Bipolar Disorder vs Depression. Sometimes it’s hard to tell. That’s what I’m talking about in this video.
I’m Dr Tracey Marks and if you’re new here, I talk about mental health education and self-improvement. I produce weekly episodes every Wednesday So if you don't want to miss one, press subscribe and the notification button as well. Bipolar disorer can first show itself as depression, mania or hypomania.
If you start out with a depressive episode, you can have that diagnosis for years until you have your first manic or hypomanic episode, then your diagnosis will change to either bipolar 1 or bipolar 2. But there are some signs that your depression, may really be bipolar disorder even if you haven’t received that diagnosis yet. And why does this matter?
Because the treatment for bipolar disorder is different from unipolar depression. Here are 5 signs that you may really be on the bipolar spectrum as we now call it. I base this information on the diagnostic manual that we use and the Bipolarity Index by Dr Gary Sachs.
The reference to his research article is in the description below. Number 1. Your first depressive episode occurs before age 20 In bipolar, the average age of onset is between ages 15 and 20, Whereas with unipolar depression it tends to be between 30 to 40.
This doesn't mean, yes it's possible that you can have a depressive episode as a child not really have anything else happen until your 30's again. But in general, bipolar disorder that includes both depression and mania tends to present itself in the late teen years. Whereas unipolar depression as we call it where all you have is depressive episodes tends to occur or present for the first time later in life.
2. You don’t get better with antidepressants, and in some you may even get worse. Antidepressants are more likely to cause mixed states where you may become anxious, agitated - we call it wired by tired.
You could've responded well to an antidepressant in the past. But now your depression just still can't seem to get better with antidepressants. And it could be that now your bipolar disorder is just starting to become more evident 3.
You have a family member with bipolar disorder. And this is more important if it’s a first degree relative such as a parent or child, this wouldn't apply to a cousin. .
4. You have 3 or more depressive episodes in a 5 year time span. Bipolar disorder tends to be cyclical and reoccurs on a somewhat regular or frequent basis.
So in a typical course you may have a depressive episode that is then followed by mania or hypomania. Then maybe that one will be followed later on sometime by a depressive episode. And these episodes though can be months or even a year or more apar.
t But it still just keeps cycling. Whereas the depression alone you tend to have an episode that may or may not come back at some point but you don't generally get this pattern of repeating itself unless it's a part of seasonal affective disorder which is a different entity from singular depression. So when a person has repetitive depressive episodes we now start to think more along the lines of considering whether the person has a bipolar spectrum illness.
And you know the hypomanic episodes can float by unnoticed. Hypomania generally doesn't cause impairment. I'm going to have a future video talking about bipolar 1 versus bipolar 2.
But because it doesn't the same level of impairment that manic episodes cause, It's possible that you can have a hypomanic episode where you just feel really good, on top of the world, doing things you want to do no problem. And not really see it as a problem. Such that if you really take a step back and look it really looks like you had repetitive depressive episodes.
but the hypomania just went unnoticed. So that could be a reason why your repetitive depressive episodes may really be a part of bipolar two disorder in this case. Lastly number 5.
You take a mood stabilizer and have full recovery within 1 month now this is still tricky sign because we will use mood stabilizers as an add-on treatment for treatment resistant depression. Now this is not an absolute. It doesn't mean that if you've ever in your life responded well to a mood stabilizer such as Abilify, Rexulti, Seroquel which we use these drugs for other reasons too, it doesn't mean if you've done well with one of those, you have bipolar disorder.
What this all means is it's just little hints or suggestions that is some of these things have been an issue with you, you might want. You and your doctor might want to think about whether or not Your illness is really your depression that you're seeing at the moment is really part of a bipolar illness. And why does this matter?
Because the way that we treat bipolar disorder is different than the way that we treat depression. And as I've mentioned some people can do worse, some people with bipolar disorder can do worse with antidepressants. Particularly antidepressants alone.
So what your doctor would do differently is either add a mood stabilizer to your antidepressant, or nix the antidepressant altogether and use 1 or even 2 mood stabilizers to treat you. That's some of the differences that you would see if you were being treated for bipolar disorder versus depression. That's it.
