Unipolar depression is a mental health condition that involves a low, sad, or hopeless mood.
The term “unipolar,” which comes from the roots “uni” (one) and “polar” (end), means you have symptoms from only one end of the mood spectrum.
This sits in direct contrast to bipolar disorder, where you may experience both low mood states, or periods of depression, and high mood states, or periods of mania or hypomania.
Unipolar depression often serves as an umbrella term for all types of depression that involve only one mood state. But some people also use the term more specifically as a synonym for major depressive disorder (MDD).
Here’s a quick rundown on how to recognize unipolar depression, as well as how to get help for any symptoms of depression, regardless of your specific diagnosis.
The main diagnostic criteria for unipolar depression involve having a low mood for at least 2 weeks.
For example, you may feel sad, irritable, or generally discontent with life, and these feelings typically won’t improve if your situation changes or something positive happens.
You may also experience anhedonia, or feel less excitement, enjoyment, or pleasure, even when spending time with people you love and doing activities you’d usually enjoy.
Other core depression symptoms include:
- Change in appetite: You might feel hungry more often or have little desire to eat at all.
- Significant changes in weight: Your body weight goes up or down by
at least 5%in 1 month.
- Fatigue: You feel tired almost all the time, no matter how much you sleep.
- Sleep disturbance: You may have trouble falling asleep and staying asleep, or find yourself sleeping much more than you typically would.
- Psychomotor changes: Your body may feel very fidgety, or your movements may feel much slower than usual.
- Extreme guilt: You may blame yourself excessively for mistakes or believe you’re “worthless.”
- Difficulty thinking: You may notice brain fog, or trouble remembering things, concentrating, or making decisions.
- Thoughts of suicide: You may have recurring thoughts about death, dying, or suicide, though you may not have a specific plan or intent to die.
How to get help for thoughts of suicide
If you’re having thoughts of suicide, help is available right now.
You can access compassionate, confidential support from trained crisis counselors by calling 988 to reach the Suicide and Crisis Helpline.
Prefer to connect over text? You can also text “HOME” to 741-741 to reach a crisis counselor at Crisis Text Line.
You can connect with these free helplines 24/7, 365 days a year.
Unipolar depression can involve a wide range of symptoms, and not everyone will have every symptom. You need at least five of the above symptoms for a diagnosis of MDD, according to the most recent edition of the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5).” That said, two people with depression may experience the condition very differently.
According to a 2018 study, a combination of extreme guilt, anhedonia, and thoughts of suicide often suggests severe depression. But any combination of symptoms can feel overwhelming and severe, not to mention have a major impact on your everyday life.
Again, unipolar depression often refers to major depressive disorder (MDD), which also goes by the names major depression, clinical depression, or classic depression.
Major depression often appears in mood episodes that last weeks or months. After the episode, your symptoms will typically improve. But
Other types of depression that can fall under the “unipolar” umbrella include:
- Persistent depression: Also called dysthymia or chronic depression, this condition lasts at least 2 years. It involves milder symptoms of depression that never fully disappear. In other words, you’ll experience a low mood and other symptoms of depression on an ongoing basis or most days.
- Seasonal depression: This type of depression, also called seasonal affective disorder (SAD) or MDD with a seasonal pattern, specifically relates to changes in the seasons. Generally, depression symptoms appear during the colder months and disappear when the warmer months arrive, though you could experience symptoms in the reverse pattern.
- Postpartum depression: This type appears after pregnancy. Along with other depression symptoms, you may also find it difficult to bond with your child or experience fear and anxiety related to your role as a parent.
- Situational depression: Symptoms of this type of depression typically show up within 3 months after a stressful or traumatic event. This type of depression also goes by the name reactive depression, since your symptoms show up as a reaction to a specific stressor.
Depression with features of psychosis
In the general population, about 4 in every 1,000 adults experience depression with features of psychosis. With this subtype of depression, delusions, paranoia, and hallucinations may factor into your mood symptoms.
For example, you might develop a deep but unfounded belief that your friend got divorced because of a joke you told at their wedding 5 years ago. You may feel immensely guilty and avoid your friend because you’re convinced you sabotaged their life and don’t deserve them.
If you have depression with features of psychosis, you’ll only experience psychosis during a mood episode. Symptoms of psychosis that happen when you don’t have depression could suggest another condition, like schizophrenia.
You don’t need to have severe depression to experience symptoms of psychosis.
According to 2021 research, you can experience symptoms of psychosis even if you have milder symptoms of depression.
If you read over the criteria for an episode of depression that happens with bipolar disorder, you may notice these signs and symptoms basically match the criteria for an episode of MDD.
The truth is, even mental health experts often find it difficult to distinguish unipolar depression from bipolar depression, or an episode of depression that happens with bipolar disorder.
