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Is There A Difference Between Bipolar Disorder And Bipolar Depression

What Is The Outlook Of Bipolar Disorder

Bipolar Disorder vs Depression – 5 Signs You’re Likely Bipolar

The prognosis for bipolar disorder is often poor unless its properly treated. Many people with bipolar disorder who receive appropriate treatment can live fulfilling and productive lives.

Bipolar disorder results in approximately nine years reduction in expected life span, and as many as1 in 5 people with bipolar disorder commit suicide. An estimated 60% of all people with bipolar disorder have drug or alcohol dependence.

This is why its essential to seek medical care and stay committed to treatment for bipolar disorder.

Regular and continued use of medication can help reduce episodes of mania and depression. By knowing how to recognize the symptoms and triggers of these episodes, theres a better chance for effective treatment and finding coping methods that may prevent long periods of illness, extended hospital stays and suicide.

Demographic And Clinical Variables In Mdd And Bd

A total of 164 participants were all outpatients, the demographic and clinical characteristics of drug-free patients with MDD and BD-II are presented in Table . We found no significant differences between-group differences with regards age, sex, height, weight, education levels, and marital status . BD-II patients tend to be more extroverted , and have higher rates for drinking and smoking compared to MDD patients. There were also no significant differences in age of onset, disease courses, and family history of mental illness between BD-II and MDD patients . For clinical symptoms, our results showed that BD-II patients had more severe anhedonic symptoms than MDD patients . However, HAMD-17 and HAMA scores show no significant differences between those two patient groups . The power calculation showed that the statistical power for the SHAPS reached 96.78%, which indicated a high statistical power of our sample size to detect the difference of SHAPS score between the BD-II and MDD patients. Our stepwise logistic regression analysis further revealed that SHAPS score , drinking habit and extroversion as important influencing factors for the identification of BD-II.

Table 1 Comparisons between drug-naïve MDD patients and BD-II patients

Is Bipolar Depression Worse Than Unipolar Depression

Theres no way to say which is worse than the other. Both major and bipolar depression is challenging to manage for various reasons. However, bipolar depression is more episodic than unipolar, which can be stressful on both the individual and the people around them.

Agitation and impulsivity, which are common behaviors in people with bipolar disorder, can add a level of stress that a person with depression may not experience. People with bipolar disorder may go on excessive shopping or gambling sprees during manic episodes or feel the need to take out a huge loan for a sudden business idea.

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Themes Uncovered By Expert Panel That Could Lead To Diagnostic Missteps

  • Ruling out of BP initially by labeling all depressed patients as potentially having BP
  • Assumption that TRD is probably misdiagnosed BP without consideration of the many other possible factors that can account for TRD
  • Lack of clarity about hallmark symptoms as outlined in DSM-5, which leads to uncertainty in differential diagnosis, due to overlapping symptoms and comorbidity
  • Lack of clarity about best predictors of achieving an accurate diagnosis of MDD vs BP and also risk factors that predispose a patient to a bipolar diagnosis
  • Overreliance on screening tools to serve as a proxy for diagnosis in lieu of complete clinical assessment and data gathering to fit together the constellation of signs and symptoms
  • Discounting of the family history too quickly by inappropriately dismissing it or, conversely, giving it too much weight
  • Misinterpretation of the words used by the patient to describe a family members psychiatric history

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How Are Bipolar Disorder And Depression Related

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Research shows that common comorbidities of bipolar disorder include anxiety, substance use disorder, ADHD, eating disorders, and other medical issues .7, 9 Further, John Hopkins Medicine reports that major depression and bipolar disorder are on a list of several mental health disorders identified as the highest cause of disability.10

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Studies Of Bipolar Depression And Unipolar Depression

In one large-scale, case-register study including data from 38000 participants internationally, the age of onset for bipolar disorder was 6 years younger than for that of unipolar depression . Nevertheless, the onset of depression was not examined separately.

