Bipolar Disorder or Depression?

Medically Reviewed by Jennifer Casarella, MD on December 08, 2022

Bipolar disorder and depression have many similarities. But they also have some key differences. It's important to know how to tell one from the other to get the right treatment.

Depression is more than just feeling low. It's a deep sadness or emptiness you can't shake. You might feel hopeless, worthless, and restless. You might lose interest in things that you used to enjoy. Depression (also called major depressive disorder or MDD) often goes hand-in-hand with sleep problems, changes in appetite, and trouble concentrating. It can lead to suicidal thoughts or actions. People who suffer with depression might have some days that are better than others. But without proper treatment, their mood tends to remain low.

Bipolar disorder (sometimes called manic depression) is different. If you have it, you have extreme mood swings. You experience periods of depression (similar to MDD). But you also have periods of great highs.

Bipolar refers to the opposite ends, or poles, of the emotional spectrum -- the highs (mania) and the lows (depression). You might be severely depressed for a period of hours, days, weeks, or even months before entering a manic period. The mania could range from several days to two months or longer. It's also possible to have a type of bipolar disorder in which you experience manic and depressive symptoms at the same time. You might feel sad and hopeless but also be very agitated and restless.

The highs of bipolar disorder might feel enjoyable. But they also can be dangerous. Risky behavior could put you in physical danger. And mania is usually followed by extreme depression.

About 6 million American adults have bipolar disorder. That might sound like a lot. But it's much rarer than depression, which affects slightly over 16 million American adults.

Recognizing Mania

If you have bipolar disorder and are having a manic episode, you might be very energetic, get very little sleep because you're so wired, and find yourself talking faster because your thoughts are racing. You might feel like the world's best multitasker. You might also take risks that you normally wouldn't take. Examples could include going on a spending spree or driving recklessly.

Sometimes this kind of behavior is easy to spot, but not always. That's especially true if you have a milder form of a high, called hypomania. You might feel good, be happy that you're extra energetic, and think that you're just being productive. Friends and family members may be better able to notice that you're acting out of character.

The Right Treatment

Getting the correct diagnosis isn't always easy. A mental health expert who only sees you at your low points might not know about your manic behavior unless you or someone who knows you well brings it up. And some people with bipolar disorder may also have additional conditions that make both diagnosis and treatment more challenging. Examples include substance abuse or an anxiety or eating disorder.

If you think you might have bipolar disorder, it's important to raise your concerns with a mental health expert and work closely with them to arrive at the correct diagnosis. Bipolar disorder is a lifelong condition. Proper treatment is often a combination of counseling and medication. It's the best way to manage your symptoms.

A mood stabilizing medication, such as lithium or divalproex is often used to manage bipolar disorder. Some people take antidepressants in addition to a mood stabilizer or an antipsychotic medication. Taking an antidepressant by itself could actually trigger a manic episode. That's another important reason to figure out if you have bipolar disorder or depression.

Over time, your condition may shift and your medications may need to be tweaked. Your healthcare provider may encourage you to track your symptoms. By recording your daily mood, sleep patterns, life events, and other details, it may help you and your provider stay on top of your condition and make sure that you get the most effective treatment possible.

Show Sources


Depression and Bipolar Support Alliance: "Bipolar Disorder;" "Depression Statistics."

Mayo Clinic: "Bipolar Disorder."

National Institute of Mental Health: "Bipolar Disorder;" "Depression."


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