Some evidence suggests, however, that unipolar depression and bipolar depression appear to manifest differently in your brain.
Depression with bipolar disorder
If you have bipolar disorder, your neurons may show better “teamwork” during emotion- or reward-related tasks than if you have MDD. In other words, your mood state may be more likely to change in response to outside stimuli.
You may also have a thinner dorsolateral prefrontal cortex (DLPFC). This part of the brain affects executive functioning skills, like planning and behavior control.
In one 2018 study, researchers compared 30 adults with bipolar disorder, 30 adults with MDD, and 30 adults with no history of mental health conditions.
When researchers specifically focused on people experiencing an episode of depression with either bipolar disorder or MDD, they found that people with bipolar disorder tended to report greater improvements in their mood in response to positive stimuli or changes.
This group also experienced more stress when facing new scenarios and tended to make more of an effort to avoid unpleasant feelings or difficult situations.
That said, all of these differences are overarching patterns, not rules set in stone. Mental health professionals will typically only diagnose bipolar disorder if you also experience episodes of mania or hypomania.
What about depression with mixed features?
These symptoms may feel less intense than symptoms typically associated with an episode of mania, but they could foreshadow future episodes of mania.
Between 13% and 20% of people originally diagnosed with depression with mixed features go on to meet the diagnostic criteria for bipolar I or bipolar II disorder.
A number of treatments can help address symptoms of any type of depression.
According to the American Psychological Association, unipolar depression is often treated with second-generation antidepressants. Your doctor or psychiatrist may prescribe a:
- selective serotonin reuptake inhibitor (SSRI), which affects serotonin levels
- serotonin-norepinephrine reuptake inhibitor (SNRI), which affects serotonin and norepinephrine levels
- norepinephrine/dopamine reuptake inhibitor (NDRI), which affects norepinephrine and dopamine levels
You may need to try a few medications to find the one that works well for you. If you don’t notice any improvement after
They can recommend another type of antidepressant or change the dose of your current medication. In some cases, an adjustment to your dose can make a difference in your symptoms.
Research consistently suggests a combination of therapy and medication treats depression more effectively than medication alone.
Therapy approaches known to effectively treat depression symptoms include:
- behavioral activation therapy
- cognitive behavioral therapy (CBT)
- interpersonal therapy
- psychodynamic therapy
Depending on your symptoms and concerns, your therapist may also recommend other types of therapy, such as:
- acceptance and commitment therapy (ACT)
- dialectical behavioral therapy (DBT)
- mindfulness-based cognitive therapy
If therapy and medication don’t seem to have much benefit, you have a few other options to consider:
- Transcranial magnetic stimulation (TMS) stimulates your nerve cells with electromagnetic pulses, which may help promote pre-depression activity levels in your brain.
- Light therapy involves using a box to emit bright light for a set period of time each day. This approach often proves helpful for treating seasonal depression with a winter onset.
- Meditation can work well as an addition to professional treatment since it can help you name and accept uncomfortable emotions and push back against self-punishing thoughts.
- St. John’s wort, a medicinal herb known for its anti-anxiety and antidepressant effects, also proves helpful for some people. Just make sure to ask a doctor or other healthcare professional before trying St. John’s wort. It can interact with some medications, including antidepressants.
It’s not always easy to recognize whether a low mood suggests a mental health condition or a temporary emotional slump.
That said, reaching out to a professional for more support may be a good next step if your symptoms:
- have lasted more than 2 weeks
- affect your ability to perform daily tasks, like grocery shopping, going to work, or caring for basic hygiene needs
- affect your personal and professional relationships
- involve thoughts of self-harm or suicide
A care team for depression may involve a few different professionals. To get medication, you will need a prescription from a psychiatrist, primary care doctor, or other prescribing clinician. For therapy, you might connect with a therapist, social worker, or psychologist.
Our guide can help you start your search for a therapist.
Your regular doctor or another healthcare professional can refer you to mental health professionals in your area. You can also contact your insurance provider for more information about covered therapists or out-of-network benefits. Your plan may cover some — or all — of the cost of therapy.
If you prefer to work with a therapist virtually, you also have options for online therapy.
Unipolar depression often refers to major depression, but it can describe other types of depression, too. In a nutshell, this term helps distinguish depression from episodes of depression that happen with bipolar disorder.
Symptoms can include emotional distress, such as feelings of guilt and thoughts of suicide, cognitive symptoms like brain fog, or physical symptoms like fatigue and changes in appetite.
Just as unipolar depression can have many faces and presentations, it also responds to many kinds of treatments. Even if the first few approaches you try don’t seem to make much difference, don’t give up. You still have options, and the right support can go a long way toward improving your symptoms.
Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.