Bipolar Disorder vs. Depression

April 19, 2023

Major depressive disorder is characterized by persistent sadness and feelings of loss and hopelessness over a period of time. Bipolar disorder, by contrast, includes periods of depression or average moods alternating with periods of elation and optimism.

What are the symptoms of major depressive disorder (depression)?

  • Prolonged feelings of sadness or hopelessness
  • Changes in appetite, either loss of appetite or too much eating
  • Thoughts of death or suicide
  • Insomnia or sleeping too much
  • Tiredness
  • Poor concentration
  • Loss of interest in previously enjoyable activities
  • Poor memory
  • Irritability
  • Vague pains or physical complaints that do not respond to treatment

How is depression treated?

Treatment of Depression usually includes antidepressants, often in addition to talk therapy. Selective serotonin reuptake inhibitors (SSRIs) are used to increase the amount of serotonin, a neurotransmitter, to help brain cells communicate with one another. Serotonin and norepinephrine reuptake inhibitors (SNRIs) increase levels of serotonin and norepinephrine, another neurotransmitter, between brain cells.

Here are some examples of SSRIs:

Prozac (fluoxetine)
Celexa (citalopram)
Paxil (paroxetine)
Zoloft (sertraline)

Here are some examples of SNRIs:

Pristiq (desvenlafaxine)
Cymbalta (duloxetine)
Effexor (venlafaxine)

Atypical antidepressants have similar but unique ways of working. Trazodone, an atypical antidepressant, works by increasing serotonin levels between brain cells and blocking certain brain receptors. It is used to treat insomnia and as a mood stabilizer as well as an antidepressant.

What are the symptoms of bipolar disorder?

Bipolar disorder, formerly known as manic-depressive disorder, can show the same signs and symptoms as major depressive disorder, although not all patients show depression. All patients do experience episodes of extremely energetic activity, optimism, and elevated mood, called mania or hypomania. Signs and symptoms are:

  • Feeling abnormally happy or “high” for sustained periods
  • Getting little sleep
  • Racing thoughts and talking fast
  • Impulsivity
  • Distractibility
  • Overconfidence
  • Risky behavior such as gambling or overspending

How is bipolar disorder treated?

Sometimes antidepressants are used to treat bipolar disorder, although these medications can bring on manic episodes, so they can only be used alongside medications developed for bipolar disorder.

Mood stabilizers

Lithium was the first medication found effective for some patients with bipolar disorder and is still used for some, although blood levels must be carefully monitored. It can make psoriasis worse, and it is associated with increased risk of hypothyroidism (sluggish thyroid). It is not recommended for pregnant or breastfeeding women. Overdosing on it can be dangerous.


Depakene (valproic acid)
Depakote (divalproex)
Tegretol (carbamazepine)
Lamictal (lamotrigine)


Zyprexa (olanzapine)
Risperdal (risperidone)
Seroquel (quetiapine)
Abilify (aripiprazole)
Geodon (ziprasidone)
Latuda (lurasidone)
Saphris (asenapine)

Antidepressant-antipsychotic Symbyax consists of antidepressant fluoxetine and antipsychotic olanzapine, working together to treat depression and stabilize mood.

Anti-anxiety benzodiazepines such as Valium can be used to improve sleep on a short-term basis but generally should be avoided.

Did you know? QuickMD can help you manage your depression or bipolar disorder remotely through telemedicine by offering counseling and prescription refills of your antidepressants.

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