Depression and Bipolar: Knowing the Difference
- Bipolar I – Bipolar is broken up into several types, bipolar I is the disorder that people mostly picture. With bipolar I, there are three stages of function in rotation: depressive episodes, normal function and manic episodes. In depression, there are only depressive episodes and normal functioning. The difference is the mania. Mania is a period of at least a week where you experience symptoms opposite that of a depressive episode. You will feel incredibly energized with less need for sleep and driven to accomplish tasks around the house. During a manic episode, your mood will be elevated with improved self-esteem and confidence. Manic episodes are not problem-free, though, as people often get themselves into trouble during manic periods by making poor choices, spending money excessively and being more sexually promiscuous. The signs of a manic episode are usually very clear to the people in your life. Because they are so different than your normal functioning, they are easy to identify.
- Bipolar II – The real issue between bipolar disorder, depression and migraine becomes apparent with bipolar II. This is a variation of bipolar I marked by hypomanic symptoms rather than full mania. Hypomanic episodes are shorter in duration and lower in intensity. Symptoms only have to exist for four consecutive days to count as a hypomanic episode and they do not need to be as destructive as symptoms during mania. Studies are showing that people with migraines have a much higher rate of bipolar II than previously suspected.
Bipolar II creates such issues because there is already a normal cyclical pattern with migraines. You feel bad for a period of time before, during and after a migraine and then symptoms totally alleviate. When the migraine is gone, you can get more things done around the house, have more energy and feel better about life generally. Those good days experienced when migraines are not present could be periods of hypomania that you cannot distinguish from normal functioning because your frame of reference is so distorted. Migraines are so bad that you cannot tell the difference anymore.
Treating Bipolar with Migraines
Of course, being able to accurately identify your symptoms leads to better diagnosis and treatment. Education and effective self-monitoring is a necessary step in improving your prognosis. If your treatment has hit a brick wall, consider other avenues. Here are some:
- CBT – Cognitive behavioral therapy (CBT) is very effective for mood disorders like depression and bipolar. A therapist can help in gathering information about your symptoms that you have missed or found to be insignificant. Once diagnosis is established, a therapist can suggest behavioral interventions to limit the negative consequences associated with depressive, manic and hypomanic episodes.
- Relaxation – Learning relaxation techniques may be a part of your CBT treatment or you may need to supplement this at-home or elsewhere. Search the internet for relaxation techniques with good results for people with migraines and bipolar. Experiment with each technique during depressive episode and hypomanic/manic episodes as it will have different results. Ideally, you can fill your toolbox with a variety of relaxations that you can use when the time is right.