Different mental health conditions can share symptoms, which can make them hard to tell apart. Bipolar 1 disorder and depression (also called major depressive disorder and sometimes called unipolar depression) may look similar at times, but they are different mood disorders.

Both bipolar 1 disorder and depression affect mood. They can shift how you feel compared to your usual self and make it harder to function day to day. The key difference is that depression involves one main mood state — feeling persistently low — while bipolar 1 disorder includes both highs (mania) and lows (depression).

This article explains more about how bipolar 1 disorder and major depressive disorder differ.

Symptoms of Bipolar 1 vs. Depression

To tell these two mental health conditions apart, it helps to look closely at symptoms. Some overlap, but there are also important differences.

Depression Symptoms

Depression is a mood disorder that affects how you feel, think, and act. It can cause ongoing sadness and loss of interest in activities you once enjoyed. Other symptoms of depressive episodes include:

• Feelings of hopelessness
• Changes in appetite or weight
• Sleep problems, such as sleeping too much or too little
• Low energy or fatigue (extreme tiredness)
• Trouble thinking or concentrating
• Feelings of worthlessness or guilt
• Thoughts of death or suicide

Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

Bipolar Disorder Symptoms

People with bipolar 1 disorder (also written as bipolar I disorder) may also experience depression. However, bipolar 1 disorder also includes mood changes such as manic or mixed episodes.

Manic episodes involve an elated or very irritable mood, along with symptoms like high energy and a decreased need for sleep. These episodes last at least seven days or are severe enough to require hospitalization. Some people also experience hypomania, which is a milder form of mania. Depressive episodes in bipolar 1 disorder last two weeks or longer.

Some people have symptoms of mania and depression at the same time. For example, you may feel very energized but also sad or hopeless. These are called episodes with mixed features.

Manic symptoms are different for everyone but can include:

• Unusually high, excited, or irritable mood
• Racing thoughts or rapid speech
• Increased energy and reduced need for sleep
• Impulsive or risky behavior
• Inflated self-esteem or overconfidence
• Trouble focusing or being easily distracted

Symptoms of depressive episodes in bipolar 1 disorder include the same symptoms of depression listed above.

Shared Risk Factors

These conditions are both mood disorders, so they share many risk factors. Some people have a higher risk of depression or bipolar 1 disorder due to differences in brain structure or function. Certain health conditions, like heart disease, multiple sclerosis, and thyroid disease, are also linked to mood disorders. These conditions can also develop as a side effect of certain medications.

These conditions are both mood disorders, so they share many risk factors.

According to Mayo Clinic, mood disorders are more common in women than in men. Having a close family member, such as a parent or sibling, with bipolar 1 disorder can increase your risk. A history of trauma or of alcohol or substance use can also raise your risk.

Key Differences in Treatment

Healthcare providers treat both depression and bipolar 1 disorder with medication and psychotherapy (talk therapy). However, the medications used are typically different.

Healthcare providers treat both depression and bipolar 1 disorder with medication and psychotherapy. However, the medications used are typically different.

Treating Depression

Depression often requires treatment to improve. If severe depression is left untreated, it can lead to self-harm and suicidal thoughts.

Depression is usually managed with antidepressants, including selective serotonin reuptake inhibitors (SSRIs). These medications affect serotonin, a neurotransmitter (brain chemical). There are several types of SSRIs, and it may take time to find the right one.

Other types of antidepressants include:

• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants
• Atypical antidepressants

Psychotherapy also helps treat depression. Cognitive behavioral therapy (CBT) and interpersonal therapy are two common types. These therapies help you identify negative thought patterns and learn new ways to cope with stress and symptoms.

Treating Bipolar 1 Disorder

Doctors prescribe medications for bipolar 1 disorder based on symptoms. Mood stabilizers help balance mood during hypomanic, mixed, and manic episodes and are often the foundation of treatment. Antipsychotics are also used to help manage manic and depressive episodes. Sometimes, providers prescribe a combination of medications.

In some cases, antidepressants may be added along with antipsychotics or mood stabilizers. However, antidepressants are usually not used alone in bipolar 1 disorder because they can trigger mania.

Psychotherapy can help you understand triggers for manic or depressive episodes and learn how to manage them. Common types include:

• CBT — Helps identify disruptive behaviors and beliefs that may lead to mania or depression and teaches coping strategies
• Interpersonal and social rhythm therapy — Focuses on building regular daily routines for meals, sleep, and exercise to help stabilize mood
• Family therapy — Helps loved ones recognize signs of mania and depression and provide support

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

Join the Conversation

On MyDepressionTeam, people share their experiences with depression and bipolar 1 disorder, get advice, and find support from others who understand.

Have you or a loved one noticed differences between depression and bipolar 1 disorder symptoms? Let others know in the comments below.