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WHAT IS BIPOLAR DEPRESSION?

Depressive episodes are the “lows” of bipolar disorder

If you’re on this site, you may already have asked yourself, “Do I have bipolar depression?” To understand bipolar depression it’s important to know what it is—and what it isn’t.  Bipolar depression isn’t just feeling sad. It refers to the “lows,” or depressive phase, of bipolar disorder. If this is what you’re dealing with, some or all of the symptoms of bipolar depression* may be all too familiar:

  • Depressed mood most of the day
  • Loss of interest or pleasure in most activities, most of the time
  • Significant weight change
  • Changes in sleep patterns—sleeping too much or not at all
  • Fatigue or loss of energy
  • Feelings of worthlessness or guilt
  • Trouble concentrating or making decisions
  • Frequent thoughts of death or suicide; suicide attempts

If you have 5 or more of these symptoms almost every day in a single 2-week period—in a way that’s different from before—you may be having a major depressive episode associated with bipolar disorder.

*American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. American Psychiatric Publishing: Washington, DC. 2013;25(2):160-161. 

Understanding bipolar disorder

Bipolar disorder—the larger condition that includes bipolar depression—is a long-lasting, or chronic, illness that can affect anyone. It can begin when you’re young or old, but half of all cases start between the ages of 15 and 25. There is no cure. But for many people the symptoms can be controlled with treatment.

As the name suggests, bipolar disorder is a condition that affects the brain in a way that can cause extreme mood swings. People with bipolar disorder can go from mania—feeling euphoric and on top of the world (or revved up and irritable)—to feeling sad, hopeless, or worse. The time spent in these moods can vary in length. Occasionally, for some people, the change can even happen in as little as a day. These highs and lows are called “episodes” of mania and depression. That’s why you’ll sometimes hear bipolar disorder referred to as manic depression. Some people may experience mood swings that are less extreme than a full manic episode, known as hypomania.

People with bipolar disorder have normal moods about half the time, when they aren’t experiencing symptoms of either mania or depression. But sooner or later, everyone with bipolar disorder experiences one or more depressive episodes. Most people find the symptoms of depression harder to deal with because they happen more often and last longer than the symptoms of mania. On average, people with bipolar disorder spend three times as much of their time in a depressed mood as in manic episodes.

For more information about bipolar disorder, watch our video.

If you are struggling with bipolar depression, you’re not alone

No matter how isolated you may feel at times, you have plenty of company. Bipolar disorder and bipolar depression are more common than many people realize.

  • Bipolar disorder affects about 10.4 million people in the United States
  • As many as 29 million people worldwide are estimated to have bipolar disorder

Bipolar depression can be tough to manage

Bipolar depression can get in the way of the important things in life—family, home, and work. That’s hard enough. But the fact is, it can take up to 10 years of being misdiagnosed before bipolar disorder is recognized. This is partly because of the wide variety of symptoms, and also because people (even doctors) don’t always recognize the highs as being abnormal.

People usually see a doctor and get diagnosed when they’re in the low phase. Because of that, their bipolar depression may be diagnosed as a different depressive disorder at first. This is important since the two conditions can be treated very differently. There are ways to treat bipolar depression, but even when you’re getting treatment, you may still have symptoms.

Are you living with depression? Have you had—or has someone close to you noticed—a pattern of symptoms like those listed above? Could you be one of the people whose bipolar depression has been missed—or misdiagnosed? Time to ask your doctor about bipolar depression.

Effective treatment begins when you speak to your doctor

If you’re already diagnosed and still struggling with symptoms of bipolar depression, you can take steps to change that. Speak to your doctor about how you’re feeling and what you can do.

If you’re not sure where to begin, here’s help for you. Use our Daily Mood Monitor to track your moods day by day and share the result with your doctor. And use our custom guide, Now You’re Talking: A guide to getting what you need from your next doctor’s appointment, to get the conversation started.

Work with your healthcare team to find the right medication for you
Medications prescribed for bipolar disorder work differently for each person. Many of these types of medications work gradually; it may take some time to notice improvements.

There's no way to tell in advance how you’ll respond to a particular medication. So be sure to work with your doctor and your support team to find a medication and dose that works for you. Be honest about the positives and negatives of your treatment experience. And don’t give up.

In the meantime, it’s important to take your medication as directed by your healthcare provider.

If you have serious thoughts about suicide, call your healthcare provider right away or go to the emergency room.
You can also call the National Suicide Prevention Lifeline 24 hours a day at
1-800-273-8255.

Next: Bipolar depression treatments

Effective treatment for bipolar depression usually includes a combination of medicine and talk therapy. More >


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