If you’re in San Diego, California and wondering whether the low mood you’re feeling could be part of bipolar disorder, you’re not alone. Bipolar illness involves shifts in mood, energy, sleep, and activity that cycle over time. People often notice the “high” periods (mania or hypomania), but depressive episodes are just as common—and often the hardest part of life with bipolar disorder.
Below, you’ll learn how bipolar depression tends to show up, how it can differ from “unipolar” major depression, and when to seek help. We’ll also point you to our office at San Diego clinic, plus credible resources and next steps.
What is Bipolar Depression?
Bipolar disorder features mood episodes—times when symptoms are present most of the day, nearly every day, for at least two weeks for depression (or about a week for mania). Between episodes, people often return to their usual baseline, but without treatment, episodes may return more often or become more severe over time.
A depressive episode in bipolar disorder shares many features with major depression (sadness, loss of interest), but clinical patterns and history (past mania/hypomania, family history, episode triggers) help distinguish them. That distinction matters because treatment choices can differ. Authoritative guidance emphasizes careful assessment to separate bipolar from unipolar depression.
Common Bipolar Depression Symptoms
While every person’s experience is unique, the following symptoms are frequently seen in bipolar depression (you don’t need all of them to qualify):
Persistently low or empty mood and/or loss of interest in activities you usually enjoy
Fatigue or loss of energy; everything feels heavier than usual
Changes in sleep (often sleeping more than usual, yet still unrefreshed; some have insomnia)
Changes in appetite (often increased appetite or weight changes)
Psychomotor changes (moving or thinking more slowly; others feel agitated inside)
Problems with concentration, memory, and decision-making
Feelings of worthlessness or excessive/inappropriate guilt
Thoughts of death or suicidal ideation (seek help immediately)
These symptoms must last most of the day, nearly every day, for at least two weeks and cause real-life impairment (work, school, relationships).
Clues It Might Be Bipolar Depression
No single sign “proves” bipolar disorder, but Advanced Psychiatry Associates offices pay attention to:
A history of mania or hypomania (periods of elevated/irritable mood with less need for sleep, increased energy, impulsivity, or racing thoughts)
Antidepressant sensitivity (past antidepressants that triggered agitation, sleeplessness, or clear hypomania/mania)
Family history of bipolar disorder
Mixed features (some “up” symptoms—like racing thoughts or irritability—showing up during a depressive episode)
Early-onset recurrent depressions, or depressions with atypical patterns (more sleeping/eating, leaden paralysis)
If any of this sounds familiar, a structured evaluation can clarify the diagnosis and steer you toward the safest, most effective plan. APA, as an authoritative organization, highlights the importance of accurate diagnosis and phase-specific care.
How Bipolar Depression Affects Daily Life
Work & school: slower processing, missed deadlines, presenteeism (you’re there, but not “there”), and avoidance of once-manageable tasks.
Sleep & energy: oversleeping without feeling restored; “wired and tired” nights; daytime fatigue.
Emotions: lingering guilt/shame, irritability, or tearfulness; some feel “numb.”
Thinking: rumination (“stuck” thoughts), indecision, and increased errors.
Relationships: withdrawal, less interest in socializing or intimacy, conflict from irritability or missed plans.
When To Get Help in San Diego California
Seek an evaluation if symptoms last two weeks or more, cause daily impairment, or include any safety concerns. A comprehensive assessment looks at your full history (including past “up” spells), medical contributors (thyroid, sleep disorders, substances), and what’s helped or harmed in the past. National and international guidelines underline the value of timely, accurate diagnosis and ongoing follow-up.
At Advanced Psychiatry Associates in San Diego, we offer:
Bipolar Disorder evaluation and ongoing care
Medication Management tailored to your phase and history
Psychotherapy and Counseling (CBT- and rhythm-focused skills)
Depression care for overlapping concerns
Flexible access: in-clinic or telehealth statewide
You can check location details on Advanced Psychiatry Associates in San Diego page and Schedule an appointment online in minutes.
What Treatment Typically Looks Like
Medication (Phase-Specific)
For bipolar depression, Advanced Psychiatry Associates has evidence in bipolar illness. Antidepressants, if used, are typically paired with a mood stabilizer and chosen carefully to lower the risk of switching into mania. Your prescriber weighs benefits, risks, and your past responses. APA authoritative guidelines summarize these phase-specific choices.
Psychotherapy (Skills That Protect You Between Episodes)
Combining medication with structured therapy helps many adults: CBT to reduce depressive thinking and avoidance, Interpersonal and Social Rhythm Therapy (IPSRT) to stabilize daily routines/sleep, and family-focused approaches to align support at home. National resources emphasize that therapy plus medication often improves outcomes and relapse prevention.
Lifestyle & relapse prevention
Regular sleep–wake timing, daylight exposure, consistent meals, and substance-use reduction can lower relapse risk and ease symptoms. Keeping a personal early-warning sign list (sleep shrinking, irritability, spending spikes, racing thoughts).
Note on advanced treatments: We provide Transcranial Magnetic Stimulation TMS and Esketamine SPRAVATO programs for treatment-resistant unipolar depression. These are not first-line treatments for bipolar depression; your clinician will discuss what’s evidence-based for your presentation and when other options (including hospital-based care/ECT in severe cases) are appropriate.
Ready To Talk?
If the symptoms above ring true, you don’t have to figure this out alone. APA San Diego psychiatry team can help you clarify what’s happening and create a personalized, phase-specific plan that supports relief and stability.
Book now: Schedule an appointment (telehealth or in-clinic)
Visit us: Advanced Psychiatry Associates in San Diego (address, hours, directions)
Learn more: Bipolar Disorder, Depression, Psychotherapy and Counseling, Medication Management
You deserve care that fits your life—and a plan that helps you feel like yourself again.
