Any of the following manifestations can be bipolar depression.

• Recurring thoughts of suicide
• Guilt
• Isolation
• Hopelessness
• Problems concentrating
• Persistent feeling of sadness
• Chronic pain without a known cause
• Anxiety
• Disturbance in sleep
• Disturbance in appetite
• Anger
• Fatigue
• Loss of interest in daily activities

A study was conducted on bipolar depression in 2003 by Robert Hirschfeld, M.D. of the University of Texas Medical Branch, Galveston. In the study bipolar patients were found to be fared worse in their depressions than uniploar patients (major depression). In terms of potential for suicide, disability, and lost years of productivity, bipolar depression is now recognized as the most dangerous aspect of depression leaving unipolar depression behind.

A patient of severe depression such as bipolar and unipolar depressions may show the symptoms of psychosis. Symptoms of psychosis include:

Delusions which can be defined as false personal beliefs that are not subject to reason and are not explained an individual’s cultural thoughts.

Hallucinations that is defined as seeing, hearing or otherwise sensing the existence of stimuli that doesn’t exist.

Besides the above two symptoms, sufferers of bipolar depression can also suffer from paranoid thoughts. Such thoughts can be persecution or monitoring of the patient himself/herself by some powerful entity such as a hostile force or government. These paranoid thoughts can also make the patients believe that the people close to him/her will leave and abandon him/her.

In patients of bipolar depression, unusual and intense religious beliefs such as their strong belief that God has given them a role to play in the world or they have supernatural powers.