Unipolar Depression: Symptoms, Causes, Treatment

Unipolar depression is a term used interchangeably with major depressive order, and is characterized by continuous feelings of sadness, low mood, feelings of worthlessness, lack of interest in activities you used to enjoy, as well as suicidal ideation.

Unipolar disorder is a serious mental health disorder affecting 8.4% of the U.S. population. The disorder is more prevalent among women than men, and among younger people (aged 18-25) than older people. In 2020, 14.8 million adults had a severe episode of unipolar disorder, and 66% of people with the disorder were treated.

Unipolar vs. Bipolar Depression

The term unipolar depression is used to distinguish major depressive disorder from bipolar disorder, which is characterized by alternating periods of mania and depression. Sometimes bipolar disorder is misdiagnosed as unipolar depression. In these cases, treatment is not successful, as treatment for the two disorders differs.

Unipolar depression has distinct differences from bipolar disorder, including lack of manic/hypomanic episodes; however, depression is also a symptom of bipolar disorder. It’s important that if you are having signs of depression, you receive a proper diagnosis from a medical professional, who will determine if you are experiencing unipolar depression or bipolar depression.

Characteristics and Symptoms of Unipolar Depression

Experiencing unipolar depression, or major depressive disorder, is different from feeling sad and down from time to time. Unipolar depression is characterized by feelings of depression that are persistent, intense, and that make it challenging for you to function normally or relate to others.

Some of the main characteristics of unipolar depression include:

• Feeling sad most days or having a chronic low mood
• Not enjoying activities that used to bring you pleasure
• Finding it difficult to experience joy or happiness
• Feeling emotionally numb
• Having trouble concentrating
• Lack of energy
• Noticeable changes in hunger
• Trouble sleeping
• Feeling agitated
• Having trouble completing tasks
• Feeling like you don’t matter
• Feeling guilty
• Experiencing thoughts of suicide or self-harm

Diagnosis of Unipolar Depression

In order to receive a diagnosis of unipolar depression, you will need to be evaluated by a doctor or psychiatrist. Evaluations for depression often include a physical exam, a medical and family history questionnaire, and bloodwork to look for markers of disease. Sometimes other medical conditions are confused with unipolar depression, including thyroid or hormonal disorders, so it’s important to rule those out.

According to the DSM-5-TR, in order to be diagnosed with unipolar depression (major depressive disorder), you need to have had symptoms of a depressive episode for two weeks or more, and experience five or more of the following symptoms:

• Depressed mood (or irritable mood in children)
• Little to no interest in activities that used to give you pleasure
• A noticeable change in appetite or weight
• Challenging sleep issues
• An inability to stop moving (agitation) or acting extremely sluggish
• Low energy, inability to concentrate, and fatigue
• Feelings of intense worthlessness, self-blame, and guilt
• Trouble thinking clearly or making everyday decisions
• Thoughts of death or suicide

Causes of Unipolar Depression

There are several factors that contribute to unipolar depression. Usually it’s not just one factor that causes the condition, but several taken together—a perfect storm of causes, so to speak.

Some of the most common causes of unipolar depression include:

• Having a family member with depression (heredity is a contributor in 35% of cases)
• A history of childhood abuse, including physical, sexual, and mental abuse
• Differences in brain chemistry and neurology

Additionally, certain risks factors may make you more prone to developing unipolar depression, such as:

• Being divorced, separated, or widowed
• A history of substance abuse
• Having other mental health conditions, including social anxiety disorder and panic disorder
• Being a woman (women are two times as likely to be diagnosed with depression)
• Having other medical conditions, especially if you are an older person
  

Treatment for Unipolar Depression

It is difficult to live with unipolar depression, and you may find the diagnosis upsetting. But the silver lining is that unipolar depression is treatable. If you are experiencing symptoms, especially if you are having thoughts of self-harm or suicide, it’s imperative that you receive prompt treatment.

Usually treatment works best if you combine common treatments such as therapy and medication. Here’s what to know about the most common ways of treating unipolar depression.

Therapy

Psychotherapy is an effective way to treat unipolar depression. It’s best to find a therapist who has experience treating the condition. Importantly, you want to find a therapist you feel comfortable with—someone who validates your feelings and makes you feel emotionally safe.

Types of therapy used to treat unipolar depression include interpersonal therapy and cognitive-behavioral therapy.

Medication

Medication is often the first line of defense for unipolar depression, and is especially important in cases of severe depression or suicidal ideation. Types of medication used to treat unipolar depression include:

• Selective serotonin reuptake inhibitors (SSRIs) 
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants (TCAs) 
• Monoamine oxidase inhibitors (MAOIs) 
• Serotonin modulators 
• Atypical antidepressants (bupropion or mirtazapine)
  

Coping With Unipolar Depression

In addition to therapy and medication, certain lifestyle changes can help you manage unipolar depression and lessen its symptoms. For example, studies have found that adding exercise into your daily routine can help mitigate and treat your symptoms.

In addition, practicing mindfulness and meditation, decreasing your use of drugs and alcohol, taking time each day to relax, and ensuring that you are getting enough sleep, can all help with unipolar depression. There is also immense value in having a strong social support network, and connecting with others who struggle with similar mental health challenges.

A Word From Verywell

If you are someone who has unipolar depression, you might feel shame or discomfort with your diagnosis. But unipolar depression is one of the most common mental illnesses out there, and you are not alone. The most important thing is that you get help. Unipolar depression is challenging, but treatment is effective and can allow you to find happiness and thrive.