Depressive & Mood Disorders

According to the National Institute of Mental health, major depression is one of the most common mental health disorders in the US. It is estimated that about 21 million adults in the US had at least one major depressive episode (about 8.4% of all US adults) in the year 2020. According to research (Statista, 2023), in early 2023 about 22% of US adults experienced depressive symptoms. It’s been a rough few years.

Bipolar disorder is often misconceived for what would better be characterized as something like mood lability or reactivity. Sometimes people think that bipolar disorder is when someone is “really mad one second, and then really happy the next.” Sometimes people think it’s when someone becomes irrationally mad and even aggressive or destructive. These things can sometimes be symptoms of bipolar disorder, but bipolar disorder is much more than that. It is a cyclical illness that includes distinct mood episodes lasting days, weeks, or months, not just moodiness throughout the day. As described below, bipolar II consists of periods of hypomania as well as significant depressive episodes, and bipolar I consists of periods of acute mania as well as either depressive or mixed episodes. 

Bipolar II disorder is very often misdiagnosed as depression. For many, hypomania can look and even feel like someone’s doing great – they’re much more social, energetic, motivated, and productive. Most individuals are not going to seek help when they feel this way. Unfortunately, these periods are eventually punctuated by a major depressive episode, and sometimes a highly uncomfortable sense of frenetic, dysregulated energy that one isn’t quite sure what to do with on the way down. The depressive episode is most likely to be when someone seeks help – they are just miserable, and want to get back to how they were feeling before. This is why individuals with bipolar disorder are often treated for depression, which can actually make their symptoms worse. This is why it’s important as providers to complete a thorough assessment, and important as a patient to try to be open and honest with your provider about all of your symptoms. 

Nobody chooses to lose interest in the things that once brought them joy, to struggle with finding a reason to get out of bed in the morning, to look in the mirror and see eyes gazing back at you with emptiness, a face you can barely recognize anymore. Nobody enjoys the roller coaster of energetic chaos that inevitably crashes into feeling so low you’re sure you’ll never feel better. There’s good news – you don’t have to feel this way, and we can help you find a way out of the darkness with no looking back, and break lifelong cycles for good. No matter how long you’ve been in your rut, or lost hope and decided to accept that this is just the way life is – we are here to tell you that it does get better. We invite you to partner with us, and we will work together to find the place where the sunlight shines back over your life and you can feel excited again about what life has in store.

Bipolar I Disorder

Someone with bipolar I disorder has experienced at least one true manic episode. A manic episode is a distinct period often described as feeling ‘on top of the world,’ typically followed by a significant depressive episode. A manic episode lasts at least seven days (or any duration if admitted to the hospital), causes significant impairment in functioning, and often requires hospitalization to prevent harm to oneself or others. A manic episode consists of several of the following symptoms:

- Persistently elevated, euphoric, expansive, or irritable mood
- Decreased need for sleep
- Inflated self-esteem or unrealistic sense of superiority 
- Increased talkativeness
- Racing thoughts
- Decreased attention span
- Excessive involvement in pleasurable activities with a high potential for painful consequences (e.g., reckless spending, sexual indiscretions)
- Psychotic features (such as delusions or hallucinations)

Bipolar II Disorder

Someone with bipolar II disorder has experienced at least one episode of hypomania and one major depressive episode. A hypomanic episode is a distinct period of elevated, expansive or irritable mood, similar to a manic episode but less intense, and lasting for at least four consecutive days. It involves similar but less severe symptoms including inflated self-esteem, decreased need for sleep, increased desire to be social, increased talkativeness, racing thoughts, distractibility, and increased impulsivity or excessive spending.

Though an episode of hypomania does not typically result in hospitalization and often does not impair daily functioning, left untreated it can create chaos and damage relationships. The more damaging and more severe component of bipolar II disorder tends to be the episodes of major depression, as described above.