Washington, D.C., 2013.

Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: A meta-analysis. Journal of Affective Disorders. Published online 2016 Sep 15.doi: 10.1016/j.jad.2016.03.063.

Arroll B, Moir F, Kendrick T. Effective management of depression in primary care: a review of the literature. BJGP Open. 2017 Jun 28. doi: 10.3399/bjgpopen17X101025.

Chaudhury P, Banerjee D. Recovering With Nature: A Review of Ecotherapy and Implications for the COVID-19 Pandemic.* Front Public Health.* 2020 Dec 10. doi: 10.3389/fpubh.2020.604440.

Cooper P. Writing for Depression in Health Care. British Journal of Occupational Therapy. 2013. doi:10.4276/030802213X13651610908452.

Roddis JK, Tanner M. Music therapy for depression. Res Nurs Health. 2020 Jan doi: 10.1002/nur.22006.

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How Bad Is Bipolar Depression

A person who has bipolar disorder will have periods of mania and depression at different times .

These arent your ordinary ups and downs that everyone goes through from time to time. Instead, the episodes are associated with severe or violent mood swings, similar to a pendulum swinging higher and higher.

Brain Activity While Anticipating A Working

• Find a therapist to overcome depression

Diagnosing bipolar disorder can be difficult. While it is not hard to distinguish between its two characteristic phasesthe high spirits of mania and the low spirits of depressionit is challenging to tell if someone who reports low mood is suffering from a depressive disorder or is in the depressive phase of bipolar disorder. Indeed, a bipolar diagnosis is only confirmed, clinically, once a depressed patient has experienced at least one episode of mania.

Mania is characterized by elevated mood , racing thoughts, ideas and speech, ill-considered risk-taking, unusually high levels of energy, and a decreased need for sleep. Hypomania, a less intense version of mania, is no less serious and is also a feature of bipolar disorders manic phase. These symptoms are distinctly unlike those experienced during the depressive phase of bipolar disorder or by people suffering from a major depressive disorder. Yet symptoms of depression in themselves are clinically identical in people with depression and in the depressive phase of bipolar disorder.

This diagnostic problem has motivated researchers to search for measurable biological markersaspects of brain activity, for examplethat might differ in depressed patients and patients in the depressive phase of bipolar disorder, perhaps facilitating more accurate diagnosis. Preliminary success has now been reported in such an effort, led by Mary L. Phillips, Ph.D.

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The Role Of Screening Instruments

The frequency of misdiagnosis and the challenge of differentiating MDD and BP highlight not only the importance of accurate differential diagnosis but also the need for and appropriate use of reliable diagnostic tools. The MDQ is one of several self-administered instruments developed to improve detection of BP.2 It was intended to be used as a screening instrument, not as the diagnostic measure.2 Unfortunately, some clinicians regard a positive screen result in the MDQ as a presumptive diagnosis.6

There has been a desire to get an easy-to-use bipolar screening tool in the hands of busy clinicians that can quickly and easily be almost a proxy for making a formal diagnosis. But screens are just thatscreens they are not proxies for actual diagnoses. Screens are meant to cast a wide net to not miss true cases they are less focused on excluding false positive cases. When we used the MDQ as a structured interview with patients to clarify their self-reported responses, we found very high positive and negative predictive value of a true bipolar diagnosis. The questions within the MDQ provide an excellent basis for a semi-structured interview with the patient that allows an experienced clinician to clarify and contextualize patients responses. Dr Goldberg

Yes, you have to do a clinical interview after you administer the MDQ, or any other screening tool, because of the modest positive predictive value . Dr Zimmerman

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Suicide And Treatment With Antidepressants

Suicide cannot be treated but only prevented . Research on treatments aimed at suicide prevention, not surprisingly, is very limited because of clinical and ethical problems arising if an inactive or ineffective treatment, such as placebo, were compared to an experimental intervention, with death as a potential outcome. In addition, it is virtually impossible to know when a suicide has been prevented, whereas suicidal acts or surrogate measures can be counted. Rarity of suicide, even among psychiatric patients, encourages research reliance on more prevalent measures related to suicide, including suicidal ideation, threats, self-injurious acts, or emergency interventions. However, the typically distant relationship of such measures to suicide limits their value in testing for therapeutic effects on suicide itself. Relating treatments to suicidal risks is further complicated by uncertain long-term adherence to recommended treatments . Treatments for BD considered for possible suicide-prevention include antidepressants, anticonvulsants and lithium, antipsychotics, ECT, and psychosocial interventions .

Table 3 Treatments aimed at reducing suicidal risk in bipolar disorder patients

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What Causes Bipolar Disorder

Scientists dont yet know the exact cause of bipolar disorder.

