What Are the Symptoms of Bipolar Depression?

What are the Symptoms of Bipolar Depression?

Some bipolar depression symptoms are the same as major depression symptoms:

• persistent sadness
• feelings of hopelessness, worthlessness, and helplessness
• loss of interest in activities or hobbies once pleasurable, including sex
• decreased energy, feeling tired
• suicidal thoughts and/or behaviors

What differentiates bipolar depression is that, at some time, the person must have also experienced episodes of mania or hypomania. If you imagine a puzzle with a hundred pieces, depression itself would take up half of the pieces in bipolar depression. The rest would be puzzle pieces that represent bipolar disorder symptoms that can go along with the depression including:

• mania
• a high level of anxiety
• aggression
• ADHD and OCD symptoms
• psychosis (detailed information on bipolar psychosis and bipolar depression with psychosis)
• rapid cycling
• agitation
• and often mixed episodes.

Outside of mania, advanced depression can share a lot of these symptoms, but it's quite rare.

Other Signs and Symptoms of Bipolar Depression

Bipolar depression and unipolar depression are diagnostically the same, but in practice, certain depression symptoms are more likely in bipolar depression. Most cases of bipolar depression have excessive sleeping and daytime fatigue. There is increased appetite and weight gain. In contrast, people with unipolar depression tend to wake up often throughout the night and may also experience early morning awakening (e.g. waking up at 4:30 and being unable to return to sleep). Although some people with unipolar depression have increased appetite and weight gain, it is more common to have a loss of appetite and weight loss.

Bipolar depression is much more likely to be accompanied by stronger symptoms of anxiety. One-half to two-thirds of people with bipolar depression have a co-occurring anxiety disorder such as obsessive-compulsive disorder, panic disorder or social anxiety disorder.

Sherri's Bipolar Depression Story

I asked Sherri, a 40-year-old woman with bipolar disorder, to describe the difference between depression and bipolar depression symptoms:

For me, bipolar depression comes with not only depression but psychosis. I start to see things that aren't there and hear things that aren't heard, like my name called over-and-over-again. I see mice running across the floor. I hear my name projected over the loudspeaker at the grocery store. I smell burning rubber in my apartment. With bipolar depression, I suffer these hallucinations and extreme paranoia. I feel like someone out there is trying to get me. I often have to cross the street if I see someone suspicious. With clinical depression, it's different. Those who experience usually only feel really down and hopeless. I feel bipolar is much worse because of the psychosis. I was diagnosed with depression before I ever had mania, so I've lived with this a long time.

See also "Bipolar Depression Early Warning Signs"