Bipolar disorder is sometimes called “manic depression,” and in its depressive phase, it can look a lot like major depression. But the two conditions aren’t the same. When you’re depressed, you may feel down for weeks or months at a time. With bipolar disorder, you have severe mood swings that take you down through periods of depression, then up through periods of elation, then down again. This cycle repeats, but without any predictable pattern.
If you’ve been having symptoms of mood disorder, it’s important to see a therapist or doctor to find out which condition you have, whether it’s bipolar disorder, depression, or some other disorder, so you can get the right treatment.
Depression involves periods of sadness, but it goes beyond just feeling blue for a day or two. When you have major depression, the down mood lasts for two continuous weeks or more. You might feel so down that you have trouble doing just about everything, including working, hanging out with friends, eating, and sleeping.
It’s important to remember that depression can manifest differently between sexes and children and older adults. But generally, if you’re depressed, you might experience:
- feeling hopeless, worthless, or helpless
- not caring about things that once meant a lot to you
- decreased interest or no interest in sex
- fatigue or low energy nearly every day
- finding food unappetizing, or turning to food for solace and eating too much
- staying up all night because you can’t sleep
- sleeping all day because you can’t get out from under the covers
- vague aches and pains, like a stomachache or headache
- thoughts about hurting yourself
In its low phase, bipolar disorder looks very much like depression, but those depressed episodes alternate with periods of overexcitement. The combination of both highs and lows are what distinguish bipolar disorder from depression.
With bipolar disorder, your symptoms will shift depending on which episode you’re in. View the table below to see common symptoms of manic and depressive episodes.
|Common symptoms during a manic episode||Common symptoms during a depressive episode|
|Feelings of extreme happiness or elation||Losing interest in activities you used to enjoy, including sex|
|Racing thoughts and talking very rapidly to get them all out||Feeling tired or physically slow, which is referred to as psychomotor retardation|
|Restlessness and fidgeting||Having trouble concentrating or remembering|
|Jumping from project to project||Eating too much or too little|
|Sleeping very little, or not at all||Sleeping too much or very little|
|Engaging in various risky behaviors because they feel good||Thinking about hurting yourself|
|Thinking you can do just about anything||Having feelings of hopelessness, worthlessness, or guilt|
Your treatment will likely combine one or more antidepressant medicines with talk therapy. Depression is very treatable and with the right approach, you should see your mood start to lift within a few weeks. However, it should also be noted that depression has a high relapse rate.
Medicines for depression target brain chemicals that affect mood and might include antidepressants such as:
- selective serotonin reuptake inhibitors (SSRIs): fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro)
- serotonin and norepinephrine inhibitors (SNRIs): venlafaxine (Effexor), desvenlafaxine (Pristiq), duloxetine (Cymbalta)
- norepinephrine-dopamine reuptake inhibitors (NDRIs): bupropion (Wellbutrin)
- atypical antidepressants: mirtazapine (Remeron), vilazodone (Viibryd)
Your doctor might also suggest cognitive behavioral therapy to counteract the negative emotions that are making you feel down. During these sessions, you’ll learn positive strategies to boost your mood. Therapy can also include your family or partner. You might take part in group-therapy sessions where you interact with others who struggle with depression.
Bipolar disorder uses many of the same treatments as depression, including antidepressant medicines and cognitive behavioral therapy. The goal of treatment is to manage and stabilize symptoms.
The first drug your doctor will likely prescribe is a mood stabilizer, such as:
- lithium (Eskalith, Lithobid)
- anticonvulsants: valproic acid (Depakene, Stavzor), divalproex sodium (Depakote), lamotrigine (Lamictal), gabapentin (Gralise, Neurontin)
Other drug options for bipolar disorder are:
- atypical antipsychotics: olanzapine (Zyprexa), aripiprazole (Abilify), quetiapine (Seroquel)
- antidepressants: fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), bupropion (Wellbutrin)
Cognitive behavioral therapy is also a cornerstone of bipolar disorder treatment. Your therapist will help you learn to recognize signs of a mood swing so you can get help before it gets out of control. Your family may be involved in your therapy sessions.
Use this chart as a guide to prepare for your discussion with your doctor.
|Decreased sex drive||X||X|
|Euphoric or high mood||X|
|Feeling like you can do anything (invincibility)||X|
|Impulsive or risk-taking behaviors||X|
|Increased sex drive||X|
|Lack of interest in activities you once loved||X||X|
If you checked only boxes in the left column, you might have depression. If you checked boxes in both columns, you might have bipolar disorder. No matter what your result, don’t try to self-diagnose. See your doctor or psychiatrist, who can confirm whether you have depression or bipolar disorder and recommend the right treatment.