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Depression is a bummer regardless of what type you’ve got. Whether it’s seasonal, situational or otherwise, there’s no “good” form of depression and no “better” kind to have. And yes, this applies even when comparing bipolar versus unipolar depression.
Whether you’ve recently been diagnosed with some form of depression or have a loved one who just reached their own diagnosis milestone, the good news is that a diagnosis can answer many questions and open doors to psychological treatments.
The bad news is that both bipolar depression and unipolar depression are long-haul treatment scenarios, and the therapies in question for these depressive disorders often take time to show full benefits.
While unipolar and bipolar are separate disorders, they’re not really all that different. In fact, they’re based on the same model of mood disorders.
Not sure what we mean? Still have lots of questions? We’re here to help you navigate them all.
We’ll start with the basics. To understand the difference between bipolar depression and unipolar depression, let’s first explore what they have in common.
At its heart, depressive illness is a disorder of mood regulation — a condition in which a person has no control over the so-called highs and lows of their moods. Someone with depression cannot regulate or prevent their low, down feelings from going to extremes.
The key difference, however, is that unipolar depression (sometimes called clinical depression, severe depression or major depression but inclusive of mild depression and seasonal affective) is mostly characterized by intense lows.
Bipolar depression, on the other hand, is defined by not just the lows but also characteristic “highs” (also called manic episodes), which are the opposite of depressive episodes.
Manic depression, as it was once called, is characterized by drastic mood swings or mood disturbances. Someone with bipolar disorder may pivot rapidly or gradually from intensely energized euphoric moments to irritable moods to debilitating, paralyzing hopelessness or indifference.
Both conditions can leave depressed patients feeling down when they bottom out. But life can potentially be more chaotic, unpredictable and rocky for someone with bipolar disorder because of the wider range of the two polar ends of their symptoms.
Mental illness varies from person to person, so it’s important to understand that no two psychiatric disorders look the same — even if both people have the same condition.
Just because you meet the diagnostic criteria doesn’t mean your experience will be cookie-cutter.
With that said, there’s one key difference between unipolar depression and bipolar depression, and it’s wrapped up in the concept of “manic” episodes (or mania).
Mania can look very different depending on the individual. At first, it may simply seem like the person is in great spirits, that they’re walking on sunshine. But the more time you spend examining them, the more other details will emerge.
Someone experiencing an elevated mood during a manic episode might, for instance, exhibit rapid speech and be difficult to interrupt — the opposite of what tends to happen to the talking patterns of a depressed person.
A manic individual may behave erratically, be constantly in motion, or be unpredictable to interpersonal dynamics, neglecting social cues and boundaries.
Manic individuals can be irritable and easily agitated. And while a depressed person may experience delusions of guilt, worthlessness or failure, someone experiencing a manic episode might be equally delusional about their relative power or wealth.
Bipolar patients experiencing manic episodes can be easily distracted or illogical and struggle with impulse control. Additionally, they may have poor insight and judgment during these episodes and might become very unreliable.
Whether someone suffers from bipolar illness is really a question of mania or not. If you’ve had episodes of mania as well as episodes of depression, it’s probably safe to say you’re not experiencing unipolar depression.
However, things quickly get cloudy when we introduce the idea of Bipolar I and Bipolar II: two subcategories of bipolar disorder.
The easiest way to explain the difference between these two versions of bipolar disorder is this: Bipolar I is considered the more extreme version, while Bipolar II is viewed as the milder of the two.
Even experts can sometimes be initially confused. If you’re in a depressive state when you talk to a healthcare professional, they may misdiagnose you as unipolar, only to see evidence of bipolar later on.
Regardless, you either have one or the other, and mania is the key determining factor.
Treatment for bipolar mania and the disorder that causes it is markedly different from unipolar depression. The fact is, bipolar is still a relatively poorly understood condition, at least in comparison with unipolar depression.
Unipolar depression is often treated with therapy, antidepressants and lifestyle changes. You might be asked to get better sleep, reduce your stress, eat a well-rounded diet, exercise, cut out booze or cut down on caffeine.
Medications like antidepressants (selective serotonin reuptake inhibitors or SSRIs, especially) are proven safe and effective for unipolar depression treatment, as is therapy.
But while antidepressants work by helping unipolar patients manage their moods, only a few medications are FDA-approved to treat bipolar depression.
In fact, antidepressants are a big no-no for bipolar patients — there’s evidence that they can trigger manic episodes, among other things. Instead, mood stabilizers and antipsychotic medications are the go-to options in pharmacology.
Though it may seem antiquated, electroconvulsive therapy is actually considered extremely effective in treatment-resistant bipolar disorder.
If you have bipolar depression or unipolar depression (or aren’t sure which one you have), you may have guessed by now that there are many variables to consider when it comes to treatment.
Medications can be dangerous if taken incorrectly. But luckily, you can’t even get your hands on them without doing the first thing we recommend: talking to a healthcare professional.
The symptoms of depression are already complicated, and when you add manic symptoms and the concept of a hypomanic episode to the picture, bipolar depression can seem scary.
But we’re here to tell you bipolar patients have just as much access to support as patients with unipolar disorder.
For depressed patients, the first step in recovering from any form of depression is getting an ally on your side. A friend, family member or loved one makes an excellent teammate in the depression treatment journey.
But equally important is expert wisdom to help devise the right treatment plan for your individual needs — in other words, support from a healthcare professional familiar with both psychiatric disorders.
If you’re experiencing recurrent depression or depressed moods combined with manic symptoms and aren’t sure where to start, we can help.
Therapy for various medical disorders is convenient and easy with our online therapy platform. Here, you can match with trusted professionals and find the right one who makes you feel safe and comfortable being vulnerable while talking about hard topics.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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