What is the difference between a patient with major depression and a patient with bipolar disorder? As clinicians, would we prescribe the same anti-depressant medications for a patient with bipolar...

What is the difference between a patient with major depression and a patient with bipolar disorder? As clinicians, would we prescribe the same anti-depressant medications for a patient with bipolar disorder?

Expert Answers
tjbrewer eNotes educator| Certified Educator

Bipolar disorder is very different from Depression.  In depression the patient has no motivation, is constantly sad or prone to sadness, apathetic etc. constantly.  This state varies by degree but is consistent if left untreated. 

Bipolar disorder is different.  The bipolar patient goes from Depressed to energetic, up all night, must get things done, mania; and then back again.  Hence the term "Manic Depression."  This can happen either at a regular interval or at random. 

As a consequence the treatment for Bi-polar would be very different as it needs to not only address the depression, but also the mania.  Just a few years ago a series of Public Service Announcements made a point of this, by announcing that many people in America were being treated for depression but not getting any better, because they had bipolar disorder, not depression. 

Since an anti-depressant doesn't treat the mania, nor the underlying causes of both the mania and the depression, it would be ineffective at treating the disorder.  So as a clinician you would not prescribe the same anti-depressant medications for a patient with bipolar disorder. 

sid-sarfraz | Student


Bipolar disorder is episodic in nature and constitutes;

  • Manic phase (of more then 4 days duration with psychotic symptoms)
  • Hypomanic phase (less then 4 days duration) and
  • Depressive symptoms.
  • There are fear/phobia's and hyper spending and hyper sexuality among the bipolar pateints.

The management of bipolar is;

  • Antipsychotics
  • Mood stabilizers


In contrast, Depression is a different disorder which constitutes a single phase of depressive symptoms and no episodic nature like bipolar.

The symptoms of depression are;

  • Loss of weight
  • Decrease sleep
  • Decrease apetite
  • Loss of interest
  • Hopelessness
  • Guilt
  • Suicidal Ideation/Attempt

The depressive symptoms are controlled by;

  • SSRI's
  • SNRI's
  • Benzodiapenies

The management is different in both disorders therefore, clinical diagnosis is the key to diagnose bipolar and manage accordingly. If anti-depressents are prescribed in bipolar the patient will deteriote.  

jess1999 | Student

If a patient is bipolar they are experiencing extreme changes in their moods. There are two extreme changes, mania and depression. During mania, the patient will feel very energetic and restless. Then, they will feel depressed where they experienced sadness.

A patient facing with major depression would have a hard time studying, working, and enjoying activities. The different between someone having major depression and someone who is bipolar is that people who are experiencing major depression doesn't go through a mania stage.

Because of the mania stage in bipolar disorders, one cannot prescribe the same anti-depressant medication.

rachellopez | Student

According to ABC news there is one main difference. With depression you have symptoms such as a sad mood, decrease of enjoyment in previously liked activities, sleep issues, decreased appetite, low energy, and suicidal thoughts.

People with bipolar disorder will also have depression symptoms, however, they will also experience hypomania. This is said to last 3 days with symptoms such as elevated mood, grandiose thinking (delusions), rapid speech, and less a need for sleep. There are two types of bipolar disorder. The one I described above is bipolar 2 disorder. Bipolar 1 disorder is more severe and lasts longer.

parama9000 | Student

Bipolar is moving between two extremes, whereas depression is simply the loss/lack of motivation to do anything. Bipolar ranges from depression to hypomania.

Bipolar is like riding a roller coaster, while depression is like sitting on a slowly sinking boat.

eli468 | Student

There a few different ways to answer this question.

For starters Major Depression is a consistent feeling of sadness and loss of interest in most if not all things. It can affect everyday life in detrimental ways and lead to very serious emotional and physical problems. It can be difficult to take care of your mental and physical health if you feel unmotivated and constantly down.

Bipolar Disorder is severe changes in a person's mood and energy. Those who suffer with Bipolar Disorder are on a roller coaster ride of feeling very active and upbeat and then the next second feeling depressed, angry, irritable, and sometimes aggressive.

Major Depression and Bipolar Disorder are sometimes caused by each other. A person may suffer major depression due to having a bipolar disorder. In this case the treatment should be for bipolar disorder which can in turn help with the depression. 

If the depression is not occurring due to Bipolar Disorder then the treatment can vary from certain drugs and anti-depressants. It may also be due to personal issues and a therapist, psychologist or psychiatrist can help to treat them.