4 Subtle Differences Between Bipolar Disorder & Depression That Are Easy To Miss

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Going through a mental health struggle is difficult enough on its own, but it's even more frustrating when you're misdiagnosed or treating the wrong issue, especially when it comes to mood disorders. Although they are quite different illnesses, there are some subtle differences between bipolar disorder and depression that some might easily miss. However, knowing what differentiates the two can help people get the right treatment they need.

Since bipolar disorder does contain depressive periods, it's not uncommon for people to miss the signs and treat it as depression instead. In fact, nearly seven out of 10 people with bipolar disorder are misdiagnosed at least once, according to research published in the journal Psychiatry.

"It’s common for people to confuse bipolar disorder and depression in someone because bipolar disorder is the combination of depression and mania or hypomania, which can present separately or together," says Laurel Steinberg, PhD, a therapist and professor of psychology at Columbia University, over email. "If someone sees a person in a purely depressed phase of bipolar disorder, there would be no evidence that the person experiences mania other times."

Because they require different treatments, it's important to be able to spot the differences between the two disorders. Here are four subtle differences between bipolar disorder and depression that some people tend to miss.

1. How It Feels To "Feel Better"

Depression and bipolar disorder tend to be confused because the "highs" of bipolar disorder are often confused for a patient feeling better. "Sometimes milder episodes of mania — called hypomania — can resemble seasons of health, as individuals are often highly productive and cheerful during these seasons," says psychologist Marie Fang, PsyD over email. "It's possible for loved ones to interpret a hypomanic episode as a sign of health rather than a symptom of bipolar disorder. Further, it's common to miss these episodes of elevated mood if they're relatively infrequent and short-lived compared to the depressive episodes."

2. The Typical Length Of A "Low"

Depressive "lows" are a component of both depression and bipolar disorder. However, in depression, the lows are constant, while individuals with bipolar disorder cycle between periods of low moods and high moods — or intense irritability along with high energy — even if the highs are short-lived. A depressed mood in bipolar disorder will typically last three months to two years at a time, and sometimes longer, says Fang.

3. How You Experience A Range Of Emotions

"Manic episodes can be mild, where you have sudden pockets of energy all the way to severe, where you feel grandiose and don't sleep for days on end," says psychologist Wyatt Fisher, Psy.D. over email. "Depressive episodes can be mild where you feel down and lack motivation all the way to severe where you can't get out of bed and feel like harming yourself. Those with bipolar experience cycles between manic and depressive pockets whereas those with depression only have depressive symptoms."

4. The Effects Of Different Medications

If someone is mistaken to have depression when they actually have bipolar disorder, it could explain why antidepressants wouldn't have an effect — or even more unfortunately, make matters worse. "Antidepressants help those with depression, but they can aggravate bipolar disorder and cause patients to become manic," says Steinberg. Recognizing that these medications aren't working can help your doctor pinpoint exactly what type of disorder you have as well as recommended the more appropriate treatment.