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Default Apr 23, 2021 at 07:26 PM
  #1
For those of us diagnosed with bipolar disorder, is our depression the same as typical unipolar depression, or does bipolar depression look and feel different than unipolar?

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Default Apr 23, 2021 at 07:37 PM
  #2
Good question. I'd like to know that, too.

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Default Apr 23, 2021 at 07:54 PM
  #3
I can say that for me, it seems my depression tends to be more of a relentless, driving anxiety state. If I combine sad and hopeless with anxiety, that is depression. But I've never lain in bed all day (not that I haven't wanted to, I just don't do it), or not taken care of chores involving my pets, for example. I guess that brings up the question of anxiety - is anxiety an aspect of mania? If it is, then wouldn't sad and hopeless (depressed) combined with anxiety be a mixed state?

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Default Apr 24, 2021 at 02:12 AM
  #4
I can differentiate between what were what I call my past "pure depressions" and mixed states. I had many fewer "pure" ones, while my mixed states seem countless.

I have read of differences between unipolar and bipolar depressions, but certainly they can be the same. A couple differences cited include a slightly higher tendency towards insomnia (unipolar) vs. hypersomnia (bipolar depression) and extreme hopelessness/sadness with possible agitation (unipolar) vs. paralyzed depression (bipolar depression).

I guess the above still brings questions about mixed states, but the extent of the agitation, and related additional symptoms, could help differentiate between bipolar vs. not. Also reactions to antidepressants and cycling tendencies.

My few pure depressions have included more hypersomnia and paralysis. My risk for suicide has seemed much lower during pure vs. mixed depression/mania. My thinking and motivation are almost nill during pure depressions. Like a figurative death, of sorts. My self care suffers greatly. I stop caring. Period!

A good journal article on this topic is at (PDF) Clinical differences between bipolar and unipolar depression The study mentioned in this article was rather large.

Last edited by Soupe du jour; Apr 24, 2021 at 02:33 AM..
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Default Apr 24, 2021 at 10:33 AM
  #5
Thank you for your detailed explanation, Soupe. Something you mentioned - the medication variable - is important to remember. It's something I easily forget...what my own "states" look like without medication is pretty much a mystery to me at this point. I've been on meds for so many, many years. I do recall that when I was on only Celexa and Klonopin I was in a very high hypomanic/manic state frequently. Bouncing between anger/rage and ecstasy feelings.

Thanks for the article. I read it - had no idea that unipolar and bipolar depressions were known to have differences in their presentations. I can certainly relate to the hypersomnia (vs. insomnia).

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Default Apr 24, 2021 at 10:43 AM
  #6
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Originally Posted by Bugtussel View Post
Good question. I'd like to know that, too.

Bugtussel, how does depression usually manifest for you?

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Default Apr 24, 2021 at 11:07 AM
  #7
My norm is slightly depressed which is better then slightly manic for me. Although I would be happier slightly manic. For me after any kind of manic episode when I come down I get really depressed much much worse than my norm.

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Default Apr 24, 2021 at 01:30 PM
  #8
My depression has aspects of insomnia. I will spontaneously awake between 3 and 4 am. I then become sleepy at all times of the day, but unable to nap. The worst part of my depression is linked to extreme anxiety. I become unable to talk or ask for help. I am trapped with ruminating thoughts inside my head.

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Default Apr 24, 2021 at 01:49 PM
  #9
Years and years ago, decades really when they were first diagnosing me they wanted to say ptsd and major depression but they were puzzled cause my depression wasn’t “classic “ I was highly oh I forget the words they used but I was in constant movement and lost a lot of weight and had very bad insomnia. Yet they back then never thought of bipolar. They just kept telling my I had atypical depression. And sadly they started the trend that went on for years, using AD which caused more agitation and less ability to sleep.

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Default Apr 24, 2021 at 06:00 PM
  #10
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Originally Posted by Bugtussel View Post
My depression has aspects of insomnia. I will spontaneously awake between 3 and 4 am. I then become sleepy at all times of the day, but unable to nap. The worst part of my depression is linked to extreme anxiety. I become unable to talk or ask for help. I am trapped with ruminating thoughts inside my head.

That sounds like my experience of depression. I'm not sure about the sleep part because meds alter sleep so much, but the anxiety and ruminating thoughts, unable to talk or ask for help...it all sounds so familiar.

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Default Apr 24, 2021 at 06:04 PM
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Years and years ago, decades really when they were first diagnosing me they wanted to say ptsd and major depression but they were puzzled cause my depression wasn’t “classic “ I was highly oh I forget the words they used but I was in constant movement and lost a lot of weight and had very bad insomnia. Yet they back then never thought of bipolar. They just kept telling my I had atypical depression. And sadly they started the trend that went on for years, using AD which caused more agitation and less ability to sleep.

Many decades ago I experienced very much the same. I was told I had "agitated depression" or "atypical depression", which was treated with antidepressants. Of course, that caused terrible anxiety and irritability/anger (and ecstatic states, but they fluctuated along with the extreme anger). So then they gave me benzos along with the AD. Were mood stabilizers even a thing? Oh, yes...I remember being on lithium for some time, then Depakote. I guess it's just Lamictal that's a more recent medication.

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Default Apr 24, 2021 at 06:12 PM
  #12
I know you asked about BP but I'd like to answer too if you don't mind. My depression feels like the flu. I'm tired, drained, numb, I don't sleep well, though I lay in bed for longer than I should, I won't cook but I'll overeat I won't shower, sex drive goes to 0, I wish I'd die /hurt but I have no energy to go out of my way to do it. So putting things on top of the fridge is enough deterrent for me.

