Bipolar depression refers to an episode of clinical depression that occurs in a person who has been previously diagnosed with bipolar disorder. Bipolar depression isn’t a diagnosis in and of itself, but rather one of the two major components that make up bipolar disorder (the other being a manic or hypomanic episode).
People with untreated or under-treated bipolar disorder will often cycle between these two types of mood — depression and mania (or hypomania, in bipolar II disorder). Effective treatment helps reduce the likelihood of cycling and helps even out the hills and valleys of a person with bipolar disorder’s life.
Most people with bipolar disorder will experience a cycle of depression. How deep or long that depressive cycle is depends on the person, their personality and resilience, the kind of treatment they’re undergoing (if the person is in treatment), their genetics and biological makeup, stress levels, and social and environmental factors. There is no quick cure or overnight treatment for bipolar depression. Just like clinical depression, bipolar depression treatment takes time and concerted effort.
People with bipolar depression tend to experience racing thoughts, irritability, increased energy, and grandiose thinking. Suicidal thoughts are not uncommon (Yong-Ku, 2018).
Symptoms of Bipolar Depression
According to the American Psychiatric Association (2013), the symptoms of bipolar depression are the same as they are for clinical depression. The important distinction is that the episode of depression occurs in the context of a diagnosis of bipolar disorder I or bipolar disorder II.
In order for a person to be diagnosed in a depressive episode in bipolar disorder, the individual needs to be experiencing five (5) or more of the following symptoms nearly every day:
- The person is experiencing a depressed mood most of the day, shown either by subjective feelings — feeling sad, blue, or empty — or by observations made by others.
- The person is experiencing a greatly diminished interest and pleasure in nearly all activities in their life, such as having no interest in hobbies, sports, or other things the person used to enjoy doing.
- The person is experiencing significant weight loss (or a significant decrease in appetite) when not dieting, or they are experiencing significant weight gain (or a significant increase in appetite).
- The person has trouble getting to sleep or staying asleep (insomnia) or simply sleeping too much throughout the entire day (hypersomnia).
- The person is experiencing a sense of restlessness, inability to sit still, pacing, pulling at clothes (psychomotor agitation) or slowed speech, movements, and very quiet talking (psychomotor retardation)
- The person feels tired all the time, fatigued, and complains of having no energy whatsoever — even for the simplest of tasks like taking a shower or eating.
- The person has overwhelming feelings of guilt, such as ruminating over minor past failings, or worthlessness.
- The person can’t concentrate or think clearly, or is experiencing an overwhelming amount of indecisiveness. The person may appear easily distracted, or complains of memory difficulties.
- The person is experiencing constant, recurrent thoughts of death or suicidal thoughts.
A bipolar depressed mood caused by substances (such as drugs or alcohol) is not considered a major depressive disorder, nor is one that is caused by a general medical condition. Bipolar depression needs to cause significant distress in the person’s life in order for it to be diagnosed.
When a person is experiencing bipolar depression, the individual usually has little interest in doing things they normally enjoy doing, like hanging out with friends, engaging in hobbies, socializing, or even going to work or school. They may entirely and utterly hopeless, with no sense of having a future worth living. Troubles with eating and sleep patterns are common, as are problems with their ability to remember things or concentrate. People with bipolar depression may complain of being in a “haze” with their thinking, not being able to care to focus long enough on a particular task or issue (McManamy, 2006).
Diagnosis & Treatment
Bipolar depression is typically diagnosed by a mental health specialist, such as a psychologist or psychiatrist. While a general practitioner or family physician can make a preliminary diagnosis, a person should consult a mental health professional for a definitive diagnosis. Mental health professionals are also the best specialists to provide treatment for bipolar disorder.
According to the National Institute of Mental Health (2018), bipolar depression is readily treated as a component of a person’s overall treatment plan for bipolar disorder. You can learn more about what bipolar depression treatment entails here.
For more information
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
McManamy, J. (2006). Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn’t Tell You… That You Need to Know. Living Well (Collins).
National Institute of Mental Health. (2019). Bipolar disorder. Retrieved from https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml on February 21, 2019.
Yong-Ku, K. (2018). Understanding depression. Springer: New York.