Normal depression vs. bipolar depression Watch

Anonymous #1
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I know the main difference between depression in bipolar is that people with bipolar have mania as well as depression but is there actually a difference in symptoms between the type of depression that people with bipolar experience in the depressed cycle compared to just regular non bipolar depression? Is one type generally more severe than the other?
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~Tara~
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That would depend on the severity of either. Even in bipolar there can be milder depression or clinical depression. This is the same for depression overall. Given that bipolar is often discovered through meds giving manic reaction to people with bipolar, that says that there is little to no difference. Depression is depression, manic is manic and the difference is about the overall collection of symptoms.
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Anonymous #1
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Yeah. The depression seen in bipolar disorder is typically veered toward the more severe end and has distinctive features (acute onset, hypersomnia and increased appetitie, psychomotor retardation, psychotic features). "Normal" (unipolar) depression is usually milder (I.e., non-melancholic in nature) and is essentially the opposite in terms of certain features (gradual onset, insomnia and loss of appetitie, agitation, preserved insight - although psychosis can happen in normal depression, it's far more typical of a bipolar course). Bipolar depression also = equal no. of males and females (normal depression affects twice as many women).
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username861942
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(Original post by Anonymous)
Yeah. The depression seen in bipolar disorder is typically veered toward the more severe end and has distinctive features (acute onset, hypersomnia and increased appetitie, psychomotor retardation, psychotic features). "Normal" (unipolar) depression is usually milder (I.e., non-melancholic in nature) and is essentially the opposite in terms of certain features (gradual onset, insomnia and loss of appetitie, agitation, preserved insight - although psychosis can happen in normal depression, it's far more typical of a bipolar course). Bipolar depression also = equal no. of males and females (normal depression affects twice as many women).
Could I ask the source for this symptom profile? I haven't come across this difference before and would be interested to read any studies which have written about this.


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username861942
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(Original post by Anonymous)
I know the main difference between depression in bipolar is that people with bipolar have mania as well as depression but is there actually a difference in symptoms between the type of depression that people with bipolar experience in the depressed cycle compared to just regular non bipolar depression? Is one type generally more severe than the other?
As far as I know - no real difference in symptoms or severity. Someone with bipolar will not necessarily have more severe episodes than someone without bipolar. The treatment is likely to be different though - less focus on antidepressants in bipolar and more focus on mood stabilisers and certain antipsychotics which can be used to treat depression eg. Quetiapine.


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~Tara~
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I would like to know the source too so I can read up on this. It would be useful in my work.

Especially as a lot of the bipolar symptoms you mentioned could cross with someone who experiences depression and anxiety too. Even the acute onset can be linked with sustained anxiety and the natural mood stabilisation process that we have.
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Anonymous #1
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The differences between unipolar and bipolar depression are only of special import to diagnosticians and aren’t exactly known to the public at large but it’s an established fact among the psychiatric community (esp. the North American rank) that the depression seen in bipolar disorder is far less likely to be associated with certain vegetative symptoms (insomnia, anorexia, psychomotor agitation) and far more likely to be associated with the reverse (hypersomnia, increased appetite, psychomotor retardation). Mood-congruent delusions and hallucinations (e.g., delusions of sin, visions of beheaded corpses) are actually quite common in bipolar depression relative to “normal” depression (50% of bipolar depressions contain psychotic features, compared to only 15% of “regular” depressions). There are also distinct differences in onset, demographics, and course (acute onset, shorter episodes, younger age of onset, comorbid alcoholism/cocaine addiction, equal sex ratio). Only a minrority of "normal" depressions reach melancholic/psychotic proportions but that's generally the default setting for the depression seen in bipolar disorder so there's more likely to be more severe, "biological" features. The links below are just the tip of the iceberg. There's a wealth of info out there that isn't known to the general public.



http://www.blackdoginstitute.org.au/healthprofessionals/bipolardisorder/diagnosingbipolardisorder/differentiatingbipolardisorderfr omunipolardepression.cfm


