Bipolar spectrum is a miscellaneous category meant to describe people with depression who do not have bipolar disorder but who share important similarities with it. Some of these similarities can include:
Cycling: sometimes people cycle into frequent depressions. Although they do not experience the other moods of bipolar disorder, they may share in common with it an underlying problem of cycling that may respond to a mood stabilizer.
Genetics: people with depression who have a strong family history of bipolar disorder may have inherited some of the genes which underlie bipolar, but not enough to have the full condition.
Treatment response: some people do not have bipolar disorder, but respond to psychiatric medications as if they do. An example would be developing hypomania or mood swings on a medication. Another example is depressions that do not respond to antidepressants or keep coming back even while on them.
Symptoms: some people have a few symptoms of mania, but not enough qualify for bipolar disorder.
Timing of depression: the following features may suggest that a depression is related to bipolar disorder: depressions that start early in life (e.g. in teenage years), begin post-partum (after childbirth), or that come on very quickly and last less than three months.
Although bipolar spectrum is an experimental category which is still being developed, some aspects of it are recognized in the new DSM-5 (the official dictionary of psychiatric disorders). This guide recognizes many cases of worsening on antidepressants as bipolar, and also recognizes depressions that have a few symptoms of mania (called “Mixed features”).
Usually, having bipolar spectrum does not mean that you have bipolar. It does mean that you may need some careful tailoring of your psychiatric treatment. Traditional therapies for depression sometimes work well for bipolar spectrum, but often do not.
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—Updated 2/27/13 by Chris Aiken, MD