Question:

I hear a lot about depression and bipolar disorder on TV commercials.  I feel very sad sometimes.  How do I know if I may have bipolar disorder or just depression?

Answer:

The NIMH describes a Depressive Disorder as “an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression”. Depressive disorders come in different forms that include Major Depression, Dysthymia and Bipolar Disorder.  When someone is depressed, they may experience symptoms which include:

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
• Decreased energy, fatigue, being “slowed down”
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight loss or overeating and weight gain
• Thoughts of death or suicide; suicide attempts
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Dysthymia is a mild to moderate depression versus a Major Depression is a severe depression.  Dysthymic Disorder lasts longer than a Major Depressive Episode but is not as disabling with regards to work, school and pleasurable activities.  The third type of Depressive Disorder is Bipolar Disorder.  In Bipolar Disorder, not only does the individual experience the symptoms of depression (lows) but also experiences symptoms of mania (highs).  Symptoms of mania include:

• Abnormal or excessive elation
• Unusual irritability
• Decreased need for sleep
• Grandiose notions
• Increased talking
• Racing thoughts
• Increased sexual desire
• Markedly increased energy
• Poor judgment
• Inappropriate social behavior

A few gender differences that I think are worth mentioning: depression is twice as common in women than in men; about 6 million men in the US are affected by depression and many go undiagnosed; depression in men may not present with feelings of hopelessness but rather irritability and discouragement; lastly, depression has shown to be associated with a higher risk of coronary artery disease both in men and women.

If you feel that you have symptoms of depression or mania, make sure you discuss it with your physician to properly formulate a working diagnosis and treatment plan.  There is good treatment available and you don’t have to suffer needlessly.