But they do believe theres a strong genetic component. Bipolar disorder is considered one of the most heritable psychiatric conditions more than two-thirds of people with bipolar disorder have at least one close biological relative with the condition. However, just because you have a biological relative with bipolar disorder, doesnt necessarily mean youll also develop it.

Other factors that scientists think contribute to the development of bipolar disorder include:

• Changes in your brain: Researchers have identified subtle differences in the average size or activation of some brain structures in people with bipolar disorder. However, brain scans cant diagnose the condition.
• Environmental factors like trauma and stress: A stressful event, such as the death of a loved one, a serious illness, divorce or financial problems can trigger a manic or depressive episode. Because of this, stress and trauma may also play a role in the development of bipolar disorder.

Scientists are currently performing research to determine the relationship that these factors have in bipolar disorder, how they may help prevent its onset and what role they may play in its treatment.

What Types Of Therapy Are Used To Treat Bipolar Disorder

Psychotherapy, also called talk therapy, can be an effective part of the treatment plan for people with bipolar disorder.

Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to you and your family.

Different types of therapy for bipolar disorder include:

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What To Do When You Are Depressed

The first thing to realize is that youre not alone. Depression is temporary there is help, hope, and a way out. You can make lifestyle choices that will have a significant, positive impact on your depression.

If your depressive symptoms are severe or leading to suicidal thoughts or major functional impairment, seek professional help as soon as possible. Depression is a mental health condition that can be treated, and that you don’t have to “power through.”

For more mild depression symptoms or as part of a treatment plan, you may want to start with , as research shows that exercise can lift mood, especially when used in conjunction with medication and talk therapy. Even light activities like a brisk walk can relieve depressive symptoms. Choosing a team sport may help reduce feelings of isolation.

regularly may also relieve depression. This doesnt mean you have to be in the deep wilderness. Simple, nature-based activities like gardening or a stroll in the park or around your neighborhood can help.

You might also try about your feelings. This can be done in the form of therapeutic writing with a trained therapist, creative writing, or writing song lyrics, with an emphasis on what you’re feeling.

Music may also reduce depressive symptoms. The American Music Therapy Association is a good place to find out more information about formal music therapy and to locate a qualified music therapist.

Help For Bipolar And Unipolar Depression

In the end, neither bipolar disorder nor unipolar depression is worse than the other. Both can be challenging conditions to manage without professional mental health treatment.

If you or someone you care about is showing signs of either condition, we offer a residential mental health program in Boca Raton, FL, that offers a safe and comfortable environment where patients can recover from their symptoms and learn how to properly manage them. By housing clients in this program, we remove them from the distractions of their everyday lives to get down to the source of their disorders and help them find peace and healing.

Lasting recovery is possible. Call Banyan Treatment Center today at to find out how we can get you there.

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How Does Bipolar Depression Feel

How does one experience bipolar depression? That depends upon whom you ask. Many people undergo distinct periods of stability, mania, and depression. Yet other individuals can feel both depressed and manic at the same timesimultaneously feeling very sad and energized.

Holly A. Swartz, MD, associate professor of psychiatry at the University of Pittsburgh School of Medicine, says it is relatively rare for people to meet the DSM criteria for a mixed state, which requires a major depressive episode and a manic episode nearly every day for at least one week. However, individuals meeting diagnostic criteria for either a depressive episode or a manic episode often have a few subsyndromal symptoms of the opposite pole of the disorder that co-occur with their predominant mood episode, Swartz says. For example, someone will meet full criteria for a depressive episode but will also have racing thoughts.

Rapid-cyclingas defined by the DSMs diagnostic criteriais having at least four distinct episodes of major depression, mania or hypomania, or mixed symptoms within a 12-month period. But it is possible to experience more than one rapid-cycling episode a week, or even within one day, according to the National Institute of Mental Health.

Gender And Race/ethnicity Analyses

To further explore whether our results were based on differences of gender or race/ethnicity, we repeated all our analyses stratifying by gender and by racial/ethnic subgroups . Separate analyses of males and females yielded the same results that appeared when both sexes were analyzed together. Results for Whites, Hispanics, and Blacks were similar to those reported for the whole sample, although some became nonsignificant due to the smaller sample sizes. Some exceptions included, among Hispanics and Blacks, the proportion of females in the BD-I group and MDD group was comparable and among Hispanics, time from diagnosis until first treatment of depression was longer in BD-II than MDD subjects, with no differences between diagnoses in age at first treatment for depression. Sample size constraints limited the reliability of comparisons of Native American or Asian subpopulations.

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What Are The Side Effects Of Bipolar Disorder Medications

Side effects of bipolar disorder medications are common and vary by medication. Its important to talk with your healthcare provider about what you can expect when taking certain medications. Its also important to tell them if youre experiencing side effects.

