What is the Difference Between Unipolar Depression and Bipolar Depression?

by Julie A. Fast Patient Advocate

Depression is Complex

All human brains can experience depression, but there is more than one kind of depression. The most common depression is situational where a person goes through a downswing due to a life experience. This depression can often be treated by therapy that is specific to the event, such as grief counseling. In contrast, unipolar and bipolar depression are considered medical conditions. They may occur without a life experience trigger and may initially benefit a more medical than therapy-based treatment approach.

irritated woman on the phone

Unexpected Symptoms of Unipolar and Bipolar Depression

Depression is often described as weepy, sad, and hopeless, but this is only one type of depression. The other depression, irritated depression, is angry, negative, and complaining. People with irritated depression often go untreated as they are considered bitchy, rude, or negative. Irritated depression can manifest in road rage, punching and kicking tires and walls, yelling and statements, such as “I hate everyone! Leave me alone!” Both unipolar and bipolar depression can either be the typical weepy depression or irritated depression.

Unipolar vs. Bipolar Depression: What's the Difference?

Bipolar disorder includes the mood swings bipolar depression and bipolar mania. Unipolar depression and bipolar depression share the same symptoms with three main differences: 1) Bipolar depression is more episodic than unipolar, 2) Bipolar depression may tip into mania, and 3) Due to the mania risk, bipolar depression treatment is different than unipolar depression treatment.

young woman looking at pill bottle

Unipolar Depression and Bipolar Depression: Same Symptoms, Different Treatments

Unipolar and bipolar depression will look the same on a depression scale. The way a person thinks, talks, and acts will be the same. The main difference is in treatment protocol due to bipolar depression’s close association with mania. Unipolar depression can safely utilize the very effective serotonin-based treatments, such as SSRI antidepressants, amino acid supplements, and light box therapy. Bipolar depression treatment needs to be very cautious with the use of serotonin-boosting treatments, as they can cause mania.

Woman suffering from mania.

Dysphoric Mania is Bipolar Depression With Bipolar Mania

When bipolar depression combines with the energy of mania, the result is called dysphoric or mixed mania. Unlike the upbeat, happy mood of euphoric mania, dysphoric mania is energized depression. It is vocal, abusive, and loud due to the mixture of the negative depression thoughts and the energy of mania. Dysphoric mania is especially dangerous when a person is suicidal, as the sluggishness of weepy depression can be energized by mania and the decision to harm the self or others can become very active.

mother and son looking at family photo album

All People Seeking Treatment for Depression Should Be Screened for Bipolar Disorder

Due to the risk of mania that arises from serotonin-related depression treatments, all health care professionals should ask about a history of bipolar in the individual seeking depression treatment and take a full family history for the presence of bipolar in the family tree. Prescribing an SSRI antidepressant, supplements such as 5HTP or light therapy to a depressed person with a family history of bipolar disorder can cause latent bipolar to switch on even if there have been no signs of mania in the past.

Prescription pill bottles

We Can Prevent Bipolar Disorder by Treating Unipolar Correctly

If there is bipolar in the family tree of a person who only has signs of unipolar depression, treatment should follow bipolar depression protocol and NOT unipolar depression protocol. I believe we can end substance-induced bipolar disorder by following this plan. Other substances to be avoided in depression treatment when there is bipolar in the family tree are ADHD medications, steroids, hormones, and the THC in cannabis, as all are known to cause mania. Please read What is Epigenetics Theory? for more information.

Can Children Have Unipolar or Bipolar Depression?

Anyone with a brain can experience depression. If a parent has unipolar or bipolar depression that started early, it makes sense a child could inherit the symptoms just as with any genetic illness. Talking openly with young children about the brain and what depression feels and sounds like lessens fear and increases awareness that the brain is not always a well-oiled machine. From a personal story, my former partner had a suicidal episode when he was four years old. He was diagnosed with bipolar at age 21.

Do I Have Unipolar or Bipolar Depression?

If you’re depressed and simply can’t figure out why, there is a chance your mood is related to brain chemistry. Look through your family tree for signs of depression and get help just as you would for any medical problem. If you’re depressed and have bipolar disorder in the family, learn about mania and get tested for signs of mania in your own life. Unipolar and bipolar disorder are more similar to diabetes than emotional or personal problems, which is why a medical approach works well.

Woman taking a pill.

Can Unipolar and Bipolar Depression Be Treated Naturally?

Unipolar and bipolar depression are medical conditions that can respond to natural treatments such as therapy, exercise, and healthy eating, but in many cases, the depression is stronger than what nature gives us as tools. Adding a medication for persistent, suicidal depression, for example, can be life-saving. When the brain is not working correctly, medications can help get our chemistry back on track. Always keep in mind that unipolar has one treatment protocol and bipolar depression has another.

Julie A. Fast
Meet Our Writer
Julie A. Fast

Julie A. Fast is the author of Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder, Get it Done When You’re Depressed, and The Health Cards. Julie won the Mental Health America Journalism Award for the best mental health column in the U.S. and was the recipient of the Eli Lily Reintegration award for her work in bipolar disorder advocacy. Julie is CEU certified and regularly trains health care professionals, including psychiatric residents, social workers, therapists, and general practitioners on bipolar disorder and mental health management skills. She was the original consultant for Claire Danes for the show "Homeland" and is on the mental health expert registry for People Magazine. She is a sought-after coach for parents and partners of people with bipolar disorder.