Unipolar Depression And Bipolar Depression: What Is The Difference?
Depression is a complex mental health disorder that encompasses several different conditions, including major depression, also known as unipolar depression. Depression also exists in other mood disorders, such as bipolar I disorder and bipolar II disorder.
In this article, we will give you an overview of these two disorders, describe depression, and discuss their differences in detail, including the common symptoms and diagnostic criteria from The Diagnostic and Statistical Manual of Mental Disorders.
Depression symptoms: Unipolar and bipolar
Before discussing the difference between unipolar depression and bipolar disorder, we're going to provide an overview of the conditions. While the depressive symptoms are similar between the two, there are also some differences that we'll discuss later. A major depressive episode is characterized by a persistent feeling of sadness or irritable mood for at least two weeks, along with other symptoms such as tiredness, loss of interest, and guilt or intense feelings. The most important overall distinction to keep in mind is that bipolar disorder includes mood episodes with manic symptoms that are not typically present in major depression. The risk of both disorders may increase when an individual has a family history of mental health conditions. For example, those with a family history of bipolar disorder may be at a higher risk for both unipolar depression and bipolar disorder.
Unipolar depression
Unipolar depression, more commonly known as major depressive disorder or major depression, is characterized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria that focus on one prolonged mood episode at the depressive pole, without moving between highs and lows. The major symptom of unipolar depression is a persistent feeling of sadness, along with other symptoms associated with a low mood.
According to The Diagnostic and Statistical Manual of Mental Disorders, the symptoms of unipolar depression include the following:
- Feeling sad
- Loss of interest in activities for an extended time
- Irritability
- Sudden weight loss or lack of appetite
- Trouble concentrating
- Disruptions in sleep
- Lack of energy
- Guilty intense feelings
- Suicidal or morbid thoughts
If you or someone you know is experiencing suicidal thoughts, help is available. The 988 Suicide & Crisis Lifeline can be reached 24/7 by chatting with a representative or calling or texting 988.
Usually, for a unipolar depression diagnosis, symptoms need to have persisted for two weeks and represent a departure from how the individual felt before the major depressive episode.
Bipolar disorder depression
Bipolar disorder is a mental health condition in which an individual experiences fluctuations in mood, from depressive lows to manic highs. The lows, also known as bipolar depression, are characterized by symptoms that are present in many depressive disorders, including unipolar depression. The highs, referred to as manic episodes, are characterized by feelings of elation, high energy, and pleasure-seeking behavior that are very different from symptoms of a depressive episode. In certain forms of bipolar disorder, less severe manic episodes, called hypomania, can occur. There are three different types of bipolar disorder, each with specific criteria:
- Bipolar I – includes manic episodes that last for seven days or more and depressive episodes that last for two weeks or more.
- Bipolar II – includes hypomanic episodes that last for four days or more and depressive episodes that last for two weeks or more.
- Cyclothymic disorder – includes symptoms of mania and depression that persist but do not rise to the level required for a bipolar II diagnosis.
Symptoms of manic episodes include:
- Feelings of hopefulness and elation
- Talking and thinking rapidly
- High energy levels
- Disrupted sleep patterns
- Taking more risks
- Increased sense of self-importance
- Irritability
- Experiencing hallucinations
Symptoms of depressive episodes include:
- Feelings of sadness and hopelessness
- Lack of energy
- Loss of interest in activities
- Difficulties with concentration
- Disrupted sleep patterns
- Fluctuations in weight
- Slow movement and speech
- Suicidal thoughts
Unipolar depression vs bipolar depression
The most significant difference between bipolar disorder and unipolar depression is the presence of manic episodes in bipolar disorder. But are symptoms of depression experienced during depressive episodes of bipolar disorder similar to those experienced during major depression? There is some debate in the scientific community as to whether depression manifests itself differently in the two disorders, potentially due to previously functioning diagnostic criteria or the influence of medical conditions on symptoms. However, an unusual sense of similarity in depressive symptoms across both unipolar and bipolar disorders remains a topic of interest.
