Emotional Pain in Bipolar Depression

Emotional pain isn't unique to depression. For example, all of the symptoms listed under this heading in Warning Signs of Depression can appear in times of grief. Individual symptoms or a cluster of them may be triggered by other events as well - job loss, divorce, a profound disappointment. If the symptoms continue too long, they may require treatment. But by themselves, these symptoms don't necessarily indicate the presence of major depression. Let's take a look at them:

• Prolonged sadness
• Unexplained, uncontrollable crying
• Feelings of guilt
• Feelings of worthlessness
• Loss of self-esteem
• Despair/hopelessness
• Helplessness

These symptoms, especially taken individually, are not unique to clinical depression. Feeling helpless, for example, may be a reasonable initial reaction to a difficult situation.

In bipolar depression, however, a feeling of helplessness is likely to be:

• Combined with other types of emotional pain
• Combined with other types of depressive symptoms
• Prolonged beyond a reasonable time
• More severe than is reasonable

As I said, any one or more of these symptoms could be a common reaction to a traumatic event. But if they don't get any better after a reasonable amount of time, are increasing in severity or are significantly impacting your functioning, you should seek help. One element that can differentiate bipolar depression from a more expectable emotional reaction, is that in a person suffering from a mood disorder, these symptoms may also occur spontaneously, without any clear triggering stress.

At the same time, any stressful life event - be it sorrowful or even joyous - has the potential to set off a depressive episode in someone with major depression or bipolar disorder. Thus, it is particularly important to monitor someone with a history of depression, mania or hypomania after any kind of major life occurrence, such as divorce or marriage, a death or a birth.