Never stop taking your medication unless your healthcare provider tells you to do so. Abruptly stopping medication can cause severe side effects and trigger severe episodes.

The most common side effects of bipolar disorder medications include:

• Akathisia feelings of restlessness and agitation with a compelling need to move, rock or pace.

Unipolar Vs Bipolar Depression Symptoms

Major Depressive Disorder

• Feelings of guilt, worthlessness, helplessness
• Difficulty concentrating

• Loss of interest or pleasure in hobbies and activities that were once enjoyed
• May experience sleep disturbances, or oversleeping
• Overeating or loss of appetite
• Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
• More suicide attempts than with major depressive disorder
• A profound loss of energy
• Severe depression more likely to include psychotic symptoms
• Onset of depression occurs at a younger age
• More likely to have a co-occurring mental illness, such as obsessive-compulsive disorder, panic disorder, or substance abuse
• More likely to have a family history of mania
• More episodes of depression than with unipolar depression
• Use of antidepressantwithout mood-stabilizermay cause hypomania or mania

Originally printed as The Downside of Up,Fall 2010

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How It Affects Daily Life

When itâs not under control, bipolar disorder can cause problems in many areas of life, including your job, relationships, sleep, health, and money. It can lead to risky behavior. It can be stressful for the people who care about you and arenât sure how to help or may not understand whatâs going on.

Using Antidepressants To Treat Bipolar Disorder

Knowing which treatments are appropriate for certain conditions is essential with bipolar and major depression. For example, selective-serotonin reuptake inhibitor antidepressants are deemed safe and effective for treating major depression. They can also be used totreat bipolar disorder, though only in limited situations, due to the potential for triggering emergent manic episodes.

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A Quick Look At The Symptoms Of Bipolar Disorder

To begin understanding, it’s important to look at the diagnostic criteria for bipolar I disorder, which we’ll simplify a bit for your benefit:

• People with bipolar disorder experiencemanic episodes characterized by increased energy and focus as well as feelings of euphoria or irritation, for at least one week at a time. These episodes can induce feelings of grandiosity, a racing mind, and the immediate and uncontrollable urge to engage in various activities, including having lots of ideas and taking a lot. People with bipolar disorder may be physically restless and don’t sleep a lot during these times. These episodes are severe enough to interfere with daily functioning and may require hospitalization.
• They also have hypomanic episodes, which have pretty much the same symptoms, but not to the extent where other people necessarily notice or to require hospitalization.
• Depressive episodes are another characteristic symptom of bipolar disorder. When a person with bipolar is in the middle of a depressive episode, they’ll meet the diagnostic criteria for major depressive disorder. These include a depressed mood, loss of interest in previously meaningful activities, weight and appetite changes, a physical slowing down or speeding up, sleep disturbances, feelings of worthlessness or guilt, trouble concentrating and making decisions, and suicidal feelings or thoughts about death.

Major Depression And Bipolar Ii Disorder

Bipolar II disorder impacts about1.1% of the US adult population, making it less common than major depression but slightly more common than bipolar I . Diagnostic criteria are identical for major depression and depressive episodes within bipolar II, making misdiagnosis a common occurrence. However, subtle differences in the presentation of these episodes may help clinicians and individuals distinguish the two disorders.

• More than half of individuals with bipolar II have episodes withatypical depression symptoms, whereas this only occurs for 25% of those with major depression.
• In various studies, bipolar II has been associated with:
• Earlier age of onset.
• Higher suicide attempt rates.
• Higher rates of recurrent symptoms.
• Higher rates of physical symptoms, such as excessive sleeping, weight gain, and leaden paralysis .

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The Difference Between Unipolar And Bipolar Depression

Bipolar disorder and major depression share some similarities. They are sometimes confused because both can include depressive episodes, but there are some key differences.

The main difference between the two is that depression is unipolar, meaning that there are no periods of abnormally elevated mood, while bipolar disorder includes symptoms of mania.

In a recent article for PsychCentral, Sonya Matejko explored the distinction between the two conditions. To put it simply, unipolar depression is another name for major depressive disorder , also known as clinical depression, she wrote. This mood disorder is characterized by a persistent feeling of sadness or a lack of interest in things that you used to enjoy.

According to the current edition of the Diagnostic and Statistical Manual of Mental Disorders used by psychiatrists to diagnose mental health conditions patients must experience the following to receive an MDD diagnosis:

• symptoms for two weeks or longer
• episodes of depression or significant loss of interest, or both
• a change in the way you previously functioned

Diagnostic criteria include experiencing five or more of the following symptoms in a two-week period:

• feeling sad or irritable
• change in appetite or sudden weight loss
• lack of energy or unusual sense of tiredness
• loss of interest in activities you once enjoyed
• difficulty with decision making or concentrating
• having thoughts about self-harming

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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