Having Bipolar Disorder, formerly called Manic Depression, can be an emotionally turbulent journey. It is a lifelong condition characterized by intense mood swings that range from highs (mania or hypomania) to lows (depression). These drastic changes are much more severe than the ordinary ups and downs most people experience.
As a result of bipolar disorder symptoms, individuals may find it difficult to complete their day-to-day tasks efficiently due to mood symptoms and the considerable impact on one’s mental health.
Imagine that your life is a roller coaster ride, and you are going from one extreme to another.
During a hypomanic or manic episode, you may feel overstimulated, energized, or have a bunch of new ideas and plans. However, a depressive episode will sooner or later bring you down to earth and even take you deeper into the abyss of sadness.
For many people, depressive episodes in Bipolar Disorder are usually longer than manic or hypomanic episodes. They may make your life unbearable, often leading to suicidal ideation.
The Importance of Diagnosing Bipolar Disorder for Mental Health
Differentiating Major Depressive Disorder (MDD) from bipolar depression can be challenging. In many cases, people with bipolar depression are diagnosed with major depression instead, and the correct diagnosis is delayed for 6-8 years. As a result, misdiagnosed people with Bipolar Disorder don’t receive proper treatment, making their Bipolar Disorder even worse, further leading to poor well-being and mental health.
About 40% of individuals diagnosed with unipolar depression are later diagnosed with Bipolar Disorder. So, it can be difficult to diagnose Bipolar Disorder because of overlapping symptoms with other depression disorders.
That is why learning about the symptoms and signs of bipolar depression can help you to get timely treatment and avoid further complications associated with a late diagnosis of the mental illness.
If you notice any warning signs of depression, such as lack of pleasure, feelings of sadness, and hopelessness, it is always better to get yourself checked. BrainManager’s depression test will take just several minutes of your time, and it will help you determine if you need to seek help from a mental health professional.
Signs and Symptoms of Bipolar Depression
While the depressive signs and symptoms of Bipolar Disorder, also known as Bipolar Affective Disorder, are similar to those of Major Depressive Disorder, certain crucial differences will help you notice and diagnose this disorder promptly.
So, let's look at some of the common symptoms faced by people with bipolar depression.
Prolonged sadness or unexplained crying.
People with bipolar disorders, like other forms of depression, can face a profound feeling of sadness that won't go away. This depressed mood may even come out as crying without any obvious cause. No matter what you do, you won't feel better unless you follow a comprehensive treatment plan.
Significant changes in appetite and sleep patterns.
For people with Bipolar Disorder, changes in dietary habits that cause major shifts in body weight are quite common, leading to either extreme loss or gain — or both, coinciding with the different cycles. Sleep disturbances may also arise, ranging from difficulty falling asleep and staying asleep (insomnia) to excessive sleepiness (hypersomnia).
If you have Bipolar Disorder, you may have extreme mood swings and lose or gain excessive weight within the span of a single year. While experiencing a manic or hypomanic episode, you will spend a lot of energy and may even forget to eat. But when depression comes, you will become less active and may use food to suppress your feelings of sadness.
Irritability and Agitation
In contrast to those who have a Major Depressive Disorder, people with Bipolar Disorder often have a heightened level of irritability, especially during a manic episode or when there are rapid mood swings. If your significant other has manic depression, you probably feel like walking on eggshells. No matter what you do or say, it will likely irritate them.
Irritability and agitation are often present in other mental health conditions associated with having a depressed mood, such as anxiety disorders and borderline personality disorder, so these symptoms of bipolar disorder can't be viewed in isolation.
Loss of energy or fatigue.
People who suffer from a depressive episode often experience fatigue that goes far beyond the general feeling of exhaustion. Such immense energy loss can make it difficult for them to accomplish even the most basic daily tasks.
Physical complaints that are not responsive to treatment.
One might experience a variety of physical symptoms such as headaches, stomachaches, or any other symptoms that cannot be relieved with standard treatments. In order to properly give a bipolar disorder diagnosis, it is essential that a medical or mental health professional rule out another cause for the physical symptoms.
Loss of interest in previously enjoyed activities.
Anhedonia, or inability to receive pleasure, even from activities you once enjoyed, is another common symptom of major depression and bipolar depression.
Feelings of worthlessness or excessive guilt.
People may tend to unfairly hold themselves accountable for things that are out of their hands or feel guilt without any rational reason. This often leads to low self-esteem and self-confidence.
Frequent thoughts of death or suicide.
The seriousness of this symptom of bipolar depression cannot be overstated. Anyone exhibiting suicidal thoughts or ideation or attempting to take their own life should seek professional help immediately.
If you are in crisis, call 911 or your local police, or reach out to a free and anonymous crisis hotline.
The depressed mood alternates with a manic episode or hypomania symptoms.
While these depression symptoms could be indicators of a multitude of depression-related mood disorders, the key feature that distinguishes bipolar depression is the presence of mania symptoms in between the recurring periods of depression symptoms. The manic episodes are also what differentiate bipolar disorder from relapsing depression.
How Bipolar Depression Is Different from MDD?
Bipolar Disorder and Major Depressive Disorder (MDD) are two distinct conditions, differing primarily in the presence of manic or hypomanic episodes. With bipolar depression, people experience alternating — and at times simultaneous — periods of both mania and depressive symptoms.
In contrast, major depression is characterized solely by a period of prolonged sadness with no occurrence of manic behavior.
Depressive symptoms are shared between Bipolar Disorder and Major Depressive Disorder but with the added complexity of at least one manic episode. Unlike a depression relapse, where the symptoms come back after a period of happiness and somewhat normalcy, for people with bipolar disorder, this time in between includes varying degrees of hypomania symptoms.
