Different mental health conditions often share symptoms, making it hard to tell them apart. Bipolar 1 disorder and unipolar depression (also called major depressive disorder) are similar but different mood disorders.

Understanding these two conditions can help you get the right diagnosis and most appropriate treatment.

What Are Unipolar Depression and Bipolar 1 Disorder?

Unipolar depression and bipolar 1 disorder impact emotions. These disorders can make your moods seem unpredictable, affecting your ability to function. The basic difference is that unipolar depression involves one extreme mood — feeling low. People with bipolar disorder experience both extreme highs and lows.

Symptoms of Unipolar Depression

Unipolar depression causes depressive episodes. These include feelings of sadness, worthlessness, or hopelessness. Some people also have a loss of interest and motivation or sleep problems.

For unipolar depression to get better, you’ll likely need treatment. If severe depression is left untreated, it can lead to self-harm, suicidal thoughts, and, in some cases, death.

Unlike bipolar 1, major depressive disorder is characterized by only experiencing depressive episodes.

Other symptoms of depression you may experience include:

• Lack of interest in activities like hobbies or sex
• Irritability or frustration, leading to angry outbursts
• Loss of appetite and weight loss
• Food cravings and weight gain
• Unexplained headaches, stomachaches, and muscle aches

There are different types of depression, such as:

• Anxious distress — Excess worry over lack of control or future events
• Psychotic features — Including hallucinations or delusions
• Seasonal depression — Related to seasonal changes, especially in the winter with reduced sunlight
• Catatonia — Uncontrollable muscle movements or issues moving normally

Symptoms of Bipolar 1 Disorder

Like unipolar depression, people with bipolar 1 disorder (also written as bipolar I disorder) also experience depression. However, in bipolar 1 disorder, you may have mood swings brought on by manic episodes and depressive episodes.

Manic episodes are characterized by energetic, excited, irritated, or elated feelings that persist for at least seven days or are intense enough to require hospitalization. You may experience hypomania, or hypomanic episodes, which are a milder form of manic episodes. Depressive episodes in bipolar 1 disorder generally last two weeks or longer.

If you have four or more manic or depressive episodes within one year, that’s called “rapid cycling.” Some people may also experience manic and depressive symptoms at the same time. For example, you may have periods when you feel extremely high or energized but at the same time feel hopeless, empty, or sad. These are called episodes of depression or mania with mixed features.

Some people may experience manic and depressive symptoms at the same time.

Manic symptoms are different for everyone. They can include:

• Feeling extremely elated or high
• Talking quickly about many ideas without pause
• Feeling as if you are unusually powerful or talented
• Experiencing persistent racing thoughts
• Sleeping less than usual
• Increasing your eating, drinking, or sexual behavior
• Feeling wired or overactive

Psychosis can also happen during severe episodes of mania. You may have hallucinations (seeing things that aren’t there) or delusions (persistent beliefs in things that aren’t true). As a result, bipolar 1 disorder is sometimes mistaken for schizophrenia.

Symptoms of depressive episodes include:

• Feeling anxious, sad, or down
• Having a low or depressed mood and low self-esteem
• Speaking slowly
• Forgetting things easily
• Struggling with decision-making and concentration
• Losing interest in activities you usually enjoy
• Feeling worthless or hopeless
• Having suicidal thoughts

Risk Factors for Unipolar Depression and Bipolar 1 Disorder

Certain risk factors increase your chances of developing these mood disorders, including your family history. You can control some but not all of these factors.

Some people have a higher risk of unipolar depression or bipolar 1 disorder because of their brain’s structure or how it functions. Various health conditions, like heart disease, multiple sclerosis, and thyroid disease, are also linked to mood disorders. They can also be a side effect of some types of medication.

According to Mayo Clinic, mood disorders happen in women more often than in men. Having an immediate family member (parent or sibling) who has bipolar 1 disorder raises the risk of developing the condition. Those who have experienced trauma or use alcohol or substances are also at a higher risk.

How Do Doctors Treat These Mood Disorders?

Healthcare providers use medication and psychotherapy (talk therapy) to treat both unipolar depression and bipolar 1 disorder. But there are some different medications for each condition.

Treatments for Unipolar Depression

Unipolar depression is usually managed with antidepressants, including serotonin reuptake inhibitors (SSRIs). These affect the brain chemical serotonin, which is a neurotransmitter. There are many different types of SSRIs. It may take some trial and error to find the right one.

Your doctor may start with an SSRI. If your symptoms don’t improve, they may try another antidepressant.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs. They work by affecting two neurotransmitters, serotonin and norepinephrine. Examples include:

• Duloxetine
• Levomilnacipran
• Venlafaxine

Tricyclic antidepressants are another effective option for depression. However, they may come with more side effects. Tricyclics are usually prescribed if other meds aren’t working. Examples include:

• Amitriptyline
• Imipramine
• Protriptyline

Another category of depression medication is atypical antidepressants. They may affect levels of serotonin, norepinephrine, or dopamine. Examples include:

• Bupropion
• Mirtazapine
• Vortioxetine

Psychotherapy also helps treat unipolar depression. Cognitive behavioral therapy and interpersonal therapy are two common types. These forms of talk therapy help identify negative thoughts that drive depression. They also teach you new ways to cope with stress and your symptoms.

Treatments for Bipolar 1 Disorder

Doctors prescribe medications for bipolar 1 disorder based on a person’s symptoms. These may include mood stabilizers, antipsychotics, and antidepressants. Sometimes, a combination of drugs is prescribed.

Mood stabilizers help balance emotions and moods during hypomanic and manic episodes. They often act as a foundation for treatment of bipolar 1 disorder. Examples include:

• Carbamazepine
• Lithium
• Valproic acid

Antipsychotics help control symptoms like mania, delusions, hallucinations, and disruptive behavior. These are often prescribed with mood stabilizers. Examples include:

• Aripiprazole (Abilify)
• Lurasidone (Latuda)
• Olanzapine and samidorphan (Lybalvi)
• Quetiapine (Seroquel XR)
• Risperidone (Risperdal)

In some cases, antidepressants can be added alongside antipsychotics or mood stabilizers. However, the research is unclear whether antidepressants benefit symptoms of bipolar disorder. In fact, it’s not recommended to take antidepressants by themselves to treat bipolar disorder because there’s a risk it may cause mania or rapid cycling.

Psychotherapy can help you learn what triggers manic or depressive episodes and how to manage them. Examples of therapy for bipolar 1 disorder include:

• Cognitive behavioral therapy — Focuses on identifying disruptive behaviors and beliefs that may lead to mania or depression; also teaches new ways to cope in stressful situations
• Interpersonal and social rhythm therapy — Focuses on creating daily routines and rhythms for meals, sleep, and exercise to manage moods
• Family therapy — Helps build a support group of family and loved ones who are taught to recognize mania and depression

If you think you may have bipolar 1 disorder or unipolar depression, talk to your healthcare provider. They may refer you to a mental health professional for diagnosis and treatment.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and their loved ones. On MyDepressionTeam, more than 150,000 members come together to ask questions, give advice, and share their stories with others who understand life with a mental health condition.

Have you experienced a major depressive episode or symptoms of mania? What treatment options have helped you? Share your experience in the comments below, or start a conversation by posting on your Activities page.