Facts About Depression and Bipolar Disorder

Mood Disorders

For those with a depressive mood disorder, that sense of internal control may be missing. When a distressing event occurs such as the death of a loved one, loss of a job, an accident or illness, an overwhelming sense of helplessness and despair can arise, resulting in a major depressive disorder. Women are affected by depression twice as often as men.

Bipolar disorder, or manic depression, is the other major type of mood disorder. A person diagnosed with bipolar disorder experiences alternating emotional swings that run from extreme “highs” to extreme “lows”. These episodes may have nothing to do with any particular event in life – they seem to spontaneously occur independent of any trigger. About one per cent of the population is affected by manic depression. It usually presents in adolescence or early adulthood, and affects men and women equally.

In addition to depression and bipolar disorder, mood disorders also include:

• Post-partum depression
• Seasonal Affective Disorder (SAD)
• Dysthymia
• Depression with psychosis

For detailed information about post-partum depression and SAD, please see our other pamphlets on these topics.

Depression

A major depressive disorder – usually just called “depression” – is different than the “blues”. Someone experiencing depression is grappling with feelings of severe despair over an extended period of time. Almost every aspect of their life can be affected, including their emotions, physical health, relationships and work. For people with depression, it does not feel like there is a “light at the end of the tunnel” – there is just a long, dark tunnel.

Symptoms of Depression

If you (or someone you know) have some of the following signs for more than several weeks, you may be experiencing a depressive illness.
Symptoms include:

• Loss of interest and a lack of pleasure in activities, including sex
• Withdrawal from social situations
• Ongoing feelings of sadness, anxiety, worthlessness, hopelessness, guilt
• Changes in appetite, or an unexplained fluctuation in weight
• Lack of energy, complaints of fatigue
• Sleep disturbances (insomnia or excessive sleeping)
• Loss of focus, decreased concentration, forgetfulness
• Complaints of physical ill health with no identifiable cause
• Thoughts of suicide

Some people have a mood disorder known as dysthymia. Dysthymia is a long-term condition which causes a mild, ongoing depression that can last for at least two years. Someone experiencing dysthymia tends to have symptoms that are less severe than that of someone with a major depressive illness, however they still have trouble coping with their day-to-day functions because of their disorder. At the other extreme, some people can experience what is known as a psychotic depression, where delusions or hallucinations occur in addition to the symptoms listed above.

Depression in Disguise

Sometimes people who are depressed don’t show signs that are considered “typical”. For example, men may have extended periods of irritability or anger rather than sadness.

These symptoms don’t come across as depression, making diagnosis more difficult.
Children who are depressed may complain of sickness, avoid school or be extremely reluctant to leave a parent. They may come across as angry, uncooperative or anti-social. Unfortunately it can be difficult to separate a child’s clinical depression from a “phase” and parents might consider the behaviour to be “normal”.

On the flip side, society often regards depression in older adults as “normal”; this cannot be further from the truth. It is not normal for older adults to have ongoing feelings of grief and hopelessness.

Bipolar Disorder

In addition to feelings of depression, someone with bipolar disorder also has episodes of mania. When people are experiencing manic periods, they exhibit symptoms that include:

• Extreme optimism, euphoria and feelings of grandeur
• Rapid, racing thoughts and hyperactivity
• A decreased need for sleep
• Increased irritability
• Impulsiveness and possibly reckless behaviour

Causes of Depression and Bipolar Disorder

A combination of factors can make a person more susceptible to depression. These include a physical illness; certain medications; stress; biochemical imbalances in the brain, hormones or immune system; and a pre-disposition towards a negative view of life. A family history also seems to contribute towards the likelihood of someone developing a clinical depression.

It is not known what causes bipolar disorder although research indicates that a genetic predisposition may contribute to the condition since it tends to run in families. Substance abuse (alcohol and drugs) and stress may also contribute to its development.

Treatment

Just like any other disease, mental illness responds better to early identification and treatment. Depression, in particular, responds very well to
treatment. Both depression and bipolar disorder can be treated with psychotherapy, counseling, education and medication. Electroconvulsive therapy, or ECT, has proven to be therapeutic for those who do not respond to other treatments. Self-help groups are also very beneficial in getting – and staying – on the road to recovery.

A supportive network of family and friends is also very helpful. A depressed individual may not want the company of others, or conversely continuously wants the company of certain people. If you are a friend or family member, try to be patient and non-judgmental; listen rather than talk, and keep an open mind to their thoughts and feelings.

Don’t let the stigma of mental illness – yours or that of others – prevent you from getting the help that is required. You would not hesitate to go to your doctor for a broken leg; seeking help for depression is no different. If you or someone you know is showing signs of depression or bipolar disorder, talk with your family doctor.

Prevention

People can take steps that help prevent the recurrence of a mood disorder or at least, minimize its impact. Healthy lifestyles that include good nutrition and physical activity are an important element of prevention. The Canadian Mental Health Association, Ontario (CMHA Ontario) in collaboration with Mood Disorders of Canada, the Nutrition Resource Centre, York University and Trillium Ontario, have a website devoted to this topic. Go to www.mindingourbodies.ca for great tips and more information.

In addition, try to maintain a balance between work and play. Family and friends, social networks and a feeling of community all help to maintain mental well-being. Avoid drinking caffeinated beverages as they tend to increase anxiety, and minimize alcohol intake as it is a depressant. Know the early signs of a recurring depression or manic episode. The sooner symptoms are identified and treatment is initiated, the better the outcome.
Getting treatment early and appropriately will lessen the impact of the episode and promote faster recovery.

For that reason, administer your own “bibilotherapy” by educating yourself on mood disorders. Go to the library and get out books, tapes and videos on the topic; attend education sessions; join a support group. You can also contact the Canadian Mental Health Association (CMHA) or other mental health agencies for more information. Find out where there is a local branch of the CMHA near you. The more you know, the better prepared you are to identify the early signs of depression or bipolar disorder.

Reach Out for Help

Whether you or someone you care about is experiencing a mood disorder such as depressionor bipolar disorder, the future does not have to be bleak.Don’t let fear or embarrassment stop you – find out more about the help that is available in your community. You are not alone.