Bipolar vs. Depression: 3 Distinct Differences

By: Jayson Tripp, MD


Bipolar disorder and depression  have similar symptoms. However, they are two very different conditions. Sometimes, unfortunately, bipolar may be misdiagnosed as depression, so it is important to understand differences between the two conditions and make sure you are upfront with your medical provider so they can provide you with an accurate diagnosis and treatment. 

1. Bipolar Disorder and Depression Affect Different Parts of the Brain

Studies show that bipolar disorder and major depressive disorder (MDD) affect certain parts of the brain. While both conditions can affect the hippocampus (the part of the brain associated with memory and emotion), patients with bipolar disorder tend to have parts of their hippocampus that are smaller than those with MDD  or other mood disorders.   

Along with the hippocampus, depression also affects the prefrontal cortex, which is associated with mood, as well as the limbic system. The limbic system contains the amygdala, which is associated with emotions like fear, pleasure, sorrow, anger, and sexual arousal.  

2. Bipolar Patients Will Have Had at Least One Manic Episode

Not surprisingly, since bipolar disorder and depression affect the brain differently, these conditions also cause different symptoms. Bipolar disorder is characterized by depressive episodes and manic episodes. These episodes can last anywhere from a few days to a few months.  

You can also go through periods when you feel no symptoms or when you feel both manic and depressive symptoms, which is known as a mixed bipolar state. The symptoms of a depressive bipolar state are similar to depression, which is why the condition may be misdiagnosed. However, the symptoms of a manic episode are nothing like depression. Symptoms of mania include:  

  • Aggressiveness  
  • Euphoria  
  • Grandiose ideas  
  • High energy  
  • High sex drive  
  • Inability to focus  
  • Increased activity   
  • Irritability  
  • Not feeling tired, even without sleep  
  • Quick to anger  
  • Racing thoughts   
  • Restlessness  
  • Unrealistic beliefs   

To be diagnosed with bipolar disorder, you need to have experienced at least one manic state following or preceding a depressive state.   

3. Bipolar Disorder and Depression Require Different Treatments

Another difference between bipolar disorder and major depressive disorder  is that they require different treatments. Depression is usually treated with antidepressants such as SSRIs or SNRIs. However, these types of medications can aggravate symptoms of mania, so doctors tend to prescribe mood stabilizers like lithium or Lamictal.  

Generally, bipolar patients take a few different medications to manage their symptoms. But of course, every case is different. There are even studies that have analyzed the effects of TMS on bipolar disorder . These studies have concluded that TMS may be a reliable treatment option for people with bipolar disorder as well as major depressive disorder.  

TMS can be prescribed as an off-label treatment for a variety of conditions, including bipolar depression. If you or a loved one is struggling with bipolar disorder, contact us to schedule an evaluation  and learn about treatment options that can help.

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