Understanding the difference between bipolar disorder and depression can be tricky. Both conditions share overlapping symptoms, making it challenging to differentiate between the two. However, identifying the right diagnosis is crucial because the treatment for bipolar disorder is quite different from that of depression.
In this article, we’ll explore five key signs that your depressive episodes might actually be part of bipolar disorder. This information is based on insights from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the Bipolarity Index by Dr. Gary Sachs.
1. Early Onset of Depressive Episodes
If your first depressive episode occurred before the age of 20, this could be a red flag for bipolar disorder.
In the USA, the average age of onset for bipolar disorder is typically between 15 and 20 years. In contrast, unipolar depression (depression without mania) tends to emerge later, between ages 30 and 40.
While there are exceptions—for example, experiencing depression as a child and having no further episodes until your 30s—bipolar disorder often reveals itself during the late teen years. This early onset often includes both depressive and manic or hypomanic episodes.
2. Poor Response to Antidepressants
Have antidepressants failed to improve your symptoms, or worse, have they made you feel more anxious or agitated?
This phenomenon, sometimes described as feeling “wired but tired,” can indicate bipolar disorder. In some cases, antidepressants may even trigger mixed states, where symptoms of depression and mania occur simultaneously.
You might initially respond well to antidepressants, but as time goes on, your depression may resist treatment. This could be because bipolar disorder is becoming more apparent, requiring a different approach to treatment.
3. A Close Family Member Has Bipolar Disorder
Genetics play a significant role in mental health conditions, including bipolar disorder.
If a first-degree relative, such as a parent or sibling, has been diagnosed with bipolar disorder, your risk of having the condition increases. While this doesn’t guarantee that you’ll develop it, it’s a strong indicator to consider, especially if combined with other signs.
4. Recurrent Depressive Episodes
Experiencing three or more depressive episodes within five years is another potential sign of bipolar disorder.
Bipolar disorder often follows a cyclical pattern, with depressive episodes alternating with manic or hypomanic episodes. These cycles can occur months or even years apart, but the recurring nature of the episodes is a hallmark of the condition.
In contrast, unipolar depression typically doesn’t follow such a repetitive pattern unless it’s tied to conditions like seasonal affective disorder.
It’s also worth noting that hypomanic episodes can often go unnoticed. Unlike full-blown manic episodes, hypomania doesn’t usually cause significant impairment. Instead, you might feel unusually energetic, productive, or confident—feelings that may not seem problematic at the time.
This subtlety can make it appear as though you’re only experiencing repetitive depressive episodes when, in reality, hypomania is part of the picture.
5. Positive Response to Mood Stabilizers
If taking a mood stabilizer results in a full recovery within a month, it might indicate bipolar disorder.
Mood stabilizers like Abilify, Rexulti, and Seroquel are commonly used to treat bipolar disorder. However, they’re also prescribed as add-on treatments for treatment-resistant depression, which makes this sign less definitive.
Still, if mood stabilizers significantly improve your symptoms, it’s worth discussing with your doctor whether your depression might actually be part of bipolar disorder.
Why This Matters
Properly distinguishing between bipolar disorder and depression is essential because the treatments differ significantly.
For instance:
- Antidepressants alone can sometimes worsen symptoms in people with bipolar disorder.
- Bipolar disorder is often treated with mood stabilizers—either alone or in combination with antidepressants.
By recognizing the signs of bipolar disorder early, you and your doctor can tailor a treatment plan that’s more likely to work for you.
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FAQs
1. What is the key difference between bipolar disorder and depression?
Bipolar disorder includes mood swings between depressive and manic/hypomanic episodes, while depression involves persistent low moods without mania.
2. Can antidepressants worsen bipolar disorder?
Yes, antidepressants can trigger mixed states or worsen symptoms in some people with bipolar disorder.
3. Is bipolar disorder hereditary?
Yes, having a close relative with bipolar disorder increases your risk.
4. What age does bipolar disorder typically begin?
Bipolar disorder often begins between the ages of 15 and 20.
5. Can hypomania go unnoticed?
Yes, hypomania may not cause significant impairment and can be mistaken for periods of high productivity or happiness.
6. What are mood stabilizers, and how do they help?
Mood stabilizers, like Abilify and Seroquel, help manage mood swings in bipolar disorder.
7. How is bipolar disorder diagnosed?
Diagnosis involves evaluating your symptoms, family history, and patterns of mood changes.
8. Can children have bipolar disorder?
Yes, but it’s less common, and symptoms may differ from those in adults.
9. How long do bipolar episodes last?
Episodes can last weeks to months and may recur over time.
10. Is bipolar disorder treatable?
Yes, with proper medication and therapy, many people manage their symptoms effectively.