Bipolar depression is a mental health condition characterized by extreme mood swings from extreme highs to depressive lows. The symptoms negatively impact the person’s ability to function in daily life, affecting their relationship, work, and overall well-being. However, for most individuals, especially in the early stages of the illness, mood episodes tend to start slowly.
Bipolar depression is a distinct and biologically complex illness with subtle shifts in mood that signal its onset. Understanding the early signs of bipolar depression is a crucial step for early intervention and accurate diagnosis. Let’s learn in this article why seeking a professional can be pivotal in managing this chronic condition.
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Early Stages of Bipolar Depression
The early stages of bipolar depression slowly creep in, and individuals usually rationalize it as stress or fatigue. Below are some key indicators of a depressive episode of bipolar disorder.
1. Low Mood and Emotional Changes
Low mood and emotional changes are a defining characteristic of a depressive episode. It doesn’t encompass sadness, but a feeling of emptiness or irritability lasts for most of the day for at least two weeks. In bipolar depression, the sadness is internal rather than a reaction to external circumstances.
Individuals may experience a range of emotional changes (Anhedonia), which may include a loss of pleasure, which is a hallmark of depression. The joy is muted, leading to a severe sense of emptiness. Additionally, irritability can also be a prominent feature, leading to short temper, frustration, and agitation for even minor issues.
2. Cognitive Slowdown or Brain Fog
Cognitive change is the early sign of bipolar depression. It isn’t just about feeling tired; it’s more like a slow mental and physical breakdown. Completing simple tasks becomes difficult as the body starts slowing down and movements become sluggish. This will significantly decrease productivity at work, school, and social engagements. The energy depletion contributes to the sense of slowing down, physically and mentally.
Cognitive impairments are a significant and overlooked aspect of bipolar depression. Individuals in the early stage may struggle with their memory and have lapses in concentration. For example, they may forget their keys, appointments, or need to read the same paragraph multiple times. Decision-making becomes difficult, and even minor choices can be overwhelming, leading to procrastination and indecisiveness. This significantly impacts the academic and professional performance of individuals. These are the first red flags of the development of bipolar depression.
3. Sleep and Appetite Paradox
Unipolar depression involves insomnia and appetite loss, but bipolar depression has atypical features. Individuals with bipolar depression start sleeping for long durations, usually 10,12, or even 15 hours a day. The mood noticeably worsens in the morning, and individuals feel unrefreshed or exhausted, with mood improving as the day goes on. This disruption in the circadian rhythms increases fatigue and cognitive difficulties.
Individuals have increased food cravings, especially for carbohydrates and comfort foods. This can lead to weight gain, which is different from the weight loss seen in unipolar depression.
4. Irritability and Guilt as Dominant Moods
The mood of early bipolar depression is dominated by different emotional states. In teenagers or young adults, depression looks like extreme irritability and not sadness. Individuals may show minor frustration that triggers reactions, impatience, and a sense of being on the edge. They may also feel worthlessness and suffer from guilt as they feel responsible for things outside their control.
5. Physical Symptoms
Bipolar Depression isn’t just a mental illness, but it manifests physically as well. At the onset of the illness, individuals may experience aches and pains with no clear medical cause. Individuals may also showcase signs of headaches, backaches, or muscle pain. These physical symptoms often contribute to the individual’s overall discomfort and distress
Causes and Risk Factors of Bipolar Depression
Bipolar depression is a complex condition that is developed by a complex interplay of genetic, biological, and environmental factors.
Genetic Factors
Bipolar depression has a strong genetic component and often runs in families. If a close family member has the condition, then you have a high chance of developing the disorder. However, the genetic condition doesn’t guarantee the illness but drastically increases vulnerability.
Brain Structure and Chemistry
Neurobiological factors play a critical role in understanding bipolar depression. Individuals with the disorder have differences in the structure and function, particularly in areas that influence emotional regulation. Imbalances in neurotransmitters, like serotonin, norepinephrine, and dopamine, are considered key contributors. Additionally, the way the brain processes emotional stimuli can also be a factor in the development of the disorder.
Environmental Triggers
Environmental triggers can precipitate the onset of bipolar mood episodes. Traumatic events, major life changes, and sleep deprivation may be triggers for depressive episodes. Additionally, excessive use of drugs and alcohol worsens the symptoms, making management difficult.
The other risk factors include hormonal changes that occur due to pregnancy, puberty, or postpartum periods. Disruptions in the circadian rhythms may also negatively impact mood and lead to the development of bipolar disorder.
When Should Patients Seek Help?
Once you recognize that the symptoms persist for over 2 weeks, it is time to get the right help. Biopolar depression requires long-term help from professionals. A mental health specialist can diagnose the issue and create a personalised treatment plan.
The treatment plan for bipolar depression constitutes a combination of medication and psychotherapy. The medications can include mood stabilizers, like Valproate, and antipsychotics, such as Olanzapine-Fluoxetine combination, or Lurasidone. Antidepressants can also be prescribed, but should always be taken alongside mood stabilizers to avert the risk of triggering mania. The common psychotherapies employed by professionals are Cognitive Behavioral Therapy (CBT) and Interpersonal and Social Rhythm Therapy (IPSRT). Alpha Healing Center is a premier luxury rehab in Mumbai that specialises in treating mental health illnesses, like bipolar depression. The center has some of the best staff with years of experience handling and guiding patients to lasting recovery. Get in touch to know more.
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- Medication Management: If a condition is treated singularly, then medications may not be effective. For example, substance abuse, medications like naltrexone, and acamprosate may provide relief, while mental disorders require antidepressants. A combination of these medications can support overall recovery.
- Therapeutic Modalities: Evidence-based therapies are very effective for treating both addiction and mental disorders. However, some therapies are more beneficial than others. Cognitive Behavioral Therapy (CBT) is effective for both addiction and many anxiety and depressive disorders. Trauma-focused therapies are better for those with PTSD. Similarly, Dialectical Behavior Therapy (DBT) is particularly beneficial for individuals with Borderline Personality Disorder and co-occurring addiction.
- Relapse Prevention: Understanding the condition helps psychologists anticipate challenges during recovery and develop relapse prevention strategies. Addressing core psychological vulnerabilities strengthens resilience and improves the prognosis for recovery.
- Reduced Stigma and Self-Blame: Identifying both the issues is incredibly helpful for clients. It allows them to understand their struggles and not worry about it as a moral failing, but rather a complex, treatable condition. This helps individuals have a greater sense of hope and get motivation for recovery.
Frequently Asked Questions
No, bipolar depression and unipolar depression have similar symptoms, but they differ in various aspects. Bipolar depression involves extreme mood swings, with manic and hypomanic highs. Unipolar depression is characterized by recurrent episodes of low mood only.
Bipolar depression is diagnosed by a mental health professional. The psychiatrist uses a comprehensive clinical assessment that follows the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Untreated bipolar depression poses a severe risk impacting a person’s life and health. It can lead to risk of suicide, cognitive decline, impaired functioning, substance abuse, and physical health issues.
