Types of Depression

Several illnesses and conditions may cause symptoms of depression. Without a complete history, bipolar depression may be mistaken for major depressive disorder. An accurate diagnosis is an important first step toward receiving appropriate care.

a man grapples with the symptoms of major depressive disorder

Bipolar disorder can be missed as a diagnosis because the symptoms of bipolar depression—the phase that people with the illness tend to spend most of their time in when they are ill—are similar to those of other types of depression.

However, to be diagnosed with bipolar disorder a person must have experienced a high period (mania or hypomania) as well. Be sure to give your doctor an accurate description of all your experiences and symptoms. This can help ensure you have an accurate diagnosis and are getting the appropriate treatment for your symptoms.

Bipolar depression or major depressive disorder?

Many people with bipolar disorder initially seek treatment for their depressive symptoms rather than for their manic symptoms. Unfortunately, the diagnosis of bipolar disorder is oftentimes missed, since it’s the manic or hypomanic episodes that differentiate bipolar disorder from major depressive disorder. In a national survey, over one-third of people with bipolar disorder who were originally misdiagnosed waited 10 years or more before receiving an accurate diagnosis. And more than two-thirds of people with bipolar disorder were originally misdiagnosed with other disorders.

The consequences of an inaccurate or delayed diagnosis can be significant. For example, treatment with antidepressants alone, such as SSRIs (selective serotonin reuptake inhibitors) or SNRIs (serotonin-norepinephrine reuptake inhibitors), can trigger a manic episode. And delayed proper treatment for bipolar disorder can mean future episodes, and marital, work, and financial problems.

Unresolved symptoms can be a clue

If you have unresolved depressive symptoms, it could be a sign for your doctor that your diagnosis and treatment need closer examination. Here are some tips you can use to work with your doctor as closely as possible.

  • Keep good records and notes of your experiences and any unresolved symptoms so that you can have a productive conversation with your doctor
  • Make a list of questions  (PDF) you want to ask your doctor and bring it to the appointment
  • Keep track of your symptoms with a Mood and Goal Tracking Diary  (PDF)
  • Tell your doctor if you have experienced mania or hypomania (less severe mania) or a manic symptom such as irritability
  • Tell your doctor if anyone in your family has been diagnosed with bipolar disorder