Evidence from a retrospective study suggests that bipolar disorder is characterized by more depressive episodes than unipolar disorder is . Several studies suggest that bipolar depressions are shorter and quicker to onset than unipolar depression . Nevertheless, findings are not consistent in this area, with two large-scale studies finding no difference between unipolar and bipolar depression in episode length .

Cross-study differences in results might be due to changes in gender or episode length over time. Parallel with the gender ratio in unipolar depression, bipolar depression is more common among women than men . One retrospective study reported that the length of bipolar depressive episodes shortened over a 15-year period .

In sum, compared to unipolar depression, bipolar depression appears associated with a younger age of onset, more frequent episodes, and greater short-term mood variability. No consistent differences have been found between episode length, although some studies suggest a shorter episode length of bipolar depressions compared to unipolar depressions. Depression severity appears comparable between bipolar and unipolar disorders.

Causes Of Bipolar Affective Disorder

Though, the causes of bipolar affective disorder have not been scientifically proven.

But then,

According to researchers, it can be caused by

  • Genetic cause and

Below are the things they found to cause bipolar affective disorder.

Genetic causes include:

  • Bipolar tends to run in families, so if anyone of your parent has it, you may likely acquire it.

Environmental causes include:

  • Too much stress can prompt it.
  • Shock or the death of a loved one.
  • You sometimes have suicidal thoughts.

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Symptoms Of Bipolar Disorder

If you have bipolar disorder, you may alternate between depression and hypomania or mania. You may also have periods in between when you have no symptoms. Its also possible to have the symptoms of mania and depression at the same time. This is called a mixed bipolar state.

Some of the symptoms of hypomania and mania are:

  • restlessness, high energy, or increased activity
  • racing thoughts or being easily distracted
  • grandiose ideas or unrealistic beliefs
  • irritability, aggressiveness, or being quick to anger
  • needing little sleep
  • a high sex drive

Severe mania can cause delusions and hallucinations. Poor judgment during a manic episode can lead to alcohol and drug abuse. Youre not likely to recognize that you have a problem. Mania lasts at least a week and is intense enough to cause major problems. People who have it often need hospitalization.

Hypomania lasts at least four days and is less severe.

How To Receive A Proper Diagnosis

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There are no specific medical tests that determine if you have major depressive or bipolar disorder. Laboratory tests are sometimes ordered to rule out potential medical contributions to your symptoms. The diagnosis is made clinically, meaning mental health professionals will evaluate your current symptoms and psychiatric history to make the diagnosis.

For this reason, it can be helpful to work with a psychiatrist, psychotherapist, and general practitioner. This can increase the chances of getting a precise diagnosis and feeling relief sooner.

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Difficulty Taking Care Of Oneself

Bipolar disorder can make it hard to take care of day-to-day responsibilities, such as eating healthy, exercising, and getting enough sleep. This can lead to problems with weight, energy levels, and overall health. People with bipolar disorder may also have trouble keeping a job or managing their finances.

What Are The Side Effects Of Bipolar Disorder Medications

Side effects of bipolar disorder medications are common and vary by medication. Its important to talk with your healthcare provider about what you can expect when taking certain medications. Its also important to tell them if youre experiencing side effects.

Never stop taking your medication unless your healthcare provider tells you to do so. Abruptly stopping medication can cause severe side effects and trigger severe episodes.

The most common side effects of bipolar disorder medications include:

  • Akathisia feelings of restlessness and agitation with a compelling need to move, rock or pace.

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Bpd Symptoms Vs Bipolar Disorder Symptoms

Although theres some overlap between the two conditions, there are a few differences.

The main differences between BPD and bipolar disorder symptoms are:

The timing of impulsive behaviors

If you have bipolar disorder, your impulsivity tends to happen during periods of mania or hypomania. But if you have BPD, impulsive urges may arise without other symptoms of mania. Impulsive urges may arise anytime or may occur in response to stressors that happen randomly.

