Bipolar disorder and major depression are two very different mental health conditions that, to the chagrin of sufferers, often manifest with similar symptoms.
Both major depression and bipolar disorder can be debilitating conditions, and giving patients a proper diagnosis will ensure they get the proper treatment and medication they need, said Dr. Keith Ablow, a psychiatrist and Fox News contributor.
“The chief mistake that a psychiatrist could make, would be not asking people if in addition to depression they also have something that is the opposite of depression,” he said. “Have they at times felt too energized, like they’re moving in too much of an upward direction?”
Symptoms of major depression
The symptoms of major depression include low mood, poor appetite or overeating, insomnia or sleeping too much, low self-esteem, difficulty concentrating and, occasionally, thoughts of suicide.
“Any of those symptoms, when they’re present, constitute an episode of major depression,” Ablow said “And, with some people, episodes of major depression tend to come and go throughout various times of their lives.”
Symptoms of bipolar disorder
People with bipolar disorder, also known as manic depression, will experience the same symptoms as people suffering from major depression, but they will also likely experience extreme highs known as manic or hypermanic episodes.
These highs include feelings of grandiosity, a decreased need for sleep, the tendency to talk too much and experiencing ideas that run too quickly through your mind.
“During these episodes, people might also experience too much involvement in activities that are pleasurable but overdone, like spending sprees, risky sexual behavior and investing too much money in businesses that don’t merit it,” Ablow said.
But not all bipolar sufferers experience extreme highs. Some have less intense mood swings called hypomanic episodes, while others may experience mixed episodes in which feelings of depression and mania exist simultaneously, Ablow said.
Treating depression and bipolar disorder
Patients who want to help their therapists identify whether they are suffering from major depression or bipolar disorder may want to do their homework, Ablow said.
“You’ll want to ask yourself if you’ve ever noticed that in addition to depression, you’ve also experienced the opposite, like you’re on a rollercoaster,” he said. “Ask family members if at times they’ve known you to be too energetic or to act grandiose.”
Treatment of major depression and bipolar disorder also should include some type of psychotherapy, Ablow said.
“I think it’s tremendously important that they receive psychotherapy even if they are taking medications that are effective, because these symptoms are indeed fueled by past or present emotional turmoil,” he said. “And competent psychotherapy can have the same benefits on the brain that antidepressants do.”
Choosing the right medication
The most common medications used to treat depression are classes of drugs called SSRIs and SNRIs. These drugs work on certain chemicals in the brain associated with depression, including serotonin and norepinephrine.
These drugs include Prozac, Paxil, Zoloft and Lexapro, all of which are SSRIs or selective serotonin reuptake inhibitors. Other treatments for major depression include Cymbalta and Effexor, which are SNRIs or serotonin norepinephrine reuptake inhibitors. These drugs work to increase the levels of serotonin and/or norepinephrine in the brain by preventing the brain from storing the excessive amounts of these chemicals for future use.
Ablow said new research shows that vitamins and supplements such as folic acid, DHEA and SAM-e are also effective depression fighters, as is electro-convulsive therapy and magnetic stimulation to the brain.
Many of the treatments for bipolar disorder include antiseizure and mood stabilizing medications such as Depakote and Tegretol, as will as major tranquilizers such as Seroquel, Zyprexa and Abilify.
“Major tranquilizers tend to create a ceiling so that you don’t get too high,” he said. “Mood stabilizers are more commonly used to make sure the bipolar sufferer doesn’t cycle through the highs and lows of the disease.”
Lithium is another mood stabilizer used to treat bipolar disorder, but is considered to carry more unpleasant side effects, such as weight gain, dehydration, kidney damage, as well as a high risk for overdosing, compared to some of the newer classes of drugs used to treat the condition.
Still, some of the newer bipolar drugs carry a weight gain side effect as well, especially for children. A study released last week found that children on widely used psychiatric drugs, including those for bipolar disorder, can quickly gain an alarming amount of weight; many pack on nearly 20 pounds and become obese within just 11 weeks.
People who believe they may be suffering from either depression or bipolar disorder should consult a doctor to determine the best course of treatment.