Ask the Expert

Q. It seems that depression and bipolar disorder share many of the same symptoms. How can I tell them apart, and why is it important?

A. Depression and bipolar disorder are different conditions with some important features in common. Both are medical illnesses involving mood that can significantly interfere with an individual's thoughts, behavior and physical health. Both are common, and are leading causes of disability. Most important, both conditions are treatable.

There is a significant difference, however, in the treatments for the two conditions, making a correct diagnosis essential.

Major depression affects between 5 and 10 percent of Americans in any given year, and is twice as common in women as in men. It can occur at any age. Common symptoms include low mood, loss of interest and pleasure in daily life, low energy, sleep and appetite disturbances, and trouble concentrating. Feelings of hopelessness, suicidal thinking or self-destructive behavior can occur in severe cases.

Bipolar disorder is less common but still affects 1 percent of the population, or more than 2 million Americans — men and women equally. A serious illness marked by dramatic mood swings, bipolar disorder includes periods of depression and also mania — the latter manifested by highly elevated moods (usually elation or irritability), excessive energy, and impulsive, risky behavior. Manic symptoms may last hours or months, and the person's mood may suddenly crash into severe depression.

Treatment for major depression typically consists of antidepressant medication (there are numerous safe and effective antidepressants available) and psychotherapy to explore causes and prevent future episodes. For more severe cases, hospitalization is sometimes required. Although it can be debilitating, with proper treatment depression is often a temporary condition and most patients can eventually return to their normal daily activities and feelings.

Bipolar disorder tends to be a lifelong condition, but can be stabilized through a combination of medication and psychotherapy. The first truly effective medication for bipolar disorder, lithium, has been available for more than 30 years, and today there are numerous other medications that have been proven effective — most recently, those used to treat epilepsy. Counseling is important, in part, to help patients keep up with treatment for this illness. (Some patients struggle to stay in treatment, insisting that they "like" how the mania feels, although it tends to be very destructive and is often followed by severe depression.)

The important thing to remember is that help is available. If you have questions about whether you or a loved one suffers from one of these treatable illnesses, please ask your family doctor or seek help from a mental health care provider.

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