There is also evidence that depressive episodes of bipolar disorder are more often characterized by dysregulation, or difficulty managing emotional responses. This can make it more difficult to react in a healthy way when one experiences external stressors (e.g., divorce, car accident, loss of job). Additionally, studies show that individuals who live with unipolar depression experience more anxiety than those who live with bipolar depression.
Further research has shown that the slowing of thoughts, speech, and movement commonly exhibited by those with depression may be more pronounced in depressive episodes of bipolar disorder than in major depression. Those who live with bipolar disorder may also have more psychotic symptoms during depressive episodes, including hallucinations and loss of touch with reality. Additionally, bipolar depression may produce more frequent sleep disturbances and mood changes early in the morning. The fact that there are also three different types of bipolar disorder adds further complexity to the distinctions between the two conditions.
Unipolar depression and bipolar depression treatment
Bipolar disorder and unipolar depression have many of the same methods of treatment, though there are some important differences as well. The first-line treatment for both disorders is often a combination of medication and therapy, typically cognitive behavioral therapy (CBT).
Cognitive behavioral therapy
The most widely used form of psychotherapy is cognitive behavioral therapy. CBT works by helping individuals identify and replace negative thought patterns that could lead to maladaptive feelings and behaviors, such as those often exhibited in mood disorders, such as bipolar disorder and unipolar depression.
In a meta-analysis of studies on the effectiveness of CBT for bipolar disorder, researchers found that treatment can improve symptoms, help participants adhere to treatment, and enhance quality of life. The review specifically noted the efficacy of therapy in conjunction with medication, which is a common combination for those with unipolar and bipolar depression.
Another meta-analysis, which combined findings from 115 studies, concluded that CBT is also beneficial for symptoms of major depression, with researchers stating that there’s “no doubt that CBT is an effective treatment for adult depression.”
Medication
Medication for both bipolar disorder and unipolar depression will often include an antidepressant to address depressive symptoms. Common antidepressants for those who experience bipolar and unipolar symptoms include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Serotonin antagonists and reuptake inhibitors (SARIs)
Medication for bipolar disorder can be more complicated as it often needs to address both manic and depressive symptoms. Sometimes, a combination of medications is necessary to ensure symptoms of one episode are not brought on by medication meant to address the other. Common medications for bipolar disorder include:
- Mood stabilizers
- Antipsychotics
- Antidepressant-antipsychotic
The information in this article is not intended to be used as medical advice. Always consult with a medical professional before starting or stopping medication.
Navigating mental health disorders with therapy
There is a large body of evidence pointing to online therapy as a useful method of treating mental health conditions like bipolar disorder and unipolar depression. In a wide-ranging analysis of peer-reviewed articles, researchers found that online therapy platforms, through both web- and smartphone-based treatment, could help individuals manage symptoms of bipolar disorder. The review specifically noted that online therapy could promote education, hopefulness, and a proactive approach to treatment.
Online therapy can provide you with clarity when it comes to navigating complex mental health concerns. Working with a licensed therapist at BetterHelp, you can learn about and manage symptoms of unipolar depression and bipolar disorder. With BetterHelp, you can get care remotely, through video call, voice call, or in-app messaging. Additionally, you’ll have the option of reaching out to your mental health professional outside of sessions. If you’re experiencing symptoms of a manic or depressive episode—or have other concerns that you’d like to relay as soon as they arise—you can send your therapist a message, and they will respond when they’re able.
A qualified professional can help you process emotions related to major depression, bipolar disorder, or other mental health conditions. Read below for reviews of BetterHelp therapists from those who have sought help for similar concerns in the past.
Is bipolar disorder depression worse than unipolar depression?
When it comes to unipolar and bipolar depression, one is not better or worse than the other. Unipolar and bipolar depression are both potentially severe mental disorders that require mental health treatment. Unipolar depression is just another name for major depressive disorder – aka depression – which is a mood disorder that causes feelings towards the sadness or depressive end of the spectrum of emotions. Bipolar disorder, on the other hand, includes signs, symptoms, and feelings that typically fluctuate between depression and mania (an abnormally elevated mood state). Bipolar depressed patients may show similar symptoms to those experiencing unipolar depression.