[/u]
Mitchell et al. compared unipolar and bipolar I disorder across a series of large databases andthat they describe as a "bipolar depression signature." These include[...] psychomotor retardation, melancholic symptoms, atypical depressivesymptoms, and an absence of anxiety or tearfulness set against a history ofpsychotic depression.
ipolar-disorder/bipolar-depression/differences-between-unipolar-depression-bipolar-depression/[/color][/size]


http://www.jabfm.org/content/18/4/271.full
http://www.blackdoginstitute.org.au/public/bipolardisorder/bipolardisorderexplained/bipolardepression.cfm
http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.163.2.225
https://www.researchgate.net/publication/8381258_Scale_matters_The_need_f or_a_Bipolar_Depression_Rating_S cale_BDRS

Atypical features of depression such as fatigue, hypersomnia, hyperphagia and rejection sensitivity are more common in bipolar II disorder than in unipolar disorder, particularly infemales. Furthermore, psychomotor retardation is more common in bipolar disorder than unipolar disorder and both types of bipolar disorder are associated with higher rates of substance misuse than the general population.”













(Original post by bullettheory)
Could I ask the source for this symptom profile? I haven't come across this difference before and would be interested to read any studies which have written about this.



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(Original post by ~Tara~)
I would like to know the source too so I can read up on this. It would be useful in my work.

Especially as a lot of the bipolar symptoms you mentioned could cross with someone who experiences depression and anxiety too. Even the acute onset can be linked with sustained anxiety and the natural mood stabilisation process that we have.
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username861942
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(Original post by Anonymous)
The differences between unipolar and bipolar depression are only of special import to diagnosticians and aren’t exactly known to the public at large but it’s an established fact among the psychiatric community (esp. the North American rank) that the depression seen in bipolar disorder is far less likely to be associated with certain vegetative symptoms (insomnia, anorexia, psychomotor agitation) and far more likely to be associated with the reverse (hypersomnia, increased appetite, psychomotor retardation). Mood-congruent delusions and hallucinations (e.g., delusions of sin, visions of beheaded corpses) are actually quite common in bipolar depression relative to “normal” depression (50% of bipolar depressions contain psychotic features, compared to only 15% of “regular” depressions). There are also distinct differences in onset, demographics, and course (acute onset, shorter episodes, younger age of onset, comorbid alcoholism/cocaine addiction, equal sex ratio). Only a minrority of "normal" depressions reach melancholic/psychotic proportions but that's generally the default setting for the depression seen in bipolar disorder so there's more likely to be more severe, "biological" features. The links below are just the tip of the iceberg. There's a wealth of info out there that isn't known to the general public.



http://www.blackdoginstitute.org.au/healthprofessionals/bipolardisorder/diagnosingbipolardisorder/differentiatingbipolardisorderfr omunipolardepression.cfm


[/u]
Mitchell et al. compared unipolar and bipolar I disorder across a series of large databases andthat they describe as a "bipolar depression signature." These include[...] psychomotor retardation, melancholic symptoms, atypical depressivesymptoms, and an absence of anxiety or tearfulness set against a history ofpsychotic depression.
ipolar-disorder/bipolar-depression/differences-between-unipolar-depression-bipolar-depression/[/color][/size]


http://www.jabfm.org/content/18/4/271.full
http://www.blackdoginstitute.org.au/public/bipolardisorder/bipolardisorderexplained/bipolardepression.cfm
http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.163.2.225
https://www.researchgate.net/publication/8381258_Scale_matters_The_need_f or_a_Bipolar_Depression_Rating_S cale_BDRS

Atypical features of depression such as fatigue, hypersomnia, hyperphagia and rejection sensitivity are more common in bipolar II disorder than in unipolar disorder, particularly infemales. Furthermore, psychomotor retardation is more common in bipolar disorder than unipolar disorder and both types of bipolar disorder are associated with higher rates of substance misuse than the general population.”
Thanks. How did you come across this if it isn't known in the general public? I asked one of the consultant psychiatrist that I work with today about this and they told me that they have never heard of differences between bipolar depression and regular depression.

Personally I would feel uncomfortable by relying on this to differentiate between depression and bipolar - may lead to being medicated and diagnosed without need.


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~Tara~
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Misdiagnosis would not be so prevalent if there were very distinct features to bipolar disorder versus depression. They follow completely different treatment plans and it can be very dangerous to put someone with bipolar on the treatment path for depression because of the manic side of the disorder.
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