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Health & FitWhat’s the Difference Between Bipolar Disorder and Depression?

20:05  22 may  2019
20:05  22 may  2019 Source:   usnews.com

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A common question asked of clinicians is, “ What ’ s the difference between bipolar disorder (also known as manic depression ) and plain old depression ? It’s a simple question to answer, because depression can either be a stand-alone diagnosis, or a part of another disorder , like bipolar .

Bipolar disorder and major depression might seem similar, but there are important differences . WebMD helps you sort it out and stay healthy. Depression (also called major depressive disorder or MDD) often goes hand-in-hand with sleep problems, changes in appetite, and trouble concentrating.

What’s the Difference Between Bipolar Disorder and Depression?© (iStockphoto) A girl sits in depression on floor near a wall.

You're sunk in a pit of hopelessness where it's a struggle to get out of bed in the morning, open the curtains or take a shower: It's all too much effort and what difference does it make? You're facing the day with depression.

You're wired – on a mission to create the world's next great screenplay or startup. Without forethought, you spend thousands of dollars on a shopping spree. Your thoughts are racing, your speech is erratic and your normal filters at work or with friends are temporarily down. You're in the midst of an episode of mania.

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What is the difference between bipolar disorder and clinical depression ? Bipolar disorder —sometimes known by its older name, manic depression —is a mental illness that causes unusual shifts in mood, energy, and activity levels, and can affect one' s ability to carry out everyday tasks.

Bipolar disorder and depression have some similarities and this can make diagnosis hard. Learn about the differences between each and how one can treat the symptoms they are seeing. The presence of mania is what separates the overlapping mood disorders .

These two seemingly opposite states of mind actually represent different phases of bipolar disorder. Unlike people diagnosed with depression alone, those with bipolar disorder must also contend with disruptive cycles of hyperactivity and impulsivity, and at times, with a reduced hold on reality.

With bipolar disorder, people tend to follow a manic episode with a depressed episode. "You can think of bipolar as cycling between highs and lows," says George Livengood, assistant national director of operations at the Discovery Mood and Anxiety Program in Southern California and other locations nationwide.

Depression and bipolar disorder share many similarities. However, significant differences also exist in their prevalence, causes, manifestations, treatments, medication side effects and health risks. In some ways, unfortunately, having bipolar disorder can mean having the worst of both worlds.

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Learn about the differences between bipolar disorder and depression , two easily confused mental-health conditions. The main difference between bipolar disorder and depression are the mania symptoms — characterized by excessive excitement or irritability, extreme elation, and delusions of

What is unipolar vs bipolar depression ? Know the difference , the symptoms, and get the proper diagnosis which is vital to treatment and mental First, you should know that unipolar depression and bipolar depression are serious disorders that require immediate attention and medical supervision.

"Mania stands in stark contrast to depression – with symptoms such as, but not limited to, elevated mood, decreased sleep with increased energy and high levels of activities, which can be reckless and unpredictable," says Dr. Jess Fiedorowicz, director of the Mood Disorders Center and associate professor at the University of Iowa.

During mania, people can have a cluster of related symptoms, among them a euphoric sensation of grandiosity, says Dr. Andrew Nierenberg, director of the Dauten Family Center for Bipolar Treatment Innovation and associate director of the Depression Clinical and Research Program at Massachusetts General Hospital.

Rapid thoughts can be difficult for patients themselves to keep up with, accompanied by uncharacteristically rapid speech such that other people can't get a word in, Nierenberg says. All this comes along with "decreased frustration tolerance, increased irritability and then a change in their usual judgment where they will do things they ordinarily wouldn't do."

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• Categorized under Health | Difference Between Major Depression and Bipolar Disorder . Some years ago, people have difficulty discerning between Major Depression and Manic Depression . Rather, how we handle our depression and what it has done to our lives may be the reason of our

The primary difference between pseudobulbar affect and other mental illnesses like depression and bipolar are that the outbursts of crying, laughing and/or In depression and bipolar disorder , this is a primary symptom, while in PBA, it happens because patients are fearful of being in social situations.

Spending huge amounts of money on impulsive purchases, having sexual indiscretions that are otherwise out of character or more subtle issues like saying things you normally wouldn't to your boss can all go along with mania. "As a result, people have really serious consequences from that sort of behavior," Nierenberg says. Psychosis – having hallucinations or delusion – can occur when people are manic.

With major depression, on the other hand, "You are in a dark hole," say Livengood, who is a marriage and family therapist. "You are in that state of depression for a significant period of time."

Each day with depression brings a lack of interest in things that used to provide you pleasure, he says: "Maybe you feel fatigued. You have a loss of energy. You're having feelings of worthlessness, guilt and hopelessness. You can even have diminished ability to think or concentrate."

With depression, instead of the intense activity of mania, people may feel unable to make the most basic exertions. They may gain weight, or lose weight without trying to diet. Sleep changes may range from insomnia to sleeping all day. Hygiene can become too hard to maintain.

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A positive shared aspect for both conditions is that treatment can vastly improve quality of life. Below, the experts further describe how bipolar disorder and depression contrast and compare.

Major depression is more common. The proportion of the global population with depression is estimated at 4.4%, according to a 2017 World Health Organization report. In comparison, "Worldwide, about 2% to 3% of people will develop bipolar disorder in their lifetime," Fiedorowicz says.

Mania is a key feature of bipolar disorder. A history of unequivocal manic or hypomanic episodes is the hallmark of bipolar disorder, Nierenberg says. These episodes are marked by a distinctly different period of time during which somebody is either so hyper, excitable or irritable that they're clearly not their normal selves, he adds.

