Bipolar Vs Anxiety And Depression

Using Antidepressants To Treat Bipolar Disorder

Knowing which treatments are appropriate for certain conditions is essential with bipolar and major depression. For example, selective-serotonin reuptake inhibitor antidepressants are deemed safe and effective for treating major depression. They can also be used totreat bipolar disorder, though only in limited situations, due to the potential for triggering emergent manic episodes.

What Are The Signs And Symptoms Of Depression

Signs and symptoms of depression can vary from mild to severe. You can have some days where symptoms are more intense than others. A depressive episode generally has at least 5 or more symptoms, and they can last most of the day for weeks at a time . If youre depressed, you may experience feelings of:

• Intense sadness

Do These Symptoms Sound Familiar

Generalized Anxiety Disorder symptoms include worrying very much about everyday things, knowing you worry much more than you should, having trouble controlling the constant worries, not being able to relax, having trouble concentrating, being easily startled, having trouble falling asleep or staying asleep, feeling tired all the time, having a hard time swallowing, trembling or twitching, having to go to the bathroom a lot, being irritable, sweating a lot, feeling light-headed or out of breath and having headaches, muscle aches, stomach aches or unexplained pains.

Phobias are strong, irrational fear of something that poses little or no actual danger. Being anxious and extremely self-conscious in everyday social situationssuch as eating or drinking in front of peopleare signs of a social phobia. People with phobias try to avoid what theyre afraid of, such as heights, public places, water or flying if they cant, they may experience panic, fear, rapid heartbeat, shortness of breath, trembling and a strong desire to get away.

Panic disorder is indicated by sudden and repeated attacks of fear that last for several minutes or longer. These panic attacks bring a fear of disaster or of losing control even when there is no real danger. A person may also have a pounding or racing heart, breathing problems, weakness or dizziness, tingly or numb hands, chest pain, stomach pain or feel hot or a cold chill. Panic attacks can occur at any time.

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Adding An Anxiety Diagnosis To Bipolar Can Feel Like Bad Newsbut Its A Key Step Toward Real Relief

Dave has been through the unshakable weight of depression and the reckless risk-taking of mania. But he says the sudden panic of anxiety is worst of all. Its been a constant in his life as far back as high school, when he remembers freezing in place at the chalkboard in algebra, unable to write the answer to an equation as sweat beaded up.

Rebecca was diagnosed with bipolar at age 21, but her persistent worrying began a decade earlier. Among other things, she was afraid her single mother couldnt afford rent and foodto the point that the youngster spent the allowance her father gave her on milk and eggs. Rebeccas internalized anxieties translated to sleepless nights, painful stomachaches, and bowel problems.

Alan not only couldnt open his mouth around girls in middle school, but his social phobia made him so panicky hed have to leave. I felt like I was crawling out of my skin, he recalls. He turned to street drugs in high school, which he says made everything worse. After two decades in treatment, discovering that he has bipolar as well as an anxiety disorder made a real dent in his symptoms.

Research indicates that more than half of people with bipolar disorder also have an anxiety disorder. Often the anxiety strikes first, suggesting that it could be a risk factor for developing bipolar, says Regina Sala, MD, PhD, of Columbia University.

After 45 years of therapy, he says, I consider myself a coach for the mentally ill.

Anxiety By The Numbers

• Three out of four people with bipolar disorder also had another psychiatric illness, most commonly an anxiety disorder, according to an international study of more than 50,000 adults published in 2011 in Archives of General Psychiatry.
• The study found that most people affected werent in regular contact with mental health professionals, which suggested a lack of appropriate treatment, concluded lead researcher Kathleen Merikangas, PhD, a researcher with the U.S. National Institute of Mental Health.
• A 2012 study led by Regina Sala, MD, PhD, found that among 1,600 patients with bipolar disorder, 60 percent had symptoms of at least one anxiety disorder during their lifetime, and 40 percent had two or more anxiety disorders.

Printed as The Tension Tango,Fall 2012

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Risk Factors For Depression And Bipolar Disorder

Anyone can have depression. You may be at an increased for it if you have another serious illness or if theres a family history of depression. Environmental and psychological factors may also increase your risk.

The exact cause of bipolar disorder is unknown. However, youre more likely to have it if someone else in you family does. The symptoms usually become noticeable during adolescence or early adulthood, but it can appear later in life.

If you have bipolar disorder, youre at increased risk of:

• substance abuse

Depression Anxiety & Bipolar Disorder

Know the Difference

Life events, relationships, job stress, financial or family problems affect us in many ways. Oftentimes these issues can be triggers for anxiety or depression. If these feelings become extremely intense and impact everyday life or our quality of life, it can become very hard to address the issues that prompted these feelings to begin with.

Sometimes being depressed can cause anxiety and the reverse is also true. Feeling anxious can cause depression if your anxiety is getting in the way of your activities. There can also be an underlying cause such as bipolar disorder. So how do you sort through your feelings to determine how best to deal with them?

The first steps in seeking treatment are to acknowledge your feelings, determine if you can, what triggers the feelings and being open and candid with a professional you trust. Your general practitioner may be able to do an evaluation or recommend a psychiatrist or psychologist specially trained in these areas. It is important that your practitioner sees you regularly to determine if the medication prescribed is right for you. A visit with your provider frequently would be reasonable and effective depending on the severity of your symptoms.

Symptoms of Depression

• Persistently feeling sad, anxious or empty
• Feelings of hopelessness like theres no way out
• Lack of interest in activities you would usually enjoy
• Difficulty sleeping, concentrating, focusing
• Changes in your appetite or weight

Symptoms of Anxiety

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Anxiety As A Symptom Of Bipolