Bipolar Disorder vs. Depression: How Do They Differ?

Published on: 22 Sep 2021
Clinically Reviewed by Jill E. Daino, LCSW-R
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Bipolar disorder and depression are similar in a number of ways, including several shared symptoms. In fact, some symptoms are so closely related, they may be confused by those not clinically trained to make a psychiatric diagnosis. 

  • Bipolar disorder is a condition that causes drastic mood swings. Your moods can range from extreme highs to very deep lows.  
  • Depression, on the other hand, is an intense sense of sadness that you can’t pull yourself out of. 

As you might imagine, although some symptoms may overlap, there are many differences between these two conditions as well. In order to get the appropriate treatment you’re seeking, it’s essential to understand what bipolar vs. depression can look like.  

What is Bipolar Disorder?

Bipolar disorder, sometimes referred to as manic depression, is a disorder that causes intense, often uncontrollable mood swings. Someone with bipolar disorder will experience extreme “highs,” (also called mania) where everything, from energy to agitation, is intensified. During a manic episode, you might feel incredible energy, happiness, impulsivity, or even restlessness. 

At the other end of the scale, the depressive state, you can feel exhausted or irritable, have difficulty making decisions, or even have suicidal thoughts.  

What are the signs and symptoms of bipolar disorder?

Wondering how to know if you are bipolar? Signs and symptoms of bipolar disorder can range, depending on the state you’re in. Symptoms, when someone is in a manic state, can widely vary from what they experience when they’re in a depressive state. Severity of bipolar symptoms (how bad they are) in either state can differ as well. 

In a manic state, manic symptoms may include:

  • Extreme overexcitement that lasts for a long time
  • Inability to focus
  • Easily distracted
  • Agitation
  • Restlessness
  • Racing thoughts
  • Over-committing to projects, work, or engagements (socially or professionally)
  • Feeling like you don’t need sleep
  • Talking fast and loudly
  • Feeling very energetic
  • Having a sense of self-importance

In a depressive state, depressive symptoms may include:

  • Feeling extreme exhaustion
  • Irritability
  • Having suicidal thoughts
  • Feeling worthless
  • Indecisiveness
  • Irregular eating habits
  • Irregular sleeping patterns
  • Difficulty focusing
  • Behavioral changes

Since bipolar disorder has a wide range of symptoms, it can be an overwhelming diagnosis at first given that there is a lot of misinformation out in the world. It is crucial to remember that with good care, bipolar disorder can be well managed. Don’t hesitate to reach out if you have concerns about any of these symptoms.”

Talkspace therapist Jill E. Daino, LCSW-R, BC-TMH

What is Depression?

Depression (also known as major depressive disorder when talking about severe depression) is a mood disorder that can cause near-constant tiredness, sadness, difficulty dealing with daily life and responsibilities, despair, and sleep and appetite disruption. Most often, depression is the result of a combination of factors and events, not just one event.

When it’s severe, depression can interfere with just about every aspect of your life. It can make simple things like showering and getting dressed feel overwhelming. It can cause you to lose interest in things you enjoyed doing at one time.  

What are the signs and symptoms of depression?

Signs and symptoms of depression can vary from mild to severe. You can have some days where symptoms are more intense than others. A depressive episode generally has at least 5 or more symptoms, and they can last most of the day for weeks at a time (or longer). If you’re depressed, you may experience feelings of: 

  • Intense sadness
  • Hopelessness
  • Pessimism
  • Worthlessness
  • Lack of interest in things you once found joy in
  • An “empty” feeling
  • Insomnia
  • Sleeping more than normal
  • Not eating enough, or eating too much
  • Restlessness
  • Inability to concentrate
  • Headaches, miscellaneous pains, or aches
  • Irritability 
  • Suicidal thoughts or attempts

I would encourage anyone who is wondering whether they are experiencing depression to reach out. Don’t wait until it gets harder — the earlier you are able to get help, the easier it can be to treat depression. I say to my patients: ‘you don’t have to wait until the house is on fire to ask for help.'”

Talkspace therapist Jill E. Daino, LCSW-R, BC-TMH

Are These Conditions Treatable?

The most important thing to remember when it comes to treating bipolar vs depression is that the earlier you start and the more consistent you are, the more effective your treatment will generally be. In both cases, medication and therapy are  common treatment options. 

Treating bipolar disorder

Bipolar disorder treatments often include a mood stabilizer and/or one of the many newer antipsychotic drugs that are available and approved for use. Most often, a combination of the two treatments is the go-to. Today, mental health care providers are able to help you find the right combo of medications that can help the symptoms of bipolar depression and bipolar disorder overall, without triggering a swing into a manic state. 

On that note, it’s important to keep in mind that a careful treatment plan will monitor your symptoms and make sure one medication isn’t affecting other areas of your bipolar disorder. 

For example, although an antidepressant can be an effective form of treatment for someone with a major depressive disorder, they’re typically not the first line of treatment for bipolar depression. And they’re almost never given as a sole treatment as it may worsen the rapid cycling for those with bipolar disorder. 

