Many people with bipolar disorder are first treated for depression, sometimes for years. That's because people usually seek help when they're down, not when they're up. Getting the diagnosis right matters, because the treatments differ.
The key difference
Depression involves low mood or loss of interest. Bipolar disorder involves depressive episodes plus at least one period of abnormally elevated or irritable mood with increased energy, called mania (bipolar I) or a milder form called hypomania (bipolar II).
Signs of hypomania or mania
- Needing much less sleep without feeling tired
- Racing thoughts or talking faster than usual
- Unusual confidence or big plans
- Spending sprees, risky decisions, or impulsive behavior
- Irritability that's out of character
- Others noticing you're "not yourself"
Hypomania can feel good, so people often don't mention it. Ask family members whether they've noticed periods like this.
Why it changes treatment
Antidepressants on their own may be less effective in bipolar depression, and in some people they can trigger mania or rapid mood cycling. Bipolar disorder is usually treated with mood stabilizers or certain other medications, sometimes alongside an antidepressant.
Other clues
- Depression that started early, in the teens or early twenties
- A family history of bipolar disorder
- Several antidepressants that didn't work or made you feel agitated
- Depression after childbirth
The good news
With the right diagnosis and treatment, people with bipolar disorder live full, stable lives. Consistent sleep, regular follow-up, and the right medication make a big difference.
This article is general information, not medical advice for your situation. If you're in crisis, call or text 988, or call 911.