Bipolar disorder and depression
Depression is one of the main reasons that clients seek me out. Unfortunately, depression is on the rise and is set to continue to increase and pervade society in the years to come. Depression is caused my many factors so it is difficult to pinpoint exactly why a person may be depressed.
The obvious signs that a counsellor would look for would be whether there is a history of depression in the family as this can make depression more likely to occur. Alcohol and drug abuse is another trigger factor and of course, how long the individual has felt low and how severe their depression is. That is, how much is it interfering with their abilities to live a normal life.
Most people with bipolar depression are not helped by antidepressants. There is a risk that antidepressants can make bipolar disorder worse by triggering mania or hypomania, causing rapid cycling between mood states, or interfering with other mood stabilizing drugs.
The difference between bipolar disorder and depression
Both feature depression however, bipolar disorder is also characterized by periods of mania (known as manic depression). Mania includes:
- Inflated self-esteem or grandiosity
- Decreased need for sleep (e.g., one feels rested after only 3 hours of sleep)
- More talkative than usual or pressure to keep talking
- Flight of ideas or subjective experience that thoughts are racing
- Attention is easily drawn to unimportant or irrelevant items
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
- Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
Depression is more consistent regarding mood intensity. Symptoms of depression include:
- Depressed mood most of the day, nearly every day
- No interest or pleasure in all, or almost all, activities most of the day, nearly every day
- Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
- Insomnia (inability to sleep) or hypersomnia (sleeping too much) nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day
- Diminished ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
Most people diagnosed with either bipolar disorder or depression generally feel better within a few months and many people can safely discontinue treatment with their doctor’s recommendation within a year. The actual length of treatment varies widely, however, based upon the severity of the disorder, the effectiveness of the treatment for that individual, and other factors.