Bipolar disorder—sometimes known by its older name, manic depression—is a mental illness that causes unusual shifts in mood, energy, and activity levels, and can affect one's ability to carry out everyday tasks. Depression usually manifests as a prolonged "low" feeling and/or extreme disinterest in activities that were once enjoyed.

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Bipolar disorder versus Depression comparison chart
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Introduction Bipolar disorder is a mental illness characterized by episodes of an elevated or agitated mood known as mania, alternating with episodes of depression. Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being, often accompanied by low self-esteem and loss of interest.
What one Feels Alternating mood episodes between overly excited and overly sad; explosive temper and irritability; between mood episodes Severe dejection and despondency, usually felt over a certain period of time and followed by feelings of inadequacy hopelessness, often thoughts of suicide.
Primarily characterized by Drastic change from usual mood and behavior Prolonged sadness that may interfere with life
Causes Genetics; environmental factors; brain-chemical imbalance. Chemical changes in the brain; low serotonin levels, change in dopamine and epinephrine
Mental symptoms Prolonged periods of extreme high and extreme low. Prolonged sadness, hopelessness, indifference, often suicidal thoughts
Physical symptoms Talking very fast, easily distracted, increasing activities, sleeping little, having an unrealistic belief in one's abilities, behaving impulsively, having problems concentrating, changing eating, sleeping, or other habits, attempting suicide. Lack of energy, no emotion, insomnia, change in appetite, slow responses, slow thinking, headaches, early-morning wakefulness or excessive sleeping, digestive problems that do not ease with treatment, headaches, cramps.
Treatment options Long-term, continuous – controls symptoms; medication and psychotherapy; electroconvulsive therapy (ECT) Psychotherapy, Cognitive-behavioral therapy, medications, ECT, rTMS and hospitalization.
Other Names Manic-depressive illness; Manic-depression Major depressive disorder; Dysthymia – long-term (less severe symptoms); Unipolar disorder
Diagnosis Physical exam, interview, lab tests Symptoms must be radical change from usual mood or behavior. Physical exam, interview, lab tests Medical conditions must be ruled out (virus, thyroid disease).
Medication Mood stabilizers; atypical antipsychotics; antidepressants. Antidepressants
Therapy Cognitive-behavioral therapy, interpersonal therapy, family-focused therapy, psychoeducation Cognitive-behavioral therapy and interpersonal therapy
At Risk Often develops in late teens or early adult years – half of all cases begin before age 25; some people suffer symptoms in childhood, some late in life. Most common mental disorder in U.S. Average onset 32 years old Women (70% more likely) 3.3% 13-18 year old have experienced.

What is Bipolar Disorder?

Bipolar disorder is sometimes known by its older name, manic depression. The illness is characterized by episodes of manic highs and depressive lows. The primary characterization of bipolar disorder is that people with bipolar experience a drastic change in their usual moods and behaviors, ranging from really happy sometimes to severely dejected. The frequency and severity of bipolar disorder depends on the form of bipolar—Bipolar I, Bipolar II, Cyclothymic Disorder, Mixed Bipolar, and Rapid-Cycling Bipolar—which a psychiatrist can help diagnose over time.

To better understand bipolar disorder, watch the hour-and-a-half-long documentary, Up/Down, in the video below:

What is Depression?

Depression is a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy life. Depressed individuals can have major depressive disorder or dysthymia, which lasts for a long time but has less severe symptoms. The primary characterization of depression is that feelings of sadness and sometimes numbness linger and interfere with daily life. The video below features The Truth About Depression, a BBC documentary:

Symptoms

Bipolar disorder is characterized by unusually intense emotional states called "mood episodes." With mood episodes, people with bipolar can feel overly excited and outgoing; this is classified as a manic episode. During mania, those with bipolar may have an unrealistic belief in their own abilities, which can result in poor decision-making. They may also speak more quickly than usual as a result of "racing" thoughts, experience insomnia, and take on new projects on top of the many they have yet to finish. During manic episodes, people with bipolar often behave impulsively and participate in high-risk behaviors.

