Bipolar Disorder and Depression: Understanding the Difference

As a college freshman, Jenna was a competitive track and field athlete who loved spending her days in her running shoes. By the time she reached her sophomore year, however, things had changed. She was filled with sadness, felt like she had no energy, and had lost interest in training. When she mentioned it to her primary care doctor, she was diagnosed with major depression and given a prescription for antidepressants.

The medication boosted her mood—a lot! She felt like she was on top of the world. It also filled her with so much energy, she felt invincible and began training all day and staying up all night doing her homework. She also became sexually aggressive, hitting on the other track athletes even though she had a steady boyfriend. She even came on to her coach multiple times, which didn’t go over well and ended up with her almost getting kicked off the team.

What went wrong?

A Common Misdiagnosis

Jenna had been misdiagnosed. In reality, she had bipolar spectrum disorder (BSD), formerly known as manic-depressive disorder. People with bipolar disorder experience dramatic swings in mood, energy, and activity levels, going from depressive episodes to manic episodes in a cyclical pattern. The antidepressants Jenna took not only failed to work, but they were also making her worse by triggering a manic episode.

Jenna isn’t alone. Among people diagnosed with major depression, about one in three are estimated to actually have bipolar disorder. This is due to the fact that the two conditions share many of the same symptoms.

Shared Symptoms of Bipolar Disorder and Depression

Depressive episodes of bipolar disease are characterized by:

• Persistent sad or negative mood
• Loss of interest in usually pleasurable activities
• Feelings of guilt, worthlessness, helplessness, and hopelessness
• Sleeping too much or too little, or waking up too early
• Decreased energy, fatigue, or feeling “slowed down”
• Difficulty concentrating
• Thoughts of death or suicide, or suicide attempts

These symptoms are very similar to those typically associated with depression. Women with bipolar disorder tend to experience more depressive episodes, which may increase their risk of being misdiagnosed with depression.

Manic Symptoms of Bipolar Disorder

On the other side of the spectrum in bipolar disorder are manic episodes.

Manic episodes are characterized by:

• Abnormally elevated mood
• Inflated self-esteem
• Decreased need for sleep
• Increase in goal-oriented activity
• Grandiose notions, ideas, or plans
• Increased talking or pressured speech
• Racing thoughts
• Inability to “turn off the mind”
• Poor judgment that leads to risk-taking behavior
• Hypersexuality or hyperreligiosity
• Excessive appetite
• Inappropriate social behavior
• Irritability or aggression
• Delusions or hallucinations

Some people with bipolar disorder don’t experience mania to this level. They have what’s called “hypomania,” which is a less severe form of mania. People may feel like they have better energy than usual and a brighter mood but not so much that they engage in risky behavior.

The Key to Healing

The good news is that bipolar disorder responds well to proper treatment. Getting an accurate diagnosis is key. Jenna had struggled for a few years before she decided to get a brain scan to find out what was really happening in her brain. The brain imaging test called SPECT, along with a complete personal history and other assessments pointed to bipolar II disorder.

There are at least 4 types of bipolar disorder, including:

• Bipolar I disorder
• Bipolar II disorder
• Cyclothymic disorder
• Bipolar disorder not otherwise specified (NOS)

Knowing her condition type helped develop a treatment plan personalized for her needs. And seeing her brain scan helped her understand that her condition was real, so it encouraged her to take her medication regularly. Compliance is a problem for many people with bipolar disorder because when they start to feel better, they don’t believe they have a problem at all and often stop taking their medication. For Jenna, seeing was believing.

With the proper treatment and good compliance, Jenna’s moods stabilized, and she eventually became a successful and well-liked track and field coach at her alma mater. At Amen Clinics, we use leading-edge brain imaging technology called SPECT as part of an overall evaluation to accurately diagnose and treat bipolar disease. If you or a loved one is suffering from dramatic mood swings that are impacting your relationships or your performance at work or school, schedule a visit or reach out today to speak to a specialist at 888-288-9834.