Depression and Bipolar Disorder: The Differences Are Important <o:p></o:p>

Managing depression or bipolar disorder is a life-long process -- one in which you, the person with the illness, must actively participate. The more you know about your illness and the treatment options available to you, the more active you are in your treatment plan, and the more committed you are to following your treatment plan, the greater your chances are for successful results. <o:p></o:p>

Depression <o:p></o:p>

Everyone, at various times in life, feels sad or "blue." It's normal to feel sad on occasion. Sometimes this sadness comes from things that happen in your life: you move to a different city and leave friends behind, you lose your job or a loved one dies. But what's the difference between "normal" feelings of sadness and the feelings caused by clinical depression? <o:p></o:p>

While it's normal for people to experience ups and downs during their lives, those who have clinical depression experience specific symptoms daily for two weeks or more, making it difficult to function at work, at school, or in relationships. <o:p></o:p>

Clinical depression is a treatable illness marked by changes in mood, thought and behavior. That's why it's called a mood disorder. <o:p></o:p>

People of all ages, races, ethnic groups, and social classes have depression. Although it can occur at any age, the illness often develops between the ages of 25 and 44. The lifetime prevalence of depression is 24 percent for women; for men, it's 15 percent. <o:p></o:p>

Bipolar disorder differs from unipolar depression. <o:p></o:p>

Bipolar Disorder (Manic-Depression) <o:p></o:p>

More Than A Mood Swing <o:p></o:p>

Manic-depression is a treatable medical illness marked by changes in mood, thought, energy and behavior. It is also known as bipolar disorder because a person 's mood can alternate between the "poles" of mania and depression. This change in mood or "mood swing" can last for hours, days, weeks, or even months. <o:p></o:p>

Bipolar disorder affects more than two million adult Americans annually. Like depression and other serious illnesses, bipolar disorder can also adversely affect spouses, family members, friends, and people in the workplace. It usually begins in late adolescence, although it can start in early childhood or as late as the 40s and 50s. An equal number of men and women develop this illness and it is found among all ages, races, ethnic groups, and social classes. The illness tends to run in families and is inherited in many cases. <o:p></o:p>

Mood swings that come with bipolar disorder can be severe, ranging from extremes in energy to deep despair. Or they can be milder, ranging from deep depression to mild periods of high energy, racing thoughts or other manic symptoms. The way the mood swings disrupt normal activities distinguishes bipolar mood episodes from ordinary mood changes. <o:p></o:p>

Unlike people with clinical (unipolar) depression, most people who have bipolar disorder talk about experiencing the "highs" and "lows" of the illness. The "highs" are periods of mania, energy, or euphoria. <o:p></o:p>

Symptoms of Mania <o:p></o:p>

• Increased physical and mental activity and energy <o:p></o:p>
• Heightened mood, exaggerated optimism and self-confidence <o:p></o:p>
• Excessive irritability, aggressive behavior <o:p></o:p>
• Decreased need for sleep without experiencing fatigue <o:p></o:p>
• Inflated sense of self-importance, grandiose delusions <o:p></o:p>
• Racing speech, racing thoughts, flight of ideas <o:p></o:p>
• Distractibility, impulsiveness, poor judgement <o:p></o:p>
• Reckless behavior such as spending sprees, rash business decisions, erratic driving, and sexual indiscretions <o:p></o:p>
• In the most severe cases, delusions and hallucinations<o:p></o:p>

These "highs" and "lows" are frequently seasonal. Many people who have bipolar disorder report feeling symptoms of depression during fall and winter, and symptoms of mania and/or hypomania (a less severe form of mania) during spring. <o:p></o:p>

Types of Episodes <o:p></o:p>

Manic Episode: A distinct period of persistently elevated, expansive, or irritable mood, lasting at least one week. During this period, three or more symptoms of mania must be present. <o:p></o:p>

Major Depressive Episode: A period of two weeks or more during which five or more symptoms of depression are present. <o:p></o:p>

Hypomanic Episode: Similar to a manic episode, except that delusions or hallucinations are not present and it is less severe. Must be clearly different from the individual's typical nondepressed mood, with a clear change in functioning and observable behaviors that are unusual or out-of-character. <o:p></o:p>

Mixed Episode: When symptoms of a manic and a major depressive episode are both present every day for at least a one-week period. <o:p></o:p>

Rapid Cycling: Four or more manic, hypomanic, mixed, or depressive episodes in any 12-month period. <o:p></o:p>

Types of Bipolar Disorder <o:p></o:p>

Different types of bipolar disorder are determined by patterns of symptoms or episodes. The main types of bipolar disorder are: <o:p></o:p>

