When Major Depression Becomes Bipolar Disorder

It is not uncommon for someone to be diagnosed with one mood disorder only to develop new symptoms associated with a different mood disorder. During the course of treatment for mood disorders, someone’s diagnosis could potentially change several times. For example, someone with major depression may experience a hypomanic episode and be newly diagnosed as having bipolar II disorder. Suppose that person later has a manic episode, their diagnosis would change to bipolar I disorder.

Someone with major depression may experience recurrent depressive episodes. They may only seek treatment for the disorder at the times when symptoms are at their worst. In the midst of a depressive episode, with the sense of hopelessness, despair, and suicidal thoughts, it is difficult for the depressed person to recall a time when they felt exceptionally good. They may have had hypomanic episodes, but in their depressed state, they don’t have the ability to remember them. Therefore, past hypomanic episodes may go undetected and untreated for years. In those cases, the person diagnosed with major depression doesn’t really have that mood disorder. They actually should be diagnosed and treated as having bipolar II disorder, but their recount to their doctor of their mood history is incomplete.

If someone diagnosed with major depression has a manic episode, their diagnosis will most likely change to bipolar I disorder, unless the manic episode is a direct result of antidepressant treatment. In that case, they may unofficially be diagnosed as having bipolar III disorder, but their official diagnosis of major depression would not change. A manic episode as a result of antidepressant treatment does not meet the criteria for bipolar I disorder. The doctor may change the antidepressant treatment prescribed in order to alleviate the manic symptoms.

If facing a manic episode for the first time, someone previously diagnosed as having major depression is likely to experience overwhelming frustrations. At first, they may feel relieved to be free from the symptoms of a depressive episode. A manic episode can feel good, and certainly much better than feeling suicidal and worthless! But, the feeling of euphoria is only one symptom of the manic episode. The impulsive, potentially dangerous changes in behavior can bring a series of new problems for the individual.

Facing the troublesome symptoms of a manic episode can be a source of frustration for the person who previously experienced only depressive episodes. The patient may experience intense feelings of uncertainty and self-doubt. The new symptoms of their struggle with mood disorders may cause distressing insecurity. They may feel a loss of control over their mood or mind.

Just like major depression, bipolar disorder is treatable. The best defense to learn to live with bipolar disorder is to work with their doctor to find the best treatment for them. No mood disorder is an easy road. Each requires effort to manage the symptoms. A transition to bipolar disorder can be a difficult one, but with good communication with the doctor, therapy, and education about the disorder, the person can expect to learn how to live with their new diagnosis and the symptoms associated with it.

Next article: Major Depression, Dysthymic Disorder, And Cyclothymic Disorder