ORGANUM

Differentiating bipolar and unipolar depressions

The depressive episodes in bipolar disorders are similar to those seen in unipolar depressive disorders. Many experts in the field feel that they are quantitative differences in the episodes experienced by bipolar patients; researchers have attempted to find this difference albeit it elusive.

Although the data is inconsistent and controversial, some clinicians report that the depressed patients who we prospectively diagnose as Bipolar tend to have hypersomnia, psychomotor retardation, psychotic symptoms, a history of postpartum episodes, a family history of bipolar type I disorder, and a history of anti-depressant induced hypomania.


Bipolar

Unipolar

History of mania/hypomania

Yes

No

Temperament and personality

Cyclothymic (emotional reactivity and affective dysregulation) and extroverted

Dysthymic and introverted

Sex ratio

Equal

Women > Men

Age of onset

Teens, 20s and 30s

30s, 40,s and 50s

Postpartum episodes

More common

Less common

Onset of episodes

Often abrupt

More insidious

Number of episodes

Numerous

Fewer

Duration of episodes

3-6 months

3-12 months

Psychomotor activity

Retardation > agitation

Agitation > Retardation

Sleep

Hypersomnia > Insomnia

Insomnia > Hypersomnia

Family history

Bipolar disorder

+

+/-

Unipolar disorder

+

+

Alcoholism

+

+

Pharmacological response

Antidepressants

Induce hypomania-mania

+/-

Lithium Carbonate

Prophylaxis

+/-