Is your depressed patient bipolar?

Bipolar Unipolar
Substance abuse Very high Moderate
Family history Almost uniform Sometimes
Seasonality Common Occasional
First episode <25 years Very common Sometimes
Postpartum illness Very common Sometimes
Psychotic features <35 years Highly predictive Uncommon
Atypical features Common Occasional
Rapid on/off pattern Typical Unusual
Recurrent major depressive episodes (>3) Common Unusual
Antidepressant-induced mania or hypomania Predictive Uncommon
Brief major depressive episodes (avg <3 months) Suggestive Unusual (episode duration usually >3 months)
Wearing off of antidepressant efficacy Suggestive Uncommon
Mixed depression (presence of hypomanic features within the depressive episode) Predictive Rare