The following is an excerpt from an article I wrote for healthyplace.com on the difference between bipolar depression and uni polar depression. I wonder how well you can do! A lot of it was new to me as I wrote the article!
A Quiz: Name that Depression
The following examples will help you (or someone who cares about a person with depression) get really clear on the depression you experience. This can lead to the right treatment plan.
1. Have you ever been depressed and thought, “What is going on? I felt fantastic just last month! I had so much energy and life was great. I don’t understand this. Nothing happened? What’s wrong with me? Who am I?” and then you feel fine again a few months later. (BP Depression with rapid cycling between mania and depression.)
2. You went through a job loss and got depressed for the first time and then the depression went away when you got another job. (Situational Depression.)
3. You were depressed, took an antidepressant and then suddenly things got better. You felt your head clear and even your vision got razor sharp where colors were gorgeous and people looked beautiful. Life was full of hope and you couldn’t wait to make plans for the future. If someone said you seemed abnormally upbeat, you said, “I finally found a medication that worked and now you want me to go back to being depressed?” (Antidepressant induced mania.)
4. After a down mood for over a year you went through months of feeling great where you partied a lot, made friends easily, worked effortlessly and had a lot of ideas. The good mood raised a lot of confusion in your friends and family, but not enough to see it as an illness. You thought, “This is the real me! The depression is finally gone!” (A manic episode after a long BP Depression.)
4. Felt depressed and uncomfortable with agitation, trouble sleeping and the fear that someone was following you. Your thoughts were racing and your patience was low. You felt a lot of suspicion, heard voices and yet you had a lot of energy. You sometimes had suicidal thoughts. (Mixed episode with depression, mania and psychosis.)
6. People commented on your down mood and seemed confused as to why you were always depressed when you had so much to live for. You had trouble getting out of bed, had no enthusiasm for life, cried a lot and felt hopeless. Your work and relationships suffered. You had either been like this for months or had a low level depression for years. You found an antidepressant that worked and have not experienced depression again. (Unipolar depression)
7. You’re depressed and have tried five antidepressants. They don’t help at all and you feel more and more despondent. Your health care professional says, “I have no idea why these meds aren’t working. There is a drug called Lamictal that works with depression, let’s see if that will help.” You take the Lamictal and feel better. The doctor asks, “Have you ever had a mood where you were filled with energy and didn’t sleep much but were not tired at all the next day?” This question finally leads to a discussion about bipolar disorder and you both realize the medications didn’t work because you have BP Depression and have had mild mania for years without knowing what it was. Eventually the illness was stabilized with Lamictal and an antipsychotic. And you can truthfully say, “I finally feel like the real me.” (BP Depression)
What above situation describes you (or the person you care about)? Is treatment correct and adequate? The answer to these questions can help you take charge of your BP Depression so that you can get an official diagnosis, find the right combination of medications and create a treatment plan that is BP Depression specific. It may be scary, overwhelming and confusing to realize you have Bipolar Depression, but the diagnosis is a life saver. It makes sense to spend a few years finding the right treatment plan than experiencing a lifetime of depression. The results can lead to a stable life that is filled with great relationships, productive work, a true sense of purpose and joy.
Julie
This is an excerpt from my article on the difference between uni polar depression and bipolar depression published on healthyplace.com. The article is available in full on the menu to your right.
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There’s not much worse than dysphoric mania. My doctor called it agitated depression (that’s before I was properly diagnosed B1) You have the energy, but there is so much agitation and negativity associated with the mood. I spent a week in the hospital with this, heard voices, saw figures, was an angry out of control patient. Meds helped, as did time in the hospital. A very unpleasant state of mind. Helen
Hi Helen, I agree. It’s like your body wants to turn inside out. It’s so uncomfortable. I am so glad you’re better. Meds really do help this kind of mania- often it’s a combination of a mood stabilizer and an anti psychotic.
Many people get in trouble when they’re in this mood swing as it makes a person so compulsive.
Julie
I agree with the description of number 6 (I was diagnosed with post-traumatic stress disorder, dysthymia, and major chronic recurrent depression when I was 18 and I am 24 now.) Maybe it is because I also have dysthymia, but I don’t think it is totally accurate to say that depression doesn’t return after finding the right medication or that it even completely goes away. I don’t think I am bipolar because it took me about 2 years to find the right antidepressant and I never felt like what you were describing in situation #3. The main reason I changed medications was because if the stimulant was too strong (like Effexor, an SNRI) it would make my PTSD worse and I would have panic attacks or uncontrollable 2+ hour crying spells more often and over much smaller things like just being late somewhere, or someone talking to me in a harsh tone of voice but not actually yelling.
I saw the same psychiatrist and counselor for 3 years and they both said every time they saw me, I was in the same mood and that I had a flat/depressed affect. My counselor saw me every week so I don’t think I had a manic or hypomanic period that she missed. I had to change counselors after graduating from college and the one I have now basically gave up on me. She criticized me because my mood has not improved and “I am so depressed all the time”. She hasn’t seen me since my Wellbutrin XL dose was changed from 150 to 300 mg. Now it is easier for me to recover from being triggered or stressed out and I can stop crying faster. I feel calmer overall but that is the only difference.
So anyway, I just wanted to let you know there might be an option that fits somewhere between 6 and 7. My psychiatrist and counselor told me since when I was younger I wasn’t allowed to get help, the depression has become a permanent part of my personality. The brain changes from my depression and PTSD can’t go away now that I’m an adult.
I’m with Helen. When stuck at the low end of my bipolar experience, at least my mood is consistent and I can just hunker down and sleep a lot to escape it. But dysphoric mania is absolute hell. Lots of energy, but it’s all directed into anger, paranoia, and useless activity.
For me, the worst part of being Bipolar is the inability to be productive. I’m about to lose my house and am fully cognizant of how to save the situation. I know I have the ability and the skill to put things right. But this insidious illness takes away the necessary focus to act on what my mind knows to be the proper course of action. For those without Bipolar disorder, please try to understand this aspect of it. Imagine yourself with a crystal clear idea of how to fix something or being able to clearly see a path before you. Now, imagine you also have the intelligence and experience to navigate those waters. Now, imagine the frustration you’d feel being completely unable to focus on a task long enough to see it through. Even the simplest tasks.
Finally, imagine that nothing you try fixes it (medication, talk therapy, will power, etc.)… and imagine not just years of living with this reality, but decades… a lifetime.
That’s our world.
I’m new to Julie’s articles and am gobbling them up as fast as I can. So much on these topics is written by people that do not have the depth of experience necessary to speak with any authority. Julie clearly does.
Her articles have led me to conclude that I’ve been mis-diagnosed with unipolar depression and actually suffer bipoloar-II. About ‘half my puzzle’ is depression, and the other half is a mix of anger, anxiety, mania, irritability, and so on. I never knew what to make of any of the non-depression stuff. I never considered it part of my central problem. I just thought that when not depressed, life simply sucked in a more energetic way.
Great comments on this post. Amazing how intelligent and well spoken people with these diseases can be.
Thank you Julie for giving me hope.