Bipolar with Depression Question

Is it possible to have bipolar I with comorbid major depression? I was recently diagnosed with bipolar I (not II), but had a major depressive episode lasting 4 months. Is it possible my bipolar diagnosis was wrong (I've heard bipolar II's depression is longer than bipolar I's, which is only a few weeks at most), or is it possible to have bipolar I and major depressive disorder? Or would I just call it "Bipolar Depression?" Anyone else here have bipolar I and have had a depressive episode lasting about that long? I was having mixed features/mania during the depression, too, if that means anything.

A lot of people with bipolar will have very long periods of depression. That being said it is not unusual to have several diagnosis going on at the same time. Welcome to Psych Central.

Different people have episodes that last different periods of time weeks, months, even a year if I remember a post not too long ago.

I have a BP 1 diagnosis, and I've spent close to a year in depression in the past.

I don't spend too much time caring about what BP number I have. The treatment is the same for both. You just have to try and find your med cocktail, or your personal coping strategies.

Wishing you the best of luck. I hope you find the answers you need. (((HUGS)))

It's not possible to have bipolar disorder with comorbid major depressive disorder, because they're mutually exclusive by definition. If you've got one, then you don't have the other.

That's not entirely true. Bipolar II depressive episodes are, on average, a bit longer than Bipolar I depressive episodes, but that's just an average. There is a great deal of individual variation within the groups. Some people with BPII have short episodes; some people with BPI have long episodes. It just depends on the person.

I read a 2010 paper called Longitudinal Course of Bipolar I Disorder: Duration of Mood Episodes. The researchers found that the median duration of any type of BPI episode -- mania or depression -- is about 13 weeks. People who cycle, have episodes with severe onset, or a greater number of years spent ill with any mood episode take even longer to recover. That means a lot of people with BPI are having very, very long episodes. A 16 week episode like the one you had is only slightly longer than the median for BPI.

edit: I went searching for the study to see if I could find more info. This is what I found.
So 25% of people in the study had mood episodes lasting longer than 9.5 months.

And here's the section that's specifically about major depression within bipolar 1:
So 25% of people in the study who had major depressive episodes had episodes lasting longer than about 8.75 months. The median was 15 weeks with a standard error of 1.1 weeks, meaning that the average length of a BPI major depressive episode is probably somewhere between 13.9 weeks and 16.1 weeks. If that's correct, then your major depressive episode was about average for a person with BPI.

I received a diagnosis of bipolar 1 with depression in the hospital last year, so yes, it's possible to have both at the same time. I know it was confusing to me too, but what I was experiencing was depression superimposed on bipolar depression. At least that's how it was explained to me. I'd been depressed for weeks but it became critical in late October and I was suicidal, which was how I ended up hospitalized. I still think it sounds weird, but it exists.

Really? That's very odd. Every pdoc I've spoken to about this has told me they're mutually exclusive by definition. Plus, the DSM-V states that Bipolar and Major Depressive Disorder are mutually exclusive.

- from Major Depressive Disorder Criteria, pg. 161, DSM-V

I've certainly had my share of manic and hypomanic episodes. I don't know... Sometimes I think docs just make up stuff as they go. My official diagnosis was bipolar affective disorder type 1, most recent episode depressed. They shortened it to bipolar 1 with depression. I dunno.