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Default Apr 24, 2021 at 06:33 PM
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I know you asked about BP but I'd like to answer too if you don't mind. My depression feels like the flu. I'm tired, drained, numb, I don't sleep well, though I lay in bed for longer than I should, I won't cook but I'll overeat I won't shower, sex drive goes to 0, I wish I'd die /hurt but I have no energy to go out of my way to do it. So putting things on top of the fridge is enough deterrent for me.

Ugh. It's a description of major depressive disorder, or clinical depression, textbook depression...whatever name it's given, it sounds like agony. I'm so sorry that you have to suffer with such a monster.

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Default Apr 25, 2021 at 01:35 AM
  #14
I relate to a lot of what has been said here. I don't think I've ever had a "classic" depression, personally. There's always lots of anxiety, agitation, irritability, insomnia, ... I've often wondered whether I've ever had a pure depression, or whether all of my episodes have been mixed to some extent.

The insomnia is one of the most unbearable parts of the depression, to me. I'm often simply unable to fall asleep, and if I do fall asleep I wake up after one or two hours and can't get back to sleep, I'll be awake for at least a few hours. This happens night after night, regardless of how tired I am. I can't sleep during the days, either. The only way to get some sleep is with meds, like benzos or Seroquel, but obviously I have to be careful with that because I don't want to end up addicted. I'm currently undergoing ECT, and this is the first time in over a year that sleep is starting to come back to me.

The anxiety and irritability can be as relentless as the insomnia. My heart rate is at 90+ all day, every day, even though I'm in decent shape/at a decent weight and my blood pressure is fine. I can't control the ruminating thoughts, and I snap at people for minor reasons even though I don't want to and just end up feeling guilty about it. It's been called "agitated depression" by my Pdocs, as well, but luckily I already knew I had a family history of bipolar and I had a history of mood charts to take with me on my first Pdoc visits.

Another difference with "classic" depression is my appetite. The classic picture is of a depressed person with low appetite who's losing weight, but I sometimes get the opposite, where I'll eat compulsively if I don't watch myself, just chowing down loads of unhealthy stuff while hardly even tasting it. Same with libido, I'm ashamed to say that even though I do become unable to express "love", I know that at the same time I can become prone to obsessive porn-watching or things like that, when I'm depressed, even though I really don't want to. It feels like some kind of manic component shining through, because I get hypersexuality a lot during (hypo)mania as well.

Other than that, I always get "leaden paralysis" really bad when I'm depressed, where my limbs feel like they're ten times their usual weight, and psychomotor retardation, where I can't think properly and might need 10+ seconds to answer simple questions.

I'm sure there's much more that I'm forgetting to mention right now. Inability to concentrate, inability to enjoy things, self-hatred, suicidal thoughts, tremors, neck pains, lack of motivation, lack of interest, anhedonia.... the list goes on. Sometimes there are some assorted paranoid thoughts or delusions mixed in, as well.

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Default Apr 25, 2021 at 01:50 PM
  #15
I strongly relate to most of your description of "depression", FluffyD. I, too, wonder if all of my so-called depressed states are actually mixed states.

Whatever is going on, it's clear that for many of us with BD depression manifests differently than it does for those with unipolar depression. I have an image in my mind...once, when I was IP, there was a middle-aged man also IP. He would sit on a couch, slumped over, with his elbows on his knees and his head in his hands for hours at a time. When he walked it was like he was slogging through mud. He didn't speak to anyone; he seemed unable to find the energy to form words.

I remember feeling so sorry for that man. He looked like the picture on the travel brochure for clinical unipolar depression. I remember thinking then (this was before I'd been clearly diagnosed with BD) that his depression looked very different than the way my depression felt.

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Default May 05, 2021 at 07:36 AM
  #16
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For those of us diagnosed with bipolar disorder, is our depression the same as typical unipolar depression, or does bipolar depression look and feel different than unipolar?
To me, bipolar depression is very different. It is all consuming and distracts me from life. I can't eat, I can't sleep, I'm lethargic all the time, and I usually cry for days on end.

I never did that on that scale when I had unipolar depression.

My mixed episodes are horrific. They're indescribable. All I want to do is run, and keep running, until I run out of my own skin.

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Default May 05, 2021 at 10:20 AM
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...
My mixed episodes are horrific. They're indescribable. All I want to do is run, and keep running, until I run out of my own skin.

Someone here once described mixed states as "scrubbing the floor with a toothbrush while being unable to stop crying."

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Default May 05, 2021 at 02:09 PM
  #18
I'm new here and this is only my 2nd post, but thought I'd share what depression is like for me.

I have bipolar 1 and I'm slowly coming out of a bad depressive episode. I slept 12-13 hours a day, then I stayed in bed most of the day. I felt like I couldn't do anything. Couldn't clean or shower, could barely brush my teeth and hair. I couldn't drive or watch TV because I couldn't concentrate on anything. I felt suicidal and had to go into inpatient treatment. It's been a nightmare, I've never been this depressed before
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Default May 05, 2021 at 05:50 PM
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My depression has aspects of insomnia. I will spontaneously awake between 3 and 4 am. I then become sleepy at all times of the day, but unable to nap. The worst part of my depression is linked to extreme anxiety. I become unable to talk or ask for help. I am trapped with ruminating thoughts inside my head.
This is how depression manifests for me too.
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Default May 05, 2021 at 05:54 PM
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I'm new here and this is only my 2nd post, but thought I'd share what depression is like for me.

I have bipolar 1 and I'm slowly coming out of a bad depressive episode. I slept 12-13 hours a day, then I stayed in bed most of the day. I felt like I couldn't do anything. Couldn't clean or shower, could barely brush my teeth and hair. I couldn't drive or watch TV because I couldn't concentrate on anything. I felt suicidal and had to go into inpatient treatment. It's been a nightmare, I've never been this depressed before
I’m sorry you went though that.

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