Depression, Bipolar Disorder, and Anxiety: Understanding, Symptoms, and Treatment

Everyone’s experience is unique, but these patterns can help you to recognize the symptoms of depression, bipolar disorder, and anxiety:
 

Common signs of depression¹

• Persistent low mood, emptiness, or emotional numbness 

• Loss of interest in activities that used to matter 

• Sleep problems (insomnia or oversleeping) 

• Changes in appetite or weight 

• Low energy or fatigue; moving or speaking more slowly 

• Feelings of guilt, self‑blame, or worthlessness 

• Trouble concentrating, remembering, or making decisions 

• Thoughts of death or suicide

Common signs of bipolar disorder¹

• Extreme mood swings between high (manic or hypomanic) and low (depressive) states 

• Periods of unusually high energy or activity 

• Decreased need for sleep 

• Rapid speech or racing thoughts 

• Impulsivity or risky behaviour 

• Irritability or agitation 

• Periods of sadness, emptiness, or hopelessness 

• Loss of interest or pleasure in usual activities 

• Fatigue or low energy 

• Changes in sleep or appetite 

• Difficulty concentrating or making decisions 

• Feelings of guilt or worthlessness
   

Common signs of anxiety​^2–5​

• Excessive or uncontrollable worry; feeling “on edge” 

• Restlessness, muscle tension, headaches, stomach upset 

• Difficulty concentrating; irritability 

• Panic attacks (sudden surges of intense fear with heart racing, shortness of breath, or dizziness) 

• Avoidance of places or situations that trigger fear 

• Sleep disturbance (difficulty falling or staying asleep)

Severe symptoms

• Thoughts of death, self‑harm or suicide 

• Psychosis 

• Using alcohol or drugs to cope 

• Rapid decline in functioning at work or school 

• Inability to care for yourself or dependents 

• Severe panic or depression lasting most of the day for two weeks or more 

*If you are in immediate danger or thinking about harming yourself, we encourage you to reach out to a mental health professional or a crisis helpline. You can call or text 988 for immediate crisis support across Canada. 

Depression, anxiety, and bipolar disorder often overlap and can influence one another.^6–9​ Depression and anxiety frequently co-occur, sharing features such as sleep problems, concentration difficulties, irritability, fatigue, and physical tension. While depression centers on low mood and loss of interest, anxiety focuses on fear and worry—often about future threats. Bipolar disorder includes both depressive episodes and periods of elevated or irritable mood, increased energy, and impulsive behaviour, which can further intensify anxiety or follow it in a repeating pattern. 

Many people experience a cycle: anxiety drives avoidance and exhaustion, which deepens depression; depression lowers motivation to use coping skills, allowing anxiety to grow; and in bipolar disorder, these cycles can trigger or worsen mood swings. Concurrent treatment that addresses all aspects of mood and anxiety helps stabilize emotions, improve functioning, and break the cycle.

Co-occurring conditions

It’s common for depression, bipolar disorder, and anxiety to occur alongside substance use.^10,11​ Many people turn to alcohol, cannabis, or other drugs to cope with emotional pain, racing thoughts, or stress. While these substances may bring short-term relief, they often make symptoms worse over time—disrupting sleep, increasing mood swings, and interfering with medication or therapy. 

For those with depression, substances can temporarily numb sadness but tend to deepen fatigue and hopelessness. In anxiety disorders, alcohol or cannabis may seem calming at first but often heighten anxiety once their effects wear off. In bipolar disorder, substance use can intensify manic highs and deepen depressive lows, making stability harder to maintain. 

Because these conditions affect each other, the most effective approach is concurrent treatment—addressing both mental health and substance use together.^12–14​ Therapy, medication management, relapse-prevention strategies, and social support all work best when combined in one coordinated plan. With the right help, people can find balance, reduce reliance on substances, and work toward lasting recovery. 