Symptoms of unipolar and bipolar depression (whether manic or depressive episodes) can have a significant negative impact on a person’s life. Mania and depression severity can lead to challenges in daily functioning and increased risk for substance use, suicidal thoughts, and psychotic features.
There are ways to manage and cope with bipolar and unipolar depression. The most commonly used treatments are psychotherapy and medication. Lifestyle modifications may also help. Presently, there are no means to predict bipolar depression episodes accurately. However, recognizing warning signs that may indicate impending mania and depression may help.
What does unipolar depression mean?
Unipolar depression, another name for major depressive disorder or “regular” depression. Some people call major depressive disorder unipolar depression because it is the mirror opposite of bipolar disorder, a mental health condition that causes extreme highs (mania or hypomania) and lows (depression) at either pole of the emotional spectrum (which is why it is called bipolar disorder). The most significant difference between bipolar and unipolar depression is that with unipolar, the person only experiences feelings at one end of the spectrum (lows).
A broad range of factors can trigger unipolar depression. An interplay of biochemical, genetic, personality, and environmental factors may contribute to the development of the condition. Patients with unipolar depression show structural and functional alterations in the prefrontal cortex. These dysfunctions in the prefrontal cortex are associated with reduced problem-solving ability, heightened negative emotions, and suicidal behavior.
Can unipolar depression turn into bipolar depression?
No, unipolar depression or major depressive disorder cannot turn into bipolar disorder. However, it is possible for someone to be misdiagnosed with unipolar depression and later be diagnosed with bipolar disorder after further assessment of their symptoms. A study cites previous findings showing that 40% of patients with bipolar disorder initially have a unipolar disorder diagnosis. One of the prospective studies shows the diagnostic conversion from unipolar to bipolar disorders. Some bipolar patients may first show symptoms of depression before exhibiting episodes of mania or hypomania, making diagnosis of patients with bipolar disorder challenging. Diagnostic delay can be one of the unresolved issues in bipolar disorder diagnosis. Studies suggest that accurate diagnosis and treatment are usually delayed by six to eight years or more. Future research to improve the detection of bipolar disorder may be needed.
Can you have bipolar with only depression?
No, you cannot have bipolar illness with only depression. Bipolar I disorder requires a minimum of one lifetime manic episode, while bipolar II disorder and cyclothymia usually involve episodes of hypomania (less severe than mania). Episodes of mania or hypomania distinguish bipolar disorder from unipolar disorder. Bipolar without manic episodes (i.e., bipolar with only depressive episodes) is called major depressive disorder, clinical depression, or unipolar depression, which are all names for the same mood disorder (depression).
What are examples of unipolar depression and bipolar depression?
Unipolar and bipolar depression are affective disorders that can negatively affect a person’s physical and mental well-being. Unipolar depression includes conditions like major depressive disorder and persistent depressive disorder. Bipolar depression refers to the low-mood phases in bipolar I or bipolar II disorder, which alternate with periods of mania or hypomania. Individuals with bipolar disorder may experience mood swings, mood lability, sleep issues, and more. Some individuals exhibit bipolar disorder with mixed features (the outdated term is bipolar mixed states), wherein symptoms of both mania and depression are experienced in a single episode.
Unipolar and bipolar depression symptoms can significantly overlap. Both depressive symptoms of patients with bipolar depression and unipolar disorder include persistent sadness, sleep problems, fatigue, psychomotor retardation (i.e., slowed thinking and movement), GI problems, and suicidal behavior (in severe cases). This can make diagnosis challenging. However, bipolar depression involves alternating episodes of mania or hypomania, while unipolar disorder exhibits depressive episodes only.
Is unipolar disorder worse than bipolar disorder?
Bipolar disorder, compared to unipolar depression, involves significant differences in mood patterns. However, bipolar and unipolar disorder are both serious mental health conditions. Neither is “worse”—both show clinical characteristics that can be hard to live with. Bipolar often brings mood swings between highs and lows, while unipolar stays in the low range. The impact depends on each person’s experience and support.
