A relatively common misdiagnosis in mental health is mistaking a depressive episode in someone with bipolar disorder for major depressive disorder. 

While depression is present, it’s not the primary condition that needs to be addressed. In some people with bipolar disorder, treatment with antidepressants can actually trigger a manic episode, rather than stabilize mood. 

It’s easy to see why these two disorders are mistaken for one another. There’s considerable overlap in their symptoms. What’s more, those suffering often seek help during a particular low point, or depressive episode, making depression appear as the primary source of distress. 

Yet bipolar disorder, historically referred to as manic depression, is distinct from unipolar depression, or major depressive disorder, which more often co-occurs with anxiety, rather than mania or hypomania

Below, we’ll unpack bipolar disorder vs. depression in more detail, outline symptoms to be aware of, and explore treatment options for those who may be experiencing either condition. 

Depression

Depression, or major depressive disorder, often co-occurs with anxiety and is an emotional disorder prevalent among adolescents and adults. Major depressive disorder and anxiety share some overlapping symptoms and significantly impact an individual’s emotional state and overall well-being in different ways. 

Depression Symptoms

Symptoms of depression include:

• Fatigue, lack of energy
• Persistent feelings of hopelessness or pessimism
• Insomnia
• Loss of interest in daily activities

Depression can manifest as sustained sadness, feelings of worthlessness, isolation, indulging in more high-risk activities, spontaneous anger, or increased impulsivity.

Anxiety Symptoms

Symptoms of anxiety include:

• Feeling irritable or constantly on edge
• Persistent panic, fear, or dread
• Restlessness
• Uncontrollable, obsessive thoughts

Anxiety can also present as panic attacks or excessive worry—which may also lead to physical symptoms like heart palpitations, nausea, or clammy palms. An anxiety disorder is persistent, often difficult to control, and disruptive to daily life.

Bipolar Disorder

On the other hand, bipolar disorder is characterized by extreme shifts in mood, energy, and concentration, including depression and mania. This is why the disorder was originally described as manic depression. 

The expression “bipolar disorder” was coined in the 20th century to reflect the biphasic nature of mood dysregulation, oscillating between manic and depressive states.

These shifts are often categorized as manic or depressive episodes, where individuals experience heightened energy levels or feel intense sadness or hopelessness. Episode duration varies, and some people may experience both types of episodes in a short period.

Further, it’s important to note that researchers and doctors continue to subcategorize types of bipolar disorder, as it presents differently and uniquely in each patient. 

Here are the three most common types: 

Three Most Common Types of Bipolar Disorder

Bipolar I disorder

This type of bipolar disorder is defined by manic episodes that last for at least seven days, or by manic symptoms that are so severe they require immediate medical care. Depressive episodes also occur with bipolar I disorder, and typically last at least two weeks. Further, symptoms of mania and depression may co-occur.

Bipolar II disorder

Bipolar II disorder is defined by periodic depressive episodes and hypomanic episodes, which are less severe than the manic episodes associated with bipolar I. During a hypomanic episode, a person may feel good and continue managing their day-to-day life, not feeling as though anything is wrong. Yet, if left untreated, BP II can lead to more severe bipolar I disorder.

Cyclothymic disorder

This type of bipolar disorder is characterized by recurring, but less extreme, depressive and hypomanic symptoms that do not last long enough to qualify as “episodes.”

No matter the “type” present, bipolar disorder is challenging to manage; individuals who receive the right care and treatment can live productive and fulfilling lives. So, without getting too in the weeds into what “type” of bipolar disorder may be present, here are some general symptoms of bipolar disorder:

• Heightened energy levels with difficulty sleeping
• Sensitivity to failure or rejection
• Short temper or irritability
• Sudden mood swings

What are the Signs of Bipolar Disorder in Teens?

So, what does this look like in teens and young adults? As the average diagnosis for bipolar disorder, or most mental health conditions, isn’t until a person reaches their mid-twenties, it can be difficult to distinguish a mental health disorder from the typical challenges of puberty and growing up, particularly in today’s world. 

But that doesn’t mean it isn’t worth paying attention to. Here are some signs of bipolar disorder in teenagers, broken down into manic and depressive episodes.

Signs of a manic episode in teens:

• Intense feelings of happiness for long periods of time.
• An overwhelming interest in pleasurable, often risky activities.
• Impulsive or reckless behaviors, exhibiting poor judgment.
• Inflated self-esteem and sense of capability, knowledge, and/or power.
• Heightened energy levels.
• Inability to concentrate or stay focused, due to racing thoughts.
• Talking fast about a lot of different topics.
• Trouble sleeping and not feeling tired.
• Very short temper or more irritable than usual.
• Seeing things that are not there (hallucinations) or believing things that aren’t true (delusions).

Signs of a depressive episode in teens:

• Frequent and seemingly unprovoked sadness.
• Low self-esteem and feelings of worthlessness.
• Increased irritability, anger, or hostility.
• Sensitive to failure or rejection.
• Loss of interest in once-loved activities.
• Inability to get out of bed; excessive sleeping.
• Complaints of physical pain, such as headaches, stomachaches, and fatigue.
• Low energy and motivation.
• Difficulty concentrating and making decisions.
• Difficulty communicating or maintaining relationships.
• Self-harm.
• Thoughts or attempts of suicide.

Now, which symptoms come first? Again, it depends, so pay attention to what symptoms are present in your loved one as you navigate difficult discussions and the decision to seek help.

The signs of bipolar disorder can vary by age and individual. Studies show that more than half of people with bipolar disorder experience depressive episodes first. However, one-third of patients experienced both depression and mania as their first symptoms, at the same age.

Bipolar Disorder vs. Depression: Treatment Options

Before treatment can be effective, you or your loved one needs a comprehensive and accurate diagnosis. Whether struggling with depression as part of bipolar disorder, as the primary symptom of major depressive disorder, or alongside anxiety, it’s important to begin conversations with a mental health professional who can accurately assess the whole picture. 

In Turnbridge’s programs treating both bipolar disorder and major depressive disorder, for example, clients participate in:

• Cognitive behavioral therapy (CBT)
• Individual counseling
• Integrated group therapy
• Family-focused therapy
• Medication

Be sure to seek a program that offers an integrated treatment model and will customize a treatment plan based on your loved one’s needs. Yet, while medication and therapy can be monumental in treating mental health disorders, these are not the only effective modalities. 

In fact, some of the most evidence-backed methods of treating mental health disorders are complementary to these clinical modalities. For example, mindfulness and meditation, physical exercise, yoga, good nutrition, art or music therapy, and spending time in nature have all been proven effective in reducing symptoms of mental health problems. The right treatment program will prioritize lifestyle changes alongside traditional clinical care.

To learn more about mental health disorders or to seek the help of a mental health professional, do not hesitate to call Turnbridge. Turnbridge is a recognized mental health treatment provider with both inpatient and outpatient programs for young men and women. Call 877-581-1793 to speak with a treatment specialist today.