Depression and Bipolar Disorder Basics

If you are a family caregiver of someone living with a mood disorder, we want to make it easy for you to understand depression and bipolar disorder basics. On this page, we’ve put together some general information that you should know.  

Depression and bipolar disorder basics

The most basic thing you should know about depression and bipolar disorder is that they are diagnosable conditions that are sometimes referred to as “mood disorders.” Mood disorders is a category of mental health conditions that includes all the forms of depression, postpartum depression, bipolar disorder I and II, and dysthymia. Mood disorders are common. In the U.S. alone, 1 in 5 adults experiences an episode of depression in their lifetime. More than 7 million adults live with bipolar disorder. Between 3 and 4 million teens experience depression every year.

What is depression?

Depression is more than having sadness or “the blues.” In terms of mood, depression can involve a pervasive and persistent sense of hopelessness. It can impact a person’s physical wellness and their ability to think, work, and have interpersonal relationships. They might seem sad, numb, or detached. A person with depression might believe that their families would be better off without them. 

People may refer to “clinical depression,” “major depressive disorder,” or “major depression.” Those are all the same thing. (The term used for a diagnosis is major depressive disorder, or MDD.) It’s important to remember that depression is a treatable medical condition.

What symptoms might indicate depression?

Only a mental health or medical professional can diagnose depression. It’s important to know that, while there are a number of common symptoms of depression, they boil down to a loss of functioning at the person’s normal level (often referred to as “baseline”). A diagnosis of depression requires two or more consecutive weeks of (a) depressed mood or (b) loss of interest in people or activities that were previously enjoyed, plus some of the following:

• Sleeping too much or too little
• Eating too much or too little
• Having frequent anger or irritability
• Feeling empty or hopeless
• Decreased personal hygiene
• Nonspecific physical pains (e.g., headaches, stomach aches)
• Lethargy or slowed-down movement and thinking
• Difficulty concentrating, analyzing, making decisions, being organized, or remembering
• Engaging in self-harm
  Experiencing suicidal thoughts.

What does depression feel like?

Some people describe depression as feeling like a cloud blocking out all light or an invisible, heavy force weighing them down. Depression can make even the simplest task feel impossible. For some people, depression can feel physically painful. 

It’s also hard for people without depression to understand why a person who is severely depressed would think that their dying would be a positive thing for their family and friends. It’s important to remember, however, that depression attacks a person’s self-esteem so they may feel worthless, guilty, and that they are a burden on others. To them, suicide may seem perfectly rational and the best thing they can do for their family’s well-being. Read about what to do if someone you love is expressing suicidal thoughts.

What is bipolar disorder?

Bipolar disorder is a medical condition and a form of depression that is marked by episodes in which moods, energy, and activity levels significantly affect a person’s functioning. (It used to be called “manic depression.”) A person with bipolar disorder experiences mood states, whether elevated, depressed, or mixed. While everyone has up moods and down moods, people with bipolar disorder have dramatically higher highs and lower lows than the general population. 

There are two types of bipolar disorder. In bipolar I, a person has had at least one manic episode, meaning that they experienced mood elevation leading to impairment. In bipolar II, the person experiences a milder form of mood elevation called hypomania and has had at least one depressive episode.

What symptoms might indicate bipolar disorder?

There are a number of symptoms that typically appear in different states of bipolar disorder. It is unlikely that a person will display all of them, but the presence of more than a few symptoms should prompt an appointment with a clinician. If the person presents a risk to themselves or others, immediate intervention is warranted.

See above for indicators of a depressive state, as they mirror the symptoms of major depressive disorder. Indicators of a manic state can include:

• Increased energy, whether extremely positive or excessively irritable
• Decreased need for sleep without feeling tired
• Restlessness
• Racing thoughts
• Talking very quickly
• Easily distracted
• Lack of judgment
• Grandiosity: Unrealistic belief in own abilities (e.g., can fly, can accomplish tasks that cannot be achieved)
• Impulsiveness and engaging in risky behaviors (e.g., spending sprees, excessive gambling, hypersexual activity).

What is a “mixed state” in bipolar disorder? Why is it a concern?

In a mixed state, features of a depressive state co-occur or rapidly alternate with features of a manic state. Mixed states often involve a high level of distress, as the person may be experiencing a combination of depression, agitation, and compromised judgment. Family members struggle with how to help. Mixed states present treatment challenges and represent the time of greatest vulnerability for suicide.

What is anosognosia? Why is it a concern?

People with bipolar disorder tend to notice their symptoms when they are in a depressed state. Those around them may notice manic symptoms more quickly. During a manic state, people with bipolar disorder can lack insight into their moods and behavior. When a person is in a manic state, they may have seemingly limitless energy, believe that they can do anything, and experience impaired impulse control. Anosognosia is a condition that makes a person’s brain not recognize that they have a health condition so that the people who are experiencing it have an entirely different perception than someone not affected by anosognosia. Simply put, the person does not believe they are unwell. When a person with bipolar disorder does not believe there is anything wrong with their mental health, they may not readily agree to seek help.

Now that I know the depression and bipolar disorder basics, how can I help someone who is living with depression or bipolar disorder?

We’re glad you asked! Read on for information about how to help a teen, how to help an adult, and what caregivers can do. Explore our site for webinars, expert interviews, family stories, and more. Find additional caregiver support with Courage to Caregivers.