Bipolar disorder is broken down into four basic categories:

  • Bipolar I disorder encompasses the longest-lasting, most severe manic symptoms. Manic episodes last a week or more, or may require hospitalizations. Depressive episodes often occur as well. In some cases, people experience depression and mania symptoms simultaneously.
  • Bipolar II disorder also involves depressive and hypomanic episodes. However, the pattern does not include full-scale manic episodes.
  • Cyclothymia involves intermittent periods of hypomania and depression symptoms, occurring over a period of at least 24 months for adults. Symptoms don't quite meet the level of a bipolar diagnosis.
  • Unspecified bipolar disorders is a catch-all category for bipolar symptoms that don't fit the definitions for bipolar I, bipolar II or cyclothymia.

Hypomania has less impact than mania in terms of degree, duration and severity, Nierenberg explains. While hypomania may last for days, it doesn't seriously interfere with how someone functions.

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The conditions can look alike. Although mania episodes might be more obvious or startling, depression is a formidable component of bipolar disorder. "People who have depression can look the same as people who have depression with bipolar disorder," Nierenberg says. "So the biggest burden of bipolar disorder actually is the depression."

Family/genetic connection is stronger for bipolar disorder. "Bipolar disorder is highly heritable relative to other medical conditions," Fiedorowicz says. "It has been estimated to be roughly 60% to 80% heritable: nearly twice that of major depression, Type 2 diabetes mellitus or hypertension."

Bipolar disorder can affect physical health and lifespan. "People with bipolar disorder can lose an average of anywhere between eight and 20 years of life, mostly because of cardiovascular disease that can co-occur with the disorder," Nierenberg says. "So it really can be a total-body disorder and it's affiliated with a lot of medical comorbid conditions."

Suicide risk is increased for both mood disorders. Clinical depression and bipolar disorder are among risk factors for suicide and suicidal thoughts. Lithium, a standard drug for treating bipolar disorder, has been shown to lower the risk of suicide or suicide attempts. "Lithium is an effective treatment for reducing the risk of suicide in people with mood disorders," concluded an evidence review of 48 studies encompassing nearly 7,000 participants, published June 2013 in the journal BMJ.

Medications for the conditions take different courses, with some overlap. "The mainstay of treatment for bipolar disorder involves use of medications to help treat or prevent these mood episodes," Fiedorowicz says. "These medications fall primarily into two broad classes: mood stabilizers and antipsychotics."

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Lithium is a primary bipolar disorder treatment. Lithium is the first-line treatment for bipolar disorder, but it requires careful monitoring, Fiedorowicz says. "The medication has a narrow therapeutic index, meaning that the therapeutic dose is close to the dose that is toxic," he explains. People on lithium must have regular monitoring of their blood levels for signs or symptoms of toxicity such as tremor, dizziness or gastrointestinal symptoms, as well as periodic assessment of their kidney and thyroid function.

Mood stabilizers and antipsychotic medications are more frequently used for bipolar disorder. Lithium, carbamazepine (brands like Tegretol), lamotrigine (Lamictal) and valproate (Depakote and Depakene) are mood-stabilizing drugs. Antipsychotic medications also used to treat bipolar disorder include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel) and aripiprazole (Abilify). In some cases, lithium is used as an augmentation strategy for people who do not have bipolar disorder, Fiedorowicz says: "It might be added to an antidepressant that a person has partially, but not fully, responded to."

Antidepressants drugs are more commonly prescribed for depression alone. Antidepressants fall into several classes. Selective serotonin reuptake inhibitors, or SSRIs, include fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). Serotonin and norepinephrine reuptake inhibitors, or SNRIs, include duloxetine (Cymbalta) and venlafaxine (Effexor). Other classes include tricyclic antidepressants like imipramine (Tofranil), atypical antidepressants like bupropion (Wellbutrin) and monoamine oxidase inhibitors like phenelzine (Nardil).

Side effects for drugs used in bipolar treatment can be more concerning. "The mood stabilizers and antipsychotics generally have a less favorable side effect profile than antidepressant medications," Fiedorowicz says. "However, it is important to note that there is considerable variability with side effects. A given person might not experience any side effects with a medication for which side effects are common, while another might be unable to tolerate a more benign medication. Therefore, a key issue is monitoring for side effects and responding appropriately to any that develop."

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Psychotherapy helps people with both conditions. Cognitive behavioral therapy and dialectical behavioral therapy are two evidence-based approaches for treating mood disorders, Livengood says. With cognitive behavioral therapy, therapists and patients work together to identify negative, self-destructive feelings and behaviors and replace them with more constructive, positive ways of thinking and responding. Dialectical behavioral therapy is a form of CBT that helps patients develop skills to better cope with negative emotions and improve interpersonal communication and relationships.

Self-management techniques can keep people on track. Having a strong support system is important as you cope with a mood disorder. That means having people around you whom you can rely on and from whom you can take feedback. Adding structure to your day also helps, Livengood says. Keeping a regular sleep-and-wake schedule, taking medications at consistent times and monitoring your progress help you stay in control.

Self-care addresses your mental and physical health. Self-care is essential for everyone. Having a workout routine like yoga, or regularly getting outdoors and going for a bike ride are ways to take care of your physical health and your spirit, Livengood says. Have interests, be engaged and avoid being a workaholic, he advises: Keep good boundaries between work and the time you need for yourself and your family.

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