What is the difference between depression and mania

Having fluctuations in feelings, mood swings, and a wide range of emotions is very common; almost everyone can relate to emotional upheavals and changes in mood. However, when these emotions or moods are severe to the point of impairing a person’s ability to function, there may be a disorder present. It can be difficult to understand how depression and mania co-exist. Table 6 compares some of the key features of both.

Table 6: Comparison of mania and depression in bipolar disorder

	Mania	Depression
Energy Levels	Increased energy, increase in activity and/or goal directed activities. May spend more money.	Loss of energy, decrease in activity and interest in activities. Withdrawal from social contact and activities. Change in eating patterns – loss of appetite or overeating.
Changes in sleep pattern	Decreased need for sleep without feeling tired.	Disrupted sleep patterns, with trouble falling or staying asleep, waking too early, sleeping too much. Fatigue.
Thoughts and feelings	Feeling good, high or exhilarated. May think they are chosen, special, gifted, entitled. Increased libido. Increased thinking, disorganised, flood of ideas. May feel agitated, irritable, intense emotions, argumentative.	Feeling down, low, empty, hopeless, worthless, irritable or anxious. Think they are useless, a burden, and the cause of their own problems. Decreased libido. Impaired thinking, concentration, decision making, motivation. May have thoughts of death or suicide.
Speech and sensations	Pressured speech, maybe without enough time to convey all of the ideas, inappropriate. Heightened perception and sensation.	Speech can be slowed, with few ideas. Dulled perception and sensation, but in some cases some senses can be heightened (e.g., taste and smell).
Delusions, hallucinations	In severe cases of mania, there may be grandiose delusions (e.g., may think they are God, or they are a superhero sent to save the world).	In severe cases of depression, there can be nihilistic delusions (e.g., may think their body is decaying).

Adapted from Black Dog Institute [154].