Living with Depression? Hmmm, Unipolar or Bipolar?

“Yikes, Bill, I thought depression was depression. Now I find out about ‘unipolar’ and ‘bipolar.’ Help me wade through this mess!”

Just a few days ago, a Chipur reader sent along an email expressing great angst after learning there were two distinct presentations of depression. She can’t be alone in her frustration, so I tidied-up an article I’d written a looong time ago that explains the differences between unipolar and bipolar depression.

If you’re living with depression or wondering what to do about depression, I know you’ll find the information relevant and helpful.

Okay, fact is, making the distinction between unipolar and bipolar depression is crucial in terms of diagnosis and treatment – and even the very survival of the one trying to endure it.

Before we handle any other business, let’s consider 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, when it comes to mania, those who live by the psychobabble bible, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) , will cite all sorts of rigid criteria differentiating manic and hypomanic episodes. For our immediate purposes it’s best to simply consider mania within the context of a mood elevation spectrum. Good enough?

Alrighty, then – accepting that 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, and weight loss
• Feelings of sadness, hopelessness, and worthlessness
• Restlessness, agitation, and pacing
• Episodes are of longer duration
• Possibly more responsive to treatment

Bipolar

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

And that’s a quick reference guide for you.

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, primary care physician, or psychiatrist.

Living with depression? Wondering what to do about depression? A great way to get started on the relief and healing road is coming to understand the difference between the “unipolars” and “bipolars” of it all.

I mean, how can something be effectively treated if it isn’t accurately identified? Right?

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