An overly sad or hopeless state is called a depressive episode. During a depressive episode, those with bipolar may lose interest in activities they once enjoyed, such as sex, and struggle with anxiety and feelings of "emptiness." They may also experience deep tiredness, have trouble thinking, and feel upset over poor decisions they made during a manic episode. Restlessness and irritability are also common. Some experience thoughts of death or suicide during this time, and some others may even attempt suicide.

Some mood episodes include both mania and depression and are called mixed state episodes. An explosive temper or irritability can also indicate a mood episode. Between mood episodes, people with bipolar disorder often go symptom-free, which can complicate diagnosis.

Depression, by itself, is very similar to the depressive state in bipolar disorder. Depression can manifest in a number of ways, but generally is comes with feelings of hopelessness or pessimism, guilt, worthlessness, or helplessness. Sufferers often have difficulty concentrating, remembering details, and making decisions. Fatigue and decreased energy, as well as insomnia, early-morning wakefulness, or excessive sleeping, can accompany depression. Sufferers sometimes overeat or lose their appetite. Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment are other symptoms. Depression sometimes brings thoughts of suicide and suicide attempts.

Causes

Bipolar disorder cannot be tracked down to a single cause. Genetics are one cause, meaning children with a bipolar parent or sibling are more likely to develop the illness, but most children with bipolar disorder in their families do not develop the illness themselves. Environmental factors such as abuse, mental stress, and trauma also may contribute to bipolar disorder. A brain-chemical imbalance similar to that in depression is another cause.

Depression also has no single cause. Genetics can play a role, as can a variety of biological and psychological factors. Depression can also stem from trauma, difficult relationships, and mental stress, such as after the death of a loved one. With depression, sufferers experience chemical changes in the brain. They have low serotonin levels, and there is a change in dopamine and epinephrine.

At Risk Population and Diagnosis

Bipolar often develops in the late teens or early adult years, and half of all cases begin before the age of 25. Some people experience symptoms in childhood, while others don't experience them until late in life.

With one in 10 adults reporting depression, depression is the most common mental illness in the U.S. The average onset of depression is at 32 years old, and people of color are more likely to struggle with the illness than Caucasians. Women are 70% more likely to be diagnosed with depression than men are, but this may be related to how how men seek and receive help. Additionally, 3.3% of 13- to 18-year-olds have experienced depression.

Bipolar disorder and depression are diagnosed the same way: by conducting a physical exam, patient interviews, and lab tests. For bipolar disorder, the symptoms must be a radical change from the patients' usual mood or behavior. For depression, doctors must rule out medical conditions such as a virus or thyroid disease. MRI imaging can be used to find differences in the brain of those with bipolar disorder.

Due to bipolar disorder's cyclical nature, it is typically harder to diagnose bipolar than it is to diagnose depression. For example, those with bipolar may feel the urge to seek help and take medication during depression, but not during mania. This can easily lead those with bipolar (and their health care professionals) to assume they are depressed, but not necessarily manic.

Treatment

Although bipolar disorder has depressive episodes, treatment for bipolar disorder differs greatly from that of depression:

Treatment for bipolar disorder needs to be long-term and continuous to control the symptoms. Treatment should include medication and psychotherapy. Medication options include mood stabilizers, such as lithium, valporic acid, and lamotrigine; anticonvulsant medications, such as gabapentin, topiramate, and oxcarbazepine; atypical antipsychotics, such as olanzapine, aripoprazole, and quetiapine; and antidepressants, such as fluoxetine, paroxetine, sertraline, and bupropion. Serious cases may be treated by electroconvulsive therapy. Therapy options include cognitive-behavioral therapy, interpersonal therapy, family-focused therapy, and psychoeducation.

Treatment for depression should also include both medication and psychotherapy. Depression is generally treated with antidepressants, usually serotonin reuptake inhibitors such as fluoxetine, sertraline, escitalopram, paroxetine, and citalopram. Therapy options include cognitive-behavioral therapy and interpersonal therapy. Severe cases may be treated with electroconvulsive therapy.

Severity of the Disorder

Both bipolar disorder and depression can seriously impact a person's life, as well as those who live around them. Sufferers may struggle in their relationships, schools, and places of work, or self-medicate with alcohol and drugs. They may attempt suicide. Bipolar disorder can also be coupled with psychotic symptoms, resulting in hallucinations and delusions.

References

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