Bipolar Affective Disorder and Depression: Understanding the Differences

Diagnosis, particularly with mental health conditions, is one of the great challenges we face as clinicians. These are very complex and varied sets of disorders with overlapping symptoms. Among the most easily confused conditions are Bipolar Affective Disorder (BAD) and Depression. Although they both involve mood disturbance and can prevent everyday functioning, they are quite different with respect to the signs, causes, and ways they are most easily treated. This is important, as both differ significantly in presentation to the clinician and course of disease; moreover, this distinction has implications on management strategies.

Bipolar Affective Disorder (BAD)

Bipolar Affective Disorder (previously called Manic-Depressive Illness) is a mental health condition that causes extreme mood swings: highs simply known as mania and lows, or depression. The mood changes can be severe and range from:

During a manic episode, the individual may experience: an elevated or irritable mood, increased energy levels, rapid speech, impulsive behaviors, and decreased need for sleep.

Features of depressive episodes include fatigue, loss of interest in activities, feelings of worthlessness, and hopelessness.

The Two Types of Bipolar Disorder:

1. Bipolar I: In this situation, the presence of at least one manic episode is seen, which may or may not be preceded/followed by hypomanic or depressive episodes. Sometimes, mania can cause psychosis or may require hospitalization.
2. Bipolar II: This is characterized by a pattern of one or more major depressive episodes accompanied by at least one hypomanic episode (a milder state than mania). Depressive episodes, on the other hand, can be very disabling (though perhaps less so than in classic bipolar depression) and thus will often require hospitalization.

The mixed episode, which is experienced by a person afflicted with Bipolar Disorder, houses both mania and depressive symptoms at the same time, making it an extremely overwhelming and frustrating ordeal to go through.

What is Depression?

Depression, also known as Major Depressive Disorder, is a common and serious medical illness that negatively affects how you feel, the way you think, and how you behave. Of course, you were probably going to deduct that last one anyway; it is described as a unipolar disorder, not bipolar. A few major signs of depression include:

• Persistent low mood
• Fatigue or low energy
• Sleep disturbances
• Guilt and worthlessness
• Difficulty concentrating
• Thoughts of suicide or attempted suicide

Unlike those who have Bipolar Disorder, people with depression do not experience manic or hypomanic episodes. The range in severity categories is as follows: i) mild, ii) moderate, and iii) severe; the illness can be episodic or chronic.

Key Differences Between Bipolar Affective Disorder and Depression

Mood patterns characterize Bipolar Affective Disorder from Depression mainly.

Bipolar Disorder involves extreme mood changes from manic episodes of very high energy to the extreme lows of depressive periods. While depression (aka Major Depressive Disorder) is a continuous low period with no manic phases. Although they have similar depressive symptoms, like exhaustion and a bleak outlook on life, bipolar disorder sufferers alternate between manic and depressive states; these “up” periods of time can lead to impulsive decision-making or actions that are out-of-character for the person.

Furthermore, treatment is different: Bipolar Disorder is usually treated with mood stabilizers, which are important to prevent mania, while depression is often treated with antidepressants. Correct diagnosis is imperative, especially in Bipolar Disorder, as wrong treatment can further deteriorate the condition.

Conclusion

Both Bipolar Affective Disorder and Depression are extremely serious mood disorders, yet they differ greatly in their presentation and management. Whereas depression is distinguished by an enduring low mood, Bipolar Disorder is characterized by cycling between mania and depression. For effective control of symptoms and improvement in quality of life, proper diagnosis and treatment are necessary, but they depend on each clinical case.