Unipolar Depression(A guide)

In this article, titled “Unipolar depression,” we will present what unipolar depression (known as major depressive disorder) is, its symptoms, causes, and prevalence, treatment, as well as the difference between bipolar and unipolar depression.

What is Unipolar Depression?

Unipolar depression or major depressive disorder (MDD) is a form of recurring depression without manic manifestations.

The lack of family history of mania in first-degree relatives, as well as characteristic biological and therapeutic reactions, confirm the diagnosis. 

The Main Difference Between Bipolar and Unipolar Depression

The father of modern nosology, Kraepelin was the first to differ people with mania from the ones with and without depression.

Since DSM-3 psychiatric nosology has classified major depressive disorder (or unipolar depression) from bipolar disorder, defined by the presence of mania.

Bipolar depression and unipolar depression differ from each other, mainly by the presence of maniacal episodes in bipolar disorder, also by etiology and phenomenology.

However, as we know, mania is biologically driven, so bipolar depression is considered more endogenous than unipolar depression. 

Unipolar Depression Symptoms

For the diagnosis of unipolar depression, the five or more of the following symptoms must manifest at least for two weeks: 

  • Almost daily depressed mood, 
  • Significant weight loss or weight gain,
  • Significant decrease or increase of appetite,
  • Fatigue almost every day,
  • Difficulty in thinking, concentrating, and making decisions,
  • Feeling guilty,
  • Feeling worthless,
  • Recurrent suicidal thoughts or suicidal attempt,
  • Sleeping disorders (insomnia or hypersomnia),
  • Psychomotor agitation or deceleration.

Unipolar depression includes an almost complete loss of motivation, sadness, a feeling of emptiness and anxiety, lasting for months or years.

Such a person has lost all hope that his/her suffering will end. Often, he/she has no desire to eat, talk, chat with people, and take a shower.

Some people become so depressed that they do not leave the darkroom for months and do not take a shower for weeks.

When something very unpleasant happens in their life, people can experience so much suffering that it seems that nothing can bring them joy.

Everyone can have difficult times. A relative’s death, divorce, or severe illness can lead to depression.

Such events traumatize a person very much, and it is known that many people develop cancer precisely after such misfortunes occur in their lives.

Death, divorce, loss of work – all this leads to the fact that the mind continually sends aggressive and painful messages to the organs of the body.

Prevalence and Causes of MDD (Unipolar Depression)

According to sociological studies, at least 16% of the population experienced conditions that meet the diagnostic criteria for major depressive disorder at least once in a lifetime.

However, less than half of people who have experienced these conditions have sought or are seeking medical and psychological help and received an official diagnosis.

Often, patients try to keep silent about the symptoms of depression.

Many are afraid of prescribing antidepressants and their side effects; some believe that controlling emotions is their business, and not the doctor’s; there are also concerns that the mention of a case of depression will fall into the medical record and somehow become known to the employer; finally, some are afraid to be referred for treatment by a psychiatrist.

This suggests that therapists should use more screening tools, including brief questionnaires, which do not exclude depression.

Major depressive disorder is more common among the population of large cities and megacities compared to the population of small cities, towns, and villages, more often among the population of developed countries than backward and developing ones.

Probably, this difference is mainly due to improved diagnostics, a higher level of medicine and health care, and a greater awareness of the population of developed countries and especially large cities about what depression is, and, as a result, more frequent visits to doctors.

However, the crowding and overpopulation of large cities, a faster pace of life, a higher level of social requirements and more stress, apparently also play a role.

Unipolar depression or MDD also occurs with increased frequency among people who are often stressed – for example, unemployed, people with an unfortunate socio-economic situation (low paid, without their own housing), or people working in hard, dull, monotonous, unloved or uninteresting work, at work associated with an increased amount of stress and psychological overload (such as top managers).

Often (but not always) a major depressive disorder develops after a mental trauma – for example, loss of work, bankruptcy, severe illness or death of a loved one, or a close person, divorce, or moving to a new place with the loss of all previous social connections.

With increased frequency, unipolar depression develops in individuals in whom relatives (especially the closest ones) have suffered or suffer from affective disorders such as bipolar affective disorder, schizoaffective disorder, and some other mental illnesses.

This indicates the vital role of a hereditary, genetic predisposition in the development of major depression and the possible presence of common mechanisms for the development of several mental disorders, which include an active component.

