Bipolar depression: Sad or mad?

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When you’re watching for emerging symptoms of bipolar depression, make sure “irritability” is on the list. You’re just as likely to be unusually crabby, intolerant, and easily annoyed during a depressive episode as to be apathetic or despondent.

More research has been done on irritability in major depressive disorder than in bipolar disorder, but results from both groups indicate that from 40 percent to 60 percent report depressive episodes marked by irritability.

“Irritable depression” (that’s a description, not a diagnostic term) is associated with more severe depressive episodes, more frequently recurring episodes, and co-existing anxiety.

A study published in the International Journal of Bipolar Disorders in December 2016 found that participants with irritable depression also tend to take longer to recover from an episode and had more “unfavorable illness characteristics,” such as higher rates of substance use and more suicidality.

All of which means it’s even more important to take preventive measures when your irritability meter ticks upward.

bp Magazine’s columnist and blogger, Julie Fast uses the terms “weepy depression” and “angry depression” to describe the different ways she can experience bipolar downshifts. Weepy depression comes with what you might call stereotypical symptoms: feeling sad and hopeless, crying a lot, shutting down socially, becoming physically lethargic and

having trouble concentrating.

With angry depression, she writes, you feel “pissed off at everyone and everything. Kittens and puppies make you mad.” You focus on the negative, finding “garbage in the gutter when there is a rainbow in the sky.”

[THIS WAS THE CONTENT OF bp’s NEWSLETTER DATED 2/16/17. You can find bp magazine’s presence at: http://www.bphope.com/ ]

I’ve passed this along to you because I suffer from angry depression and have since I was very young. It defined me for most of my life. Today, it is one of the leading indicators that alerts me to how I’m doing. For example, if I’ve been doing reasonably well and suddenly I’m bitchy with my mom for no reason, I’d better take a look at myself and see if I’m sliding down the sheer walls of the well of depression. For me, it might also indicate that I’m manic. I don’t think it only happens to me when I’m depressed. If I’m unreasonably angry and I’m aware of it, I can examine myself and see where things are going wrong. When I’m in the midst of an episode it can be hard to recognize that things are going badly. Sometimes the anger is a wake-up call alerting me that something is amiss. Sometimes I become aware of that anger by seeing what it does to those I love.

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