Depression and Bipolar Moods


A place for talking about what is bipolar disorder and how it differs from recurrent depression, as well as the types of bipolar.

Here is where you will find information and resources to help you decide if you have unipolar or bipolar depression, and what those terms mean. 

Click on an accordion item below to read more.

Unipolar vs Bipolar

How can you tell if your depression was a bipolar depression. What is unipolar depression. Why does this matter? The simple answer is, you have bipolar depression if you have ever experienced an energized (not necessarily pleasant) state that qualified as a hypomanic or manic episode.

If you spent 100,000$ in a week, didn’t sleep during that week, and were juggling a thousand tasks, and your brain was racing so fast that you could hardly keep up, you know that was probably a manic episode. But how do you sort it out if you had a milder period of being energized, especially if there was no negative consequence of that increase in energy, or maybe a big positive consequence?

We are providing information and links to some resources that we have found helpful, but this is not any easy question to answer, and often the best approach is to embrace the reality that there may be some uncertainty for a while.

One tool that has been in use for quite a while is the Bipolar Spectrum Diagnostic Scale. We have used it for more than a decade in our sister clinic (Gateway Psychiatric) and find that it is helpful. That said, if you have an episode of depression and you also have a disorder that is associated with unstable moods (borderline personality disorder, for example) you may get a positive score on the BSDS even though your mood disorder is not bipolar.

Research out of Australia that was published in 2022 tried to identify questions that would distinguish between bipolar and unipolar depression. This scale was developed from that study.

Apart from times when you are depressed or in a normal mood state, do you have times when you feel “up”? If so, check whether you experience any of the following features.

  • I have very high levels of energy
  • I feel bulletproof or invulnerable
  • I talk over people or am difficult to interrupt
  • My thoughts race so quickly that it is difficult to retain them
  • I am irritable and angry
  • My judgment becomes impaired
  • I am much more creative
  • I am very distractible
  • I feel that I can achieve great things
  • I talk more quickly

      Score 1 point for each item endorsed. For patients with a history of depression, a score of 6 or more suggests a strong likelihood of bipolar disorder (97% sensitivity and 96% specificity)

      We have also found it helpful sometimes to go over the Hypomania Checklist 32 with patients who are wondering whether their experience of being energize is similar to hypomania, or not.

      Also on the Gateway Psychiatric website are a couple of blog posts that we wrote on this topic based on research articles.