Unipolar Depression Treatment

Medications and psychotherapy usually treat unipolar depression (or major depressive disorder). 


There are different types of antidepressants, which are effectively used to treat unipolar depression:

  • Selective serotonin reuptake inhibitors (SSRIs) – vilazodone, citalopram, escitalopram, paroxetine, fluoxetine, and sertraline.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) – desvenlafaxine, duloxetine, venlafaxine, and levomilnacipran.
  • Monoamine oxidase inhibitors (MAOIs) – phenelzine, tranylcypromine, and isocarboxazid. They may be prescribed when other drugs have not worked because MAOIs can have serious side effects.


Psychotherapy, also known as talk therapy, can be helpful for unipolar depression treatment too.

Usually are used different types of psychotherapy, such as CBT (cognitive-behavioral depression) or interpersonal therapy.

Psychotherapy can help you define negative and distorted thoughts, and replace them with positive and healthy ones, and learn new, better ways to solve problems.

Other Treatment Options for Unipolar Depression

  • Electroconvulsive therapy (ECT) assumes attachment of small electrodes to head, which sends electrical impulses to the brain, intentionally triggering a brief seizure. 
  • Repetitive transcranial magnetic stimulation (TMS) is used by targeting and stimulating specific areas of the brain with a magnet.

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

  1. Depression Sourcebook: Basic Consumer Health Information About Unipolar Depression, Bipolar Disorder, Postpartum Depression, Seasonal Affective Disorder, and Other Types of Depression
  2. The Coping With Depression Course: A Psychoeducational Intervention for Unipolar Depression
  3. Depresiones bipolares y unipolares / Bipolar and unipolar depression: Qué hacer en los pacientes que no responden suficientemente a los tratamientos to standard treatments (Spanish Edition) 
  4. HFNE “Bipolar”
  5. HFNE “Major Depressive Disorder (DSM-5)”

What we recommend for Depression

Professional counselling

If you are suffering from depression then ongoing professional counselling could be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.

FAQs about the topic “Unipolar Depression.”

What is the difference between unipolar and bipolar?

The difference between unipolar and bipolar depressions is that in contrary to unipolar depression, bipolar depression, besides depressive symptoms, involves manic symptoms as well.

What is the difference between bipolar disorder and bipolar depression?

Bipolar disorder (known as manic depression) is the same bipolar depression.

Bipolar disorder is an endogenous mental disorder, manifested in the form of affective states: manic (or hypomanic) and depressive (or sub depressive), and sometimes mixed conditions. 

Does lithium work for unipolar depression?

Lithium works for unipolar depression.

It is used to treat acute episodes of unipolar depression, as well as their recurrence.

However, lithium is more widely used to treat bipolar depression

What are recurrent episodes?

The recurrent episode is a recurrent depressive disorder.

With this kind of depression, depressive phases, which can last from several months to several years, alternate with phases with a normal mood.

This type of depressive disorder can seriously affect performance and is unipolar in nature (there is no phase of mania or hypomania). 

Does Bipolar worsen with age?

Bipolar can worsen with age if it is not treated.

By the time the symptoms of the disorder can become more severe and frequent than they were in the beginning.

What are the four types of bipolar?

The four types of bipolar are:

– Bipolar I disorder (can be diagnosed if manic episodes last at least for a week, accompanied by psychotic features),

– Bipolar II disorder (it does not involve manic episodes; instead, it involves episodes of hypomania and major depression),

– Cyclothymic disorder (it is a milder form of bipolar disorder; it involves cyclical mood swings. However, the ups and downs are not that severe),

– Bipolar disorder caused by another medical or substance abuse disorder (some bipolar disorder does not have a specific pattern and does not match the other three types).


Unipolar depression or major depressive disorder (MDD) is a form of recurring depression without manic manifestations.

The lack of family history of mania in first-degree relatives, as well as characteristic biological and therapeutic reactions, confirm the diagnosis since DSM-3 psychiatric nosology has classified major depressive disorder (or unipolar depression) from bipolar disorder, defined by the presence of mania.

However, there are some ways to treat unipolar depression, such as medications (mainly antidepressants), psychotherapy (especially CBT or interpersonal therapy), as well as ECT and TMC.

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  1. Distinctions between bipolar and unipolar depression
  2. Unipolar depression in adults: Assessment and diagnosis