A clinician can help with a clear diagnosis and treatment plan, but these are some of the common associated disorders¹: 

Depressive disorders

• Major Depressive Disorder (MDD): Characterized by multiple depressive symptoms occurring most days for at least two weeks 

• Persistent Depressive Disorder (Dysthymia): A chronic form of depression involving a low or sad mood lasting for two years or longer 

• Perinatal or Peripartum Depression: Depression that develops during pregnancy or within the months following childbirth 

• Seasonal Affective Disorder (SAD): A type of depression that follows a seasonal pattern, most often worsening during the winter months when daylight is reduced 

• Premenstrual Dysphoric Disorder (PMDD): A severe form of premenstrual syndrome involving significant mood changes, irritability, or emotional distress in the week or two before menstruation 

Bipolar disorders

• Bipolar I Disorder: Characterized by at least one manic episode, which may be preceded or followed by depressive episodes  

• Bipolar II Disorder: Involves recurring depressive episodes and periods of hypomania—a milder form of mania that includes elevated mood and increased activity but does not cause severe impairment or psychosis

• Cyclothymic Disorder (Cyclothymia): A chronic pattern of fluctuating low-level depressive and hypomanic symptoms lasting for two years or more 

Anxiety disorders

• Generalized Anxiety Disorder (GAD): Involves chronic and excessive worry about multiple aspects of daily life, often accompanied by restlessness, fatigue, and physical tension

• Panic Disorder: Characterized by recurrent and unexpected panic attacks, along with ongoing fear or worry about having future attacks

• Social Anxiety Disorder: Marked by intense fear or anxiety about being judged, embarrassed, or humiliated in social or performance situations 

• Specific Phobia: Involves a persistent, excessive fear of a specific object or situation, leading to avoidance or distress when faced with the trigger 

• Agoraphobia: Characterized by fear or avoidance of situations where escape might be difficult or help unavailable, such as crowds, public transport, or open spaces 

Conditions like OCD and PTSD can be related, but are distinct, and may require a different approach to treatment.  

Most people experience depression, bipolar disorder, or anxiety because of a complex mix of biological, psychological, and social influences. Biological and genetic factors play a significant role—for example, having a family history of mood or anxiety disorders, or experiencing changes in brain chemistry that affect mood regulation, sleep, energy, and stress response.^15–22​ In bipolar disorder, these biological changes can contribute to fluctuations between depressive and manic or hypomanic states. 

Life stressors and trauma also contribute: events such as bereavement, strained relationships, financial hardship, medical illness, discrimination, or past traumatic experiences can deeply affect emotional well-being and may trigger or worsen symptoms in vulnerable individuals​.²³​

Health and lifestyle factors, including chronic pain, hormonal or thyroid changes, disrupted sleep, and substance use—can further influence how someone feels, copes, and regulates mood. Psychological patterns, such as persistent self-criticism, perfectionism, or avoidance, may reinforce distress or make recovery more difficult. Finally, environmental conditions like social isolation, lack of support, or living or working in high-pressure or unsafe settings, can increase vulnerability and make it harder to maintain emotional balance and stability.^24–26 

At the same time, protective factors such as supportive relationships, physical activity, consistent sleep, meaningful roles, and early access to counselling or treatment can strengthen resilience, promote recovery, and reduce the likelihood of relapse.^25–27​

If you’re experiencing symptoms of depression, bipolar disorder, or anxiety—or have a formal diagnosis—these conditions can affect many areas of your daily life. At work or school, you may notice reduced concentration, increased absences, or “presenteeism,” where you’re physically present but not functioning at your best due to symptoms. Your physical health can also be impacted, with headaches, digestive issues, muscle tension, cardiovascular strain, and immune changes often linked to chronic stress. Relationships may become strained due to withdrawal, irritability, conflict, or communication difficulties. In more severe periods, safety concerns can arise, including an increased risk of using substances to cope or experiencing thoughts of self-harm.  

Addressing both mental and physical health together offers the best path toward recovery and long-term well-being. 

Screening tools (often used in primary care and counselling) can help identify concerns and guide the next steps. However, screening is not a diagnosis. We recommend you seek a comprehensive assessment if: 

• Symptoms persist most days for two weeks or more 

• Anxiety or low mood interfere with work, school, or caregiving 

• You rely on alcohol or drugs to cope 

• You’ve tried self‑help strategies without progress 

Early support makes treatment more effective and reduces the chance of complications. Our admissions coordinators would be happy to have a conversation with you and determine which one of our treatment programs is right for you. 