Sleep

During periods of mania, people with bipolar disorder feel more energized and need less sleep. You might feel energized after just a few hours of sleep each night. BPD doesnt involve mania, so youre less likely to notice this.

Mood cycle time

People with BPD have short-lived moods that change within a few hours or days. People with bipolar disorder tend to have mood cycles that last for weeks or months, unless they have rapid-cycling bipolar disorder, in which case the mood cycle will be much shorter.

Relationships

BPD is characterized by a deep fear of abandonment, which can put immense strain on relationships. People with BPD often struggle to have stable relationships as they fluctuate between extreme like and dislike for people. While people with bipolar disorder might struggle with interpersonal relationships, the fear of abandonment isnt often present.

Triggers

Self-esteem

People With Depression And Bipolar Disorder Feel Sadness Differently

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Depression and bipolar disorder can both cause people to go through periods of extreme sadness and despair, and even mental health experts may find it difficult to distinguish between the two disorders. But new research suggests these conditions may have very different patterns of brain activity.

In a new study, researchers scanned the brains of people with clinical depression and other people with bipolar disorder, and measured these individuals’ reactions to emotional photographs. The researchers found differences in the amount of activity in brain areas involved in regulating emotion in bipolar patients, compared with patients who had “unipolar” depression .

“As psychiatrists, we have a big problem: We cannot distinguish unipolar depression from bipolar depression,” said Dr. Eric Ruhe, a psychiatrist at the University of Amsterdam in the Netherlands. This inability to tell which disorder a patient has is a problem because antidepressant medication usually isn’t effective for treating people with bipolar disorder, he said. Such medicines can even increase such a patient’s risk of having a manic episode, he said. During manic episodes, a person with bipolar disorder may become agitated, euphoric and sometimes psychotic.

The new findings could lead to a better way of diagnosing and treating patients with these disorders, according to the study, published today in the journal JAMA Psychiatry.

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Symptoms Of Depressive Episodes

Depressive episodes can also emerge without warning. Some of the triggers for these depressive periods include lack of sleep, excessive stress, or a negative life event, but often there is no known cause for the depression. The depressive episodes must be carefully monitored, as there is an increased risk of suicidal behavior during these phases.

Symptoms include:

  • Feelings of despair and hopelessness
  • Intense fatigue
  • Loss of interest in activities once enjoyed
  • Chronic pain with no known medical cause
  • Trouble concentrating
  • Suicidal thoughts

Treatment Of Bipolar Depression

As noted, depressive, dysthymic, and mixed states account for the majority of illness-burden in BD, and are strongly predicted by initial depressive, mixed, or anxious episodes . Remarkably few treatments are proved to be highly and consistently effective in acute episodes of bipolar depression, and there is even less evidence supporting substantial long-term protection from recurrences . In particular, there is continued controversy about the value and risks of antidepressant drugs in bipolar depression . Lack of highly effective treatments encourages widespread drug-combinations and other off-label treatments largely untested for effectiveness and safety.

Table 4 Placebo-controlled trials for acute depression in bipolar disorder

Relative paucity of experimental treatment studies for bipolar depression may reflect a broadly accepted view that major depression is similar in its clinical characteristics as well as treatment responses in BD and MDD . Instead, their characteristics differ, e.g., in family history, sex-distribution, onset-age, long-term diagnostic stability, episode duration, recurrence rates, and treatment-responses . The assumption of similarity probably contributes to the rarity of direct comparisons of treatment responses with depression in BD vs. MDD, and leaves bipolar depression as a leading challenge for psychiatric therapeutics .

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The Keys To Bipolar Disorder Self

Get educated. Learn as much as you can about bipolar disorder. The more you know, the better youll be at assisting your own recovery.

Get moving. Exercise has a beneficial impact on mood and may reduce the number of bipolar episodes you experience. Aerobic exercise that activates arm and leg movement such as running, walking, swimming, dancing, climbing or drumming may be especially beneficial to your brain and nervous system.

Keep stress in check. Avoid high-stress situations, maintain a healthy work-life balance, and try relaxation techniques such as meditation, yoga, or deep breathing.

