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How to Treat Bipolar Disorder When Depressive Episodes Are Present Transcript
Bipolar depression is a tricky animal because at first sight, it looks like depression. It could be unipolar depression. And we now know as per DSM-5 that you don't need full mania and full depression, which is one state of mixed mania. What's much more common in bipolar disorder is that there's some intermingling during the manic episode of depression and even more so during the depression of mania-like symptoms.
And that makes it harder to treat. That gives more episodes, rapid cycling, and a worse response. And an especially worse response to traditional antidepressants that we should generally avoid in bipolar depression because it can roughen the course and it can kick people into mania or at least antidepressants are not as effective for bipolar depression than for unipolar depression.
But the depressive symptoms themselves are identical. The diagnostic criteria for unipolar or for bipolar depression. It just occurs either in the context of a lifetime history of hypomania, that is bipolar 2 disorder or in the context of having had at least 1 manic episode, and that is then called bipolar 1 disorder.