For some people, the cycle between mania and depression can be years. But for those with rapid cycling bipolar disorder, the period between mood swings is significantly shorter, with four or more episodes of depression or mania in one year.
To make things even more complicated, some people experience mixed bipolar episodes. In cases of Bipolar Disorder with Mixed Features, also known as a Mixed Features Episode, symptoms of depression and mania occur at the same time or in rapid sequence without recovery in between. This group will likely experience some mania symptoms during a full-blown episode of depression.
Finally, while we’ve been talking about the bipolar depression side of this disorder and its extremes, there is another group of people with Bipolar Disorder for whom the hypomanic episode can become so severe that it includes psychotic symptoms (which can also occur during an extreme depressive episode).
Psychotic symptoms during a bipolar episode can include jumbled thoughts, mood incongruence, delusions, paranoia, hearing voices, and hallucinations. In the past, it was not uncommon for “manic depression” to be falsely diagnosed as schizophrenia, especially if the other bipolar symptoms and/or depression symptoms had yet to present themselves (or if doctors were not aware of prior history).
When psychotic symptoms were the major presenting issue and because professionals didn't know as much as they do now, it was not always easy to get bipolar disorder diagnosed properly. As a result, the treatment plan was not always the best one possible to prevent bipolar disorder symptoms from reoccurring.
Today, doctors have a better grasp on how to treat bipolar disorder and improve the mental health of those who have it. As you can see, there are many types of bipolar disorder, which is why understanding the early warning signs of this mental health condition is essential to ensure proper treatment.
Understanding the Types Of Bipolar Disorder
In order to effectively treat Bipolar Disorder, one must first be aware that there are different types. Without this knowledge, it's impossible to give a proper bipolar disorder diagnosis.
As we have already seen, how the manic or depressive episodes are experienced by people with bipolar disorder varies. Symptoms of depression and mania can be more or less severe as well as more or less frequent, depending on the type of Bipolar Disorder you have. As such, Bipolar Disorder has various forms, including Bipolar I, Bipolar II, and Cyclothymic Disorder.
Let’s look at these different types of Bipolar Disorder.
Depression in Bipolar I Disorder
People with Bipolar I Disorder experience a severe manic phase lasting for at least seven days, characterized by euphoria, increased activity levels, and often reckless behavior. In Bipolar I Disorder, a major depressive episode also typically lasts 14 days or even months if not treated. On average, people with Bipolar I Disorder have more manic episodes yearly than depressive ones. Some people with Bipolar I Disorder may not experience depressive episodes at all.
With Type I Bipolar Disorder it is also possible to experience episodes of depression with mixed features, meaning both depressive and manic symptoms may occur simultaneously. These periods can be challenging for those affected as they present a unique set of difficulties that require careful navigation to manage effectively.
Many individuals with Bipolar I Disorder experience periods of regular moods in between episodes, but some may not. Additionally, some may experience psychotic episodes.
Depression in Bipolar II Disorder
Bipolar II Disorder is characterized by a cycle of depressive and hypomanic episodes. While the latter may be less extreme than manic ones in Bipolar I, depressive episodes usually last longer than in Bipolar I Disorder.
In addition, there are more depressive episodes than hypomanic episodes experienced by people with Bipolar II Disorder per year.
So, in Bipolar II, the contrast between ups and downs is less severe than in Bipolar I. However, “the downs” usually last much longer and can be very draining and exhausting.
Depression in Cyclothymic Bipolar Disorder
Cyclothymic Disorder, commonly known as cyclothymia, is characterized by the presence of both hypomanic and depressive episodes that fail to reach a degree of severity or duration necessary for classification as Bipolar II or Bipolar II.
Depression in Cyclothymic Bipolar Disorder is usually mild or moderate, so it doesn’t feel as “bad” as in the abovementioned Bipolar Disorder types.
It's essential to bear in mind that the signs of bipolar depression differ from individual to individual and can evolve and change. Some people may experience more extreme symptoms than others. At the same time, severe episodes of depression also fluctuate with regard to how often they occur and for what length of time.
How to Treat Bipolar Disorder and Manic Depression
Considering that Bipolar Disorder involves two completely opposite states, it is typically treated with a combination of different drugs, including mood stabilizers. Plus, don't forget that the severity of mania, hypomania, and depression symptoms can also differ. So, clinicians should consider numerous factors while ensuring that prescribed medication will be as effective as possible.
Bipolar depression is best treated holistically by combining medication, talk therapy, and lifestyle changes to improve mental health. Furthermore, clinicians usually prescribe mood-stabilizing medication like lithium or monoamine oxidase inhibitors (MAOIs), antidepressants, and antipsychotics — the former being typically used as first-line treatment.
In some instances of atypical bipolar depression where other therapies don't work effectively enough, electroconvulsive therapy has proven particularly beneficial.
Along with medication and therapy, self-care is essential to manage Bipolar Disorder and bipolar depression effectively. Developing a regular sleep schedule, exercising regularly, eating balanced meals, and managing stress can all be beneficial.
In addition to these strategies, it's essential to abstain from drugs or alcohol and keep track of your moods in a journal. Creating structure through scheduling tasks throughout the day also helps tremendously. Furthermore, engaging in treatment plans prescribed by mental health professionals and joining support groups may provide even more stability for those struggling with this mental health problem alone.
Safeguarding against relapse is an integral part of treating Bipolar Disorder.
To help minimize the severity of Bipolar Disorder symptoms — or to hopefully avoid a recurrence of the extreme symptoms of this mental illness altogether — it's essential to adhere strictly to your treatment regimen (medication and therapy), get sufficient sleep, reduce stress levels, nurture positive relationships at home and in the workplace, engage in regular physical activity as well as nourishing yourself with foods that are beneficial for brain health, such as omega-3 fatty acids and B vitamins. Plus, having reliable social support systems on hand.
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