Seek support. Its important to have people you can turn to for help and encouragement. Try joining a support group or talking to a trusted friend. Reaching out is not a sign of weakness and it wont mean youre a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them, and it will only strengthen your relationship.

Stay closely connected to friends and family. Nothing is as calming to the nervous system as face-to-face contact with caring supportive people who can just listen to you talk about what youre experiencing.

Make healthy choices. Healthy sleeping and eating habits can help stabilize your moods. Keeping a regular sleep schedule is particularly important.

Monitor your moods. Keep track of your symptoms and watch for signs that your moods are swinging out of control so you can stop the problem before it starts.

Summary Of Biological Facets

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Genetic evidence suggests that one can disentangle the biological vulnerability to mania from that of depression. Comparisons of bipolar and unipolar depression are not common, but nonetheless, some data is available. Functional imaging studies suggest remarkable parallels in that both bipolar and unipolar depression are characterized by increased activation of the amygdala and other limbic regions when individuals are exposed to sad stimuli . At a neurotransmitter level, bipolar and unipolar depressive episodes are characterized by similar levels of dopamine and serotonin. When matched for number of recurrences, bipolar II depressive episodes are associated with comparable levels of norepinephrine to unipolar depressive episodes. Despite the many parallels, one set of striking differences emerges. Studies of both intracellular mechanisms and sleep deprivation suggest that people with a lifetime history of mania may have deficits in the ability to regulate neurotransmitters in the face of a challenge. Such regulatory deficits would be expected to be manifested in more rapid course changes, as well as increased vulnerability to environmental challenges. We turn towards a review of course parameters and psychosocial triggers next.

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What Are The Signs And Symptoms Of Bipolar Disorder

Wondering how to know if you are bipolar? Signs and symptoms of bipolar disorder in men or women can range, depending on the state theyre in. Symptoms, when someone is in a manic state, can widely vary from what they experience when theyre in a depressive state. Severity of bipolar symptoms 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

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How To Differentiate Major Depressive Disorder From Bipolar Depression

Bipolar disorder is common, associated with a loss of 1020 years of life, and frequently misdiagnosed as major depressive disorder. One-third of patients wait at least 10 years for an accurate diagnosis and an appropriate evidence-based treatment strategy. All patients who present with depressive symptoms should therefore be screened throughout their illness for current and past evidence of hypomania or mania, explained global expert Professor Roger McIntyre, University of Toronto, Canada, at WCP 2021.

Accurate and timely diagnosis is critical to improve outcomes

One-third of patients with bipolar depression wait at least 10 years for accurate diagnosis

Bipolar disorder impairs psychosocial functioning and affects 24% of people during their lifetime. It is associated with a loss of approximately 1020 potential years of life, mainly due to cardiovascular disease and suicide,1 said Professor Roger McIntyre, University of Toronto, Canada.

Accurate and timely diagnosis is therefore critical to enable an appropriate evidence-based treatment strategy, he said.

However, misdiagnosis is common because patients usually present with major depressive disorder or with mixed features and it can be difficult to distinguish bipolar depression from MDD.

Delays in appropriate evidence-based treatment are linked to worse outcomes

Furthermore, MDD converts into bipolar disorder in 3.9% of patients at 1 year, 1% after 25 years, and 0.8% after 510 years.2

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Cognition During Depressive Episodes

When cognition is assessed during a depressive episode, bipolar disorder, comparable to unipolar disorder, is associated with a negative cognitive style, as measured by the Attributional Style Questionnaire , the Automatic Thoughts Questionnaire , and the Dysfunctional Attitudes Scale . Similar to patients with unipolar depression, patients with bipolar depression exhibit low self-esteem . In addition, attributions of failure are correlated with depression severity in both unipolar and bipolar depression . People with current episodes of unipolar and those with current bipolar depression appear to be comparable on measures of negative attributions about events and interference from negative words on the Stroop color naming task .

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