Bipolar I Disorder <o:p></o:p>

• One or more manic episodes or mixed episodes and, often, one or more major depressive episodes. <o:p></o:p>
• Depressive episode may last for several weeks or months, alternating with intense symptoms of mania that may last just as long. <o:p></o:p>
• Between episodes, there may be periods of normal functioning. <o:p></o:p>
• Symptoms may also be related to seasonal changes. <o:p></o:p>

Bipolar II Disorder <o:p></o:p>

• One or more major depressive episodes accompanied by at least one hypomanic episode. <o:p></o:p>
• Hypomanic episodes have symptoms similar to manic episodes but are less severe. <o:p></o:p>
• Between episodes, there may be periods of normal functioning. <o:p></o:p>
• Symptoms may also be related to seasonal changes <o:p></o:p>

Cyclothymic Disorder <o:p></o:p>

• Chronic, fluctuating mood disturbance involving periods of hypomanic symptoms and periods of depressive symptoms. <o:p></o:p>
• Milder form of bipolar disorder; the periods of both depressive and hypomanic symptoms are shorter, less severe, and do not occur with regularity. <o:p></o:p>
• Many but not all people with cyclothymia may ultimately develop a more severe form of bipolar illness. <o:p></o:p>

Bipolar Disorder NOS (Not Otherwise Specified) <o:p></o:p>

Includes disorders with bipolar features that do not meet criteria for any of the above specified disorders. For example: <o:p></o:p>

• Having recurrent hypomanic episodes without depressive symptoms. <o:p></o:p>
• Having very rapid alternation between symptoms of mania and depression that do not meet the criteria for a manic episode or major depressive episode. <o:p></o:p>

What Causes Bipolar Disorder? <o:p></o:p>

Research has shown the presence of bipolar disorder indicates an imbalance in brain chemicals called neurotransmitters. Although the direct cause of the illness is unclear, it is known that genetic, biochemical, and environmental factors each play a role. Body chemistry can bring on a depressive or manic episode, due to the presence of another illness, altered health habits, stress, substance abuse, or hormonal changes. In addition, studies have shown that the illness often runs in families, and that stressful life experiences can trigger some symptoms. <o:p></o:p>

The Importance of Recognizing Mania <o:p></o:p>

When symptoms of mania are untreated, they can lead to life-threatening situations. For example, a woman with mania was injured after crashing her car. She was traveling at a high speed because she thought she was a race car driver. A man with mania impulsively invested his life savings in the stock market - and lost it all. These behaviors vary from person to person, but are typical of untreated bipolar disorder. Other behaviors include excessive spending, sexual indiscretions, and excessive gambling. <o:p></o:p>

Erratic behavior alone does not mean that someone has bipolar disorder, but when a combination of symptoms appears for longer than one week, one should see a mental health professional for immediate evaluation. Unfortunately, many people with symptoms delay seeking professional help. The average length of time between the onset of bipolar symptoms and a correct diagnosis is ten years. There is real danger involved in leaving bipolar disorder undiagnosed, untreated or undertreated - people with bipolar disorder who do not receive proper help have a suicide rate as high as 20 percent. <o:p></o:p>

When It Runs in the Family <o:p></o:p>

Although the exact cause of bipolar disorder is unknown, numerous medical studies indicate that it runs in families. More than two-thirds of people with bipolar disorder have at least one close relative with the illness or with unipolar major depression, indicating that the illness has a hereditary component. <o:p></o:p>

Even though bipolar disorder may be considered a family illness, there is no way to predict how it will affect other family members. Concerned families should consult their physicians if they have questions about symptoms and should also request a screening for mood disorders at their annual medical check-up. The Depression and Bipolar Support Alliance recommends this kind of screening as part of every individual 's health regimen or annual physical check-up, whether there is a history of mood disorders in the family or not. <o:p></o:p>

The Child with Bipolar Disorder <o:p></o:p>

There is a startling lack of research about the early onset of bipolar disorder in children. Children as young as three have been diagnosed with it, and more children than ever are exhibiting symptoms. Symptoms of bipolar disorder can emerge as early as infancy. Mothers often report that children later diagnosed with the disorder were extremely difficult and slept erratically. They seemed extraordinarily clingy, and from a very young age often had uncontrollable, seizure-like tantrums or rages out of proportion to any event. The word "no" often triggered these rages. <o:p></o:p>

As with depression, the priority for parents who think their child may have bipolar disorder is to get a correct diagnosis. Early, accurate diagnosis and treatment are crucial to a child 's development if he or she has a mood disorder. For more information about children with bipolar disorder, contact the Child and Adolescent Bipolar Foundation (http://www.cabf.org). <o:p></o:p>

Content derived from Taking On and Talking On Bipolar Disorder, Depression and Bipolar Support Alliance (formerly National DMDA) http://www.DBSAlliance.org. <o:p></o:p>