We also offer a quick online screener to help you find out if virtual treatment is right for you. In just 6 minutes, you can learn whether EHN Online is a good fit for your needs.  

We offer both inpatient and virtual programs so that care can match your needs and life. 

Inpatient (residential) treatment

For some individuals, inpatient or residential treatment offers the safest and most effective path toward recovery from depression, bipolar disorder, or anxiety. This level of care is ideal for those experiencing severe symptoms, safety concerns, or significant disruption to daily life. It’s also well-suited for people who have made multiple outpatient attempts without lasting progress, or who need the stability of a structured, supportive environment. Residential treatment can also benefit those facing co-occurring concerns, such as trauma or substance use, that may intensify mood symptoms or make self-management more difficult. 

During inpatient treatment, clients receive 24/7 support from a multidisciplinary team of medical, psychiatric, and therapy professionals. Each care plan is personalized and may include individual counselling, evidence-based therapies such as Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT), and holistic wellness services to strengthen both emotional and physical well-being. Medication management and medical monitoring ensure safe, coordinated care, particularly for those managing complex mood symptoms or medication adjustments. 

Family involvement is an important part of recovery. Through our Family Program, loved ones learn to improve communication, set healthy boundaries, and offer informed support at home. Before discharge, each client works with their care team to create a comprehensive post-treatment plan that includes Aftercare and, if needed, a step down to virtual therapy options, helping sustain stability and progress over the long term. 

Virtual Intensive Therapy Programs

For individuals experiencing mild to moderate symptoms, or those who have stabilized after more intensive treatment, EHN Canada’s Virtual Intensive Therapy Programs (VITPs) provide structured, skills-based care with the flexibility to continue daily responsibilities. These programs offer many of the same benefits as an Intensive Outpatient Program (IOP), delivered entirely online through a secure, confidential platform. They’re ideal for people who want professional support while maintaining work, school, or caregiving commitments, or for those who prefer the comfort and privacy of treatment from home. 

Each program includes multiple therapy sessions each week, combining therapist-led group programming with individual counselling. Treatment focuses on building lasting recovery skills through evidence-based approaches such as Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT). For those managing anxiety, exposure-based strategies may be incorporated to reduce avoidance and increase confidence, while relapse-prevention and mood-stabilization techniques support ongoing emotional balance. 

Delivered through a secure telehealth platform, EHN Canada’s virtual programs make it easier to stay connected to care and maintain progress in recovery. This flexible, structured model helps clients manage depression, anxiety, or bipolar disorder effectively—without putting life on hold. 

Begin by acknowledging what you’re feeling, such as saying to yourself, “I’m noticing ongoing anxiety” or “I’ve been feeling low.” Naming your emotions can help reduce shame and makes it easier to take supportive action. From there, try to create gentle structure in your day—keep regular wake and sleep times, eat balanced meals, and include short bursts of movement to help regulate mood and energy. 

In moments of stress, use calming techniques like slow, steady breathing, grounding yourself through the five senses, or taking a mindful walk. If you use alcohol or cannabis, be mindful that they can interfere with mood and sleep; seek support if reducing use feels challenging. Staying connected also matters—reach out to someone you trust, or consider joining a support group or community where you can share and feel understood. 

During particularly anxious times, limit exposure to distressing news or social media, which can heighten worry and tension. Remember, recovery doesn’t come from one big change—it’s built through small, steady steps that gradually restore balance and make professional treatment more effective. 

Recovery is not linear—and that’s okay. Long-term well-being is built through ongoing habits and support, including: 

• Therapy consistency: Continue using the skills you’ve learned, both independently and in Aftercare, to stay grounded and steady. 
• Alumni: Stay connected and supported by your fellow alumni. 
• Medication follow-up: Continue reviewing doses, side effects, and goals with your doctor or pharmacist as your needs and life circumstances change. 
• Relapse-prevention planning: Identify early warning signs—such as changes in sleep, irritability, or avoidance—and outline specific steps to take when they appear.
• Meaningful activities: Engage in work, learning, volunteering, or creative outlets that align with your values and sense of purpose. 
• Supportive relationships: Maintain boundaries and communication that protect your energy and foster connection. 
• Stepped care: Recognize when you may need to step up to more intensive support (like a VITP) and when it’s safe to step down as you regain stability.

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