Some options for medication and treatment that can be prescribed for bipolar disorder may include:

  • Antipsychotic drugs — Studies show that some antipsychotic drugs can be effective for treatment of bipolar disorder in studies. They work by targeting neurotransmitters in the brain that help stabilize behavior and mood. 
  • Central nervous system (CNS) depressants — CNS depressants cause neurotransmitters to slow down brain function and can help treat sleep issues associated with bipolar disorder and anxiety during manic states.
  • Electroconvulsive therapy (ECT) — ECT introduces a brief electrical stimulation of the brain. It can be used when someone who’s bipolar is having suicidal behavior or psychotic symptoms, but it’s not generally the first line of treatment.
  • Psychotherapy — Cognitive behavior therapy (CBT), family-focused therapy, and interpersonal or social rhythm therapy have been known to increase treatment response time. 

*NOTE: Professional treatment and guidance are important, and you should ask your doctor or licensed therapist about ways you can best manage any mental health diagnosis. 

Treating depression

Treating depression can include a combination of medication — like an antidepressant or anti anxiety medication — and therapy (such as talk therapy). In the event of a diagnosis of seasonal affective disorder (now more commonly known as major depressive disorder with seasonal pattern), some have even found successful treatment using light therapy, where doses of exposure to white light can help improve and regulate a depressed mood. 

Other options that many people have found success with (in addition to medication and therapy) include integrating some alternative therapies into your treatment plan. Some of these options might include:

  • Acupuncture — Some have found they’re able to manage and relieve stress through the ancient art of acupuncture, where trigger points might be able to stimulate the central nervous system.  
  • Exercise — Exercise is proven to increase the release of a chemical known as endorphins, which are natural mood enhancers.
  • Medication — Medication can play an important and essential role in your mental health and managing your depression diagnosis.
  • Self-care — It’s OK (and so important) to be able to recognize and respect your own limits. Too much stress is never a good thing, and it can ultimately further anxiety in all of us. Taking care of yourself by getting enough sleep, eating well, and setting boundaries for how much you’re willing to take on are all ways you can practice self-care and self-love. 
  • Supplements — Some supplements are known to reduce stress and help you feel better and brighter. 
  • Vitamins — Vitamins are another way to increase energy and keep vital nutrients in your system, so your body will have what it needs to be as healthy as possible. 

*NOTE: Professional treatment and guidance are important, and you should ask your doctor or therapist about ways you can best manage any mental health diagnosis. 

Reaching out for help can make such a difference when someone is experiencing symptoms of bipolar disorder or depression. No one has to struggle alone — help is available.”   

Talkspace therapist Jill E. Daino, LCSW-R, BC-TMH

How to get help for bipolar disorder or depression

If you’ve ever wondered: Am I bipolar or depressed?, you should absolutely find someone to talk to. Your doctor or mental health care provider is your first line of defense when it comes to correctly diagnosing, and then treating, the symptoms most people experience with either bipolar disorder or depression. 

Because these two are so closely related in terms of symptoms, it’s important that you seek out professional help with someone clinically trained and licensed in how to best set up a treatment plan. The first step to finding help is getting the right diagnosis. 

  • Wondering if you are depressed? Our depression test can help you decide on your next steps.  

Dealing with any mental health condition can feel overwhelming in the beginning. Dealing with bipolar disorder versus depression can be challenging to navigate, but there is help out there. Remember that you have resources available and access to the help you’re looking for. Any time you’re struggling with your mental health, you can:

  • Find a licensed therapist to talk to
  • Talk to your family doctor to ask for a referral
  • Be mindful of your stress and anxiety, and try to limit exposure to things that you know are triggers
  • Explore options for medication (with the help of your doctor or mental health care provider)
  • Find support groups as part of your therapy

For more information on bipolar disorders, contact Talkspace today. You can get common questions answered around bipolar relationships or the difference between depression vs. bipolar. Connecting with a licensed therapist can help you determine a diagnosis and treatment plan that’s right for you.

Sources:

  1. What Is Depression?. Psychiatry.org. https://www.psychiatry.org/patients-families/depression/what-is-depression. Published 2020. Accessed August 15, 2021.
  1. What is Bipolar Disorder? Stanford medicine. https://med.stanford.edu/bipolar/bipolar.html . Published 2021. Accessed August 13, 2021.
  1. Baldessarini, R.J., Vázquez, G.H. & Tondo, L. Bipolar depression: a major unsolved challenge. Int J Bipolar Disord 8, 1 (2020). https://doi.org/10.1186/s40345-019-0160-1. Published 2020. Accessed August 15, 2021.
  1. Rolin, Donna PhD, APRN, PMHCNS-BC, PMHNP-BC (Clinical Associate Professor and Director)1; Whelan, Jessica APRN, PMHNP-BC (Owner, Chief Executive Officer)2; Montano, Charles B. MD (Director, Principal Investigator)3 Is it depression or is it bipolar depression?, Journal of the American Association of Nurse Practitioners: October 2020 – Volume 32 – Issue 10 – p 703-713 https://doi.org/10.1097/JXX.0000000000000499 Published 2020. Accessed August 15, 2021.
  1. Depression. Mental Health Foundation. https://www.mentalhealth.org.uk/a-to-z/d/depression/. Updated 2021. Accessed August 15, 2021.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

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