Bipolar vs depression: the differences and similarities

How bipolar and depression differ in their symptoms and treatments, and how these two conditions overlap.

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Understanding the nuances of different mental health conditions is crucial for finding the right support and treatment. Two conditions under the umbrella of mental health are bipolar disorder and depression. While they share some similarities, crucial differences set them apart.

This article provides a summary of the main differences and similarities between bipolar disorder and depression. It explains what bipolar and depression are, offering insight for people dealing with these two conditions."

What is the difference between bipolar disorder and major depressive disorder?

The main difference between bipolar and depression is the presence of manic or hypomanic episodes. Depression is feeling very sad and losing interest in things you used to enjoy. It can also make it hard to do daily activities. However, it does not include the highs or manic episodes seen in bipolar disorder.

Bipolar disorder involves long periods of extreme mood swings, from high to low emotions. Mania or hypomania represents the high periods, while depression represents the low periods.

These mood swings are distinct episodes that can last for extended periods. These mood swings can affect sleep, energy levels, behaviour, judgement, and the ability to think clearly. Such episodes may occur rarely or multiple times a year.

Key points:

  • Depression involves only depressive episodes.
  • Bipolar disorder includes both manic/hypomanic episodes and depressive episodes.

Bipolar vs depression: the symptoms

Understanding the symptoms of bipolar disorder and depression can help in recognising the specifics of each condition. Symptoms include:

Depression symptoms:

  • Persistent feelings of sadness, anxiety, or emptiness
  • Loss of interest in activities once enjoyed
  • Significant weight loss or gain unrelated to dieting
  • Insomnia or oversleeping (hypersomnia)
  • Restlessness or irritability
  • Fatigue or loss of energy
  • Feelings of worthlessness, helplessness, or excessive guilt
  • Difficulty concentrating, remembering, or making decisions
  • Recurrent thoughts of death or suicide, or suicide attempts

Bipolar disorder symptoms:

Manic/hypomanic episodes (Highs):

  • Increased energy, activity, restlessness and distractibility
  • Excessively "high," overly good, euphoric mood
  • Racing thoughts and talking very fast, jumping from one idea to another
  • A lasting period of behaviour that is different from usual
  • Abuse of substances like drugs or alcohol
  • Provocative, intrusive, or aggressive behaviour
  • Decreased need for sleep

Depressive episodes (lows):

  • Symptoms similar to those listed under depression symptoms

Find a more extensive look at the symptoms of bipolar disorder and depression here:

What similarities are between depression and bipolar?

Despite their differences, bipolar disorder and depression share several symptoms, especially during depressive episodes. Depression can cause symptoms like sadness, hopelessness, and lack of interest in activities. It can also lead to fatigue, changes in appetite, and trouble sleeping. Some people with depression may also have thoughts of death or suicide.

Telling the difference between bipolar disorder and depression can be challenging because their symptoms can be similar. This is especially true when someone is experiencing a depressive episode. Symptoms of both disorders can overlap, making it hard to distinguish between them.

Bipolar depression vs bipolar disorder

The term "bipolar depression" refers specifically to the depressive phase of bipolar disorder. The depression they feel is just one part of the larger condition. This condition involves both low and high moods. 
Understanding this distinction is crucial for effective treatment. For example, some antidepressants may not be suitable for those with bipolar disorder and can even trigger manic episodes.

Bipolar vs depression: the treatments

The treatment approaches for bipolar disorder and depression differ, reflecting the different nature of each condition. Here's how treatment typically varies between the two:

Depression treatments

The most common treatments for depression typically involve a combination of antidepressant medication and psychotherapy.

Antidepressants for depression work by increasing the levels of certain chemicals in the brain, known as neurotransmitters. Neurotransmitters regulate things like sleep, appetite, and mood. Medication is not a cure for depression. However, it can allow you to stay in the right frame of mind for long-term recovery.

Which is where therapy comes in. Therapy is a helpful way to understand the root causes of depression, such as negative thoughts and behaviours. Therapy can assist in developing a more sustainable mindset. It does this by creating healthier ways of thinking and coping with triggers as they arise.

Many types of therapy can be effective for depression, depending on the circumstances of the individual. One example is cognitive behavioural therapy (CBT), a gold-standard talking therapy for treating depression.

Bipolar disorder treatments

The same mix of treatment types for depression also applies to bipolar. Many people will find a combination of therapy and medication can make a significant difference to their condition.

Medications for bipolar disorder focus on managing episodes of depression, hypomanic and mania associated with the condition. Mood stabilizers like lithium help balance out the highs of mania and the lows of depression. They are commonly used for this purpose. This helps to stabilise mood and prevent extreme mood swings.

Professionals may also prescribe antipsychotic medications such as olanzapine or quetiapine, especially if symptoms of mania are severe. Healthcare experts are careful when using antidepressants to treat bipolar depression because they can sometimes cause manic episodes. However, you can use them if your manic episodes are not as frequent or severe.

Many psychotherapies that effectively treat depression may also benefit individuals with bipolar disorder. Aside from cognitive behavioural therapy, family or couples-focused therapy is common with bipolar. Mood swings in bipolar can cause a lot of extreme emotions and reactions, which can create painful memories for loved ones. In this type of therapy, loved ones are given guidance on helping to support someone with bipolar, as well as learning strategies for coping with any emotional distress caused.

Finding the right support and treatment is crucial for anyone dealing with bipolar disorder or depression. Speak to your GP about next steps, or reach out to a private provider of mental health treatment like Priory.

Find out more about how we support people with bipolar and depression throughout our UK network of hospitals and wellbeing centres.

Self-care for bipolar and depression

In addition to treatment, there are coping strategies that can help manage the severity of your condition. Coping strategies differ for each person. Here are some ideas that can be beneficial for both bipolar disorder and depression.

  • Establish a routine: stick to a regular daily schedule for sleeping, eating, and activities to help stabilise your mood
  • Build a support network: surround yourself with friends, family, and support groups who understand your condition and can offer help when needed
  • Avoid alcohol and drugs: substance use can worsen mood disorders or interfere with the effectiveness of medication, so it’s best to avoid them
  • Keep a mood diary: track your mood changes, symptoms, sleep patterns, and significant events to identify triggers and patterns in your mood fluctuations
  • Stay healthy and active: regular physical activity, good sleep quality and a healthy diet can help manage symptoms of both bipolar disorder and depression by boosting mood-enhancing chemicals in the brain
  • Practice mindfulness and relaxation techniques: activities like meditation, yoga, or deep-breathing exercises can reduce stress and improve your overall sense of wellbeing.

Blog reviewed by Dr Donald Masi (MRCPsych, DPMSA, GMC, BSc), Consultant Psychiatrist at Priory Hospital Roehampton

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