STRUGGLING with DEPRESSION, ANXIETY, or BIPOLARITY? LEARNING can really HELP. Start with ARTICLES above or Topics below. Ty! Bill

Unipolar or Bipolar Depression? Heads or Tails? No Way!

In response to yesterday’s post, chipur reader, Wendy, threw bipolarity into the mix. And I’m glad she did. In response, I said I was going to post an article on the differences between unipolar and bipolar depression. And here goes.

Now, if one doesn’t have a lot of personal or clinical experience with the mood disorders, it may come as a newsflash that there are these two types of depression. Well, it’s fact; and making the distinction is absolutely crucial in terms of diagnosis, treatment; and, perhaps, the very survival of the one trying to endure it.

Let’s cut to the chase by first coming to understand this foundational differentiating characteristic…

If a depression is to be considered bipolar in nature a degree of mania is either a part of the equation or will be in fairly short order.

Now, disciples of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) will come up with all sorts of rigid criteria differentiating manic and hypomanic episodes. But for our purposes it’s best to consider mania within the context of a mood elevation spectrum. Actually, we could consider depression in the same light.

Okay, understanding there are per case differences, let’s take a look at the characteristics of unipolar and bipolar depression.

Unipolar

  • Impacts women more than men
  • Tends to present later in life
  • Difficulty initiating and sustaining sleep with early morning awakening
  • Loss of interest in eating, poor appetite, weight loss
  • Feelings of sadness, hopelessness, worthlessness
  • Restlessness, agitation, pacing
  • Episodes of longer duration
  • Possibly more responsive to treatment

Bipolar

  • Impacts women and men equally
  • Average age of onset around 18
  • Excessive sleep, difficulty awakening, daytime fatigue
  • Ramped-up appetite, occasional diminished appetite, binging, carb-cravings, weight gain
  • Feelings of sadness, hopelessness, worthlessness, guilt
  • Psychomotor retardation and inactivity
  • Severe anxiety; which may include panic, obsessions, compulsions, nervousness
  • Psychotic features – assorted sensual hallucinations, paranoia, delusions
  • Varying degrees of mania
  • Substance abuse
  • Much higher incidence of suicide

So there’s a quick reference guide. Again, presentations may, and very likely will, vary on a per case basis. And for gosh sakes, please don’t talk yourself into believing you’re presenting with any of these symptoms if it isn’t even a remote possibility.

That said, if you’re truly uncertain and concerned – or if any of the symptoms are in any manner interfering with your life – talk with your counselor, PCP, or psychiatrist. And if you don’t have one, get moving.

We really need your input here. What would you add, change, or delete? What else would you like to share?

  • i’m just catching up on posts and am still excited about the possiblity of fast acting medication that works…….also worth mentioning (I think) is that the mania and depression with bi-polar people aren’t always the extremes portrayed on tv, etc. that a lot of people really do suffer from a “milder” form–that just because they aren’t up for days on end and conversely sleeping for days on end doesn’t mean they aren’t bipolar…. i overheard a conversation recently about how someone “really wasn’t bi-polar” just because the symptoms (at that time) weren’t as severe……..just a thought. Karen

    • Bill

      Well, welcome back Karen. Good hearing from you. Your point about less intense presentations of bipolarity is well taken. And that’s why I really like using a spectrum. The “milder” form you’re describing would be more of a hypomania, which would lean toward a dx of bipolar II. But, again, if you consider the mania piece in bipolarity on a spectrum, assuming the depressive piece is kind of always there in one form or another, you avoid all this mania/hypomania biz. And that’s crucial because personal presentations (and interpretations) can be all over the place. Again, very nice hearing from one of chipur’s foundational readers/commenters.

  • Sorry to nitpick, I would change your wording to typical characteristics of unipolar and bipolar depression. Actually, I would state it as typical characteristics of a unipolar depression versus a bipolar disorder. You have it titled as unipolar depression and bipolar depression while you list characteristics of a depressive episode and a manic episode under bipolar. One way I explain the difference between the two is this:
    With depression, a person goes below their baseline (whatever that may be) and with bipolar, a person goes below baseline and sometime in their lives above their baseline.
    I have a self-diagnosis of obsessive-compulsive personality disorder; I tend to be perfectionist.

    • Bill

      Hi Lacy! You’re not nitpicking at all. I’m glad to refine these things as best we can. That’s how all of us learn. Glad to have heard from you.