 Estimates of the prevalence of Bipolar disorder are as high as 6 of the population.1 It is a severe and potentially lethal illness which has a different course and treatment profile to unipolar depression, commonly known simply as major depression. In 50-60 of cases however, the initial presentation of bipolar disorder is one of major depression, and several episodes of depression may occur before declaration of bipolarity, by virtue of a manic or hypomanic episode pre-bipolar depression.2,3 The mainstay of treatment for unipolar major depression is antidepressants. In contrast, antidepressant monotherapy is contraindicated in Bipolar I depression and must be used very cautiously in Bipolar II illness 4 with much concern for an unacceptable cost benefit ratio because of the risk of antidepressant induction of mania and rapid cycling increase in frequency of episodes as a consequence of antidepressants. 5. Hence treatment of the early depressive episodes of bipolar illness requires recognition of depression specific to bipolar disorder and appropriate choice of medication. 