When left untreated, unipolar and bipolar depression may lead to severe consequences. Depression severity in both disorders can lead to suicidal ideation and psychosis. While psychotic features are often associated with bipolar disorder, schizoaffective disorder, and schizophrenia, patients with psychotic depression also exhibit hallucinations and delusions. Bipolar disorder patients experiencing mania may also experience psychotic symptoms and symptoms of mania, such as racing thoughts, inflated self-esteem, and impulsive behavior (e.g., reckless sex, excessive substance use, etc). Studies suggest that bipolar disorder is associated with substance use disorders. According to the American Addiction Centers, alcohol and other substances can affect the brain and the central nervous system and may cause headaches, strokes, seizures, and cognitive disorders.
Whether one is experiencing MDD, recurrent depression, atypical depression (characterized by mood reactivity), bipolar disorder with severe mania, or bipolar spectrum disorders, treatment may help manage symptoms. If you think you or a loved one is experiencing symptoms of unipolar or bipolar depression, seek professional help.
What is the difference between major depressive disorder and bipolar depression?
Even though patients with bipolar and unipolar disorder share similarities in experiencing depressive episodes, they have significant differences. Major depressive disorder involves only depressive episodes and doesn’t have episodes of mania or hypomania (i.e., a less severe form of mania). Bipolar depression is one half of bipolar disorder, where low moods alternate with manic or hypomanic episodes.
Although both unipolar and bipolar depression exhibit similar depressive symptoms, their treatments are not the same. While bipolar and unipolar depression may similarly benefit from some form of talk therapy and lifestyle modifications, the types of medications that are most effective for these patients are different. Most doctors recommend antidepressants for patients with unipolar disorder, while mood stabilizers and antipsychotics are common medications for patients with bipolar disorder.
What are the similarities between bipolar disorder and major depressive disorder?
Unipolar and bipolar depression are both mood disorders (i.e., affective disorders) that may affect individuals of varying ages. Both bipolar and unipolar depression can cause persistent sadness, loss of interest, changes in sleep or appetite, and trouble concentrating. In their depressive phases, people may feel hopeless or tired.
Anyone can develop unipolar and bipolar depression at any age. However, the onset of these conditions is often seen during a person’s younger years. The onset of bipolar and unipolar depression usually occurs between 12 and 24 years and 20s to early 30s, respectively.
While not the only factor, genetics can play a role in the development of bipolar and unipolar depression. Twin studies suggest that bipolar disorder is highly heritable. Depression may also be associated with genetics. A study shows that genetics can be a risk factor for depression.
Unipolar and bipolar depression are treatable affective disorders. Psychotherapy and medication may be effective for both bipolar and unipolar depression. However, the types of medications can differ since antidepressants commonly used for patients with unipolar disorder may trigger episodes of mania in patients with bipolar disorder. Studies suggest that the use of antidepressant medication in bipolar disorder patients is associated with worsening rapid cycling.
What is the difference between unipolar depression and bipolar depression?
Even though bipolar and unipolar depression are both affective disorders and exhibit overlapping symptoms, they have differences. Unipolar depression has only downswings in mood. Bipolar depression comes with those downswings plus separate episodes of elevated mood (mania or hypomania). It may be worth mentioning that although depressive episodes can co-occur in bipolar disorder, diagnosis requires at least one episode of mania.
Can depression turn into bipolar disorder?
Bipolar and unipolar depression, both affective disorders, can exhibit the same signs. Sometimes, what starts as depression is later recognized as bipolar if manic symptoms emerge over time. Bipolar depression is characterized by extreme highs and lows. Diagnosis requires mania in bipolar I and hypomania in bipolar II. Note that mania is not the opposite pole of depression. These two episodes can fluctuate independently in bipolar disorder. If you notice cyclothymic temperament, unusually high energy, or risky behavior after a depressive phase, it’s worth talking with a mental health professional.
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