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Is it Bipolar or Depression?

Researchers believe they have developed a simple test to distinguish between a form of bipolar disorder and depression. Type II bipolar disorder is an underdiagnosed disease which can be easily confused with depression.

Patients with bipolar disorder experience manic or hypomanic episodes (euphoria) and depression. Type II bipolar disorder (hypomanic) patients are especially difficult to diagnose since their manic episodes are not very marked and they are usually diagnosed as depression patients.

Contrarily to what happens in type I bipolar disorder, depressive symptoms and, above all, manic symptoms alternated in this form of the disease are not evident and difficult to identify. In fact, patients suffering from it usually go to the doctor because they are depressed, without thinking that they have also had slight manic episodes (euphoria and other cognition disorders).

According to background information in the article, medical authorities lack tools to successfully identify this pathology, which can take 8-10 years to be correctly diagnosed. Furthermore, antidepressant treatment can be counterproductive in patients with type II bipolar disorder.

Accordingly, a simple tool of 32 questions – called the HCL-32 test has been developed to distinguish major depression from bipolar disorder. The study verifying the questionnaire is published in the Journal of Affective Disorders (PDF of article).

In the study, led by researcher Jules Angst, this test was able to identify more than 80 percent of patients with bipolar disorder. Although the test could not distinguish between types I and II, this decision is relatively easy to take from the clinical data of the patient.

While the test needs to be replicated among patients in wider populations, the HCL-32 test can provide very useful information to psychiatrists and even to primary-care physicians.

BipolarLab Website
IDIBAPS – Institut d’Investigacions Biomèdiques August Pi i Sunyer

Is it Bipolar or Depression?

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Is it Bipolar or Depression?. Psych Central. Retrieved on March 25, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.