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What are depression and bipolar disorder? Depression and bipolar disorder (also known as manic depression) are mood disorders, treatable medical conditions involving changes in mood, thought, energy and behavior. They can affect anyone, regardless of age, ethnic background or social status. Mood disorders are not character flaws or signs of personal weakness. A person cannot “snap out of ” or “control” mood changes caused by depression or bipolar disorder. Major depressive episode: A period of at least two weeks during which at least five of the following symptoms are present. - Sadness, crying spells
- Major changes in appetite and sleep patterns
- Irritability, anger
- Worry, anxiety
- Pessimism, indifference, feeling like nothing will ever go right
- Loss of energy, constant exhaustion
- Unexplained aches and pains
- Feelings of guilt, worthlessness and/or hopelessness
- Not able to concentrate or make decisions
- Not able to enjoy things you once liked, not wanting to socialize
- Excessive alcohol or drug use
- Recurring thoughts of death or suicide
If you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or crisis line such as 1-800-273-TALK immediately. Manic episode: A distinct period of elevated, enthusiastic or irritable mood that includes at least three of the following symptoms. - Increased physical and mental activity and energy
- Extreme optimism and self-confidence
- Grandiose thoughts, increased sense of self-importance
- Irritability, anger
- Aggressive behavior
- Decreased need for sleep without feeling tired
- Racing speech, racing thoughts
- Impulsiveness, poor judgment
- Reckless behavior such as spending sprees, major business decisions, careless driving and sexual promiscuity
- In severe cases, delusions and hallucinations (thinking, seeing or hearing things that aren’t true or don’t exist)
Hypomanic episode: Similar to a manic episode, but less severe and without delusions or hallucinations. It is clearly different from a non-depressed mood with an obvious change in behavior that is unusual or out-of-character. Individuals who have hypomanic episodes and depressive episodes are usually diagnosed with Bipolar II Disorder, while people who have full-blown manic and depressive episodes are usually diagnosed with Bipolar I Disorder. Bipolar disorder that does not follow a pattern is called Bipolar Disorder NOS (Not Otherwise Specified). Mixed state (also called mixed mania): A period during which symptoms of a manic and a depressive episode are present at the same time. Dysthymia: A long low-grade state of depressed mood, symptoms of which include poor appetite or overeating, insomnia or oversleeping, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions and feelings of hopelessness. The depressed state of dysthymia is not as severe as with major depression, but can be just as disabling.> Cyclothymia/: A milder form of bipolar disorder characterized by alternating hypomanic episodes and less severe episodes of depression. The severity of this illness may change over time. Rapid cycling occurs when a person has four or more manic, hypomanic, mixed or depressive episodes within a 12-month period. For many people, rapid cycling is temporary. How are mood disorders treated? A good treatment plan often includes medication to stabilize mood, talk therapy to help with coping skills, and support from a peer-run group like DBSA to help you manage your illness. Seeking treatment does not mean you are weak or a failure, it means you have the strength and courage to look for a way to feel better. Getting treatment for depression or bipolar disorder is no different than getting treatment for diabetes, asthma, high blood pressure or arthritis. Don’t let feelings of shame or embarrassment keep you from getting help. What is psychotherapy (talk therapy)? Psychotherapy can be an important part of treatment. A good therapist can help you cope with the feelings you are having and change the patterns that contribute to your illness. Behavioral therapy concentrates on your actions; cognitive therapy focuses on your thoughts; and interpersonal therapy looks at your relationships with others. Your loved ones may join you in sessions of family or couples therapy. Group therapy involves several, usually unrelated people working with the same therapist and each other. Many therapists use a combination of approaches. One approach is not necessarily better than another – the best choice is the one that works best for you. How is medication used to treat depression and bipolar disorder? There are many safe, effective medications that may be prescribed to relieve symptoms of depression or bipolar disorder. You and your doctor will work together to find the right medication or combination of medications for you. This process may take some time, so don’t lose hope. No two people will respond the same way to a medication, and many people need to try several before they find the best one(s). Different treatments may be needed at different times in a person’s life. Keep your own records of treatment – how you feel each day, what medications (and dosages) you take and how they affect you – to help your doctor develop a treatment plan for you. DBSA’s Personal Calendar can be very helpful with this. Your doctor may start your treatment with a medication approved to treat mood disorders. He or she might also add other medications which have been approved by the Food and Drug Administration (FDA) as safe and effective treatments for other illnesses of the brain, but have not yet been specifically approved to treat depression or bipolar disorder. This is called “off-label” use, and can be helpful for people whose symptoms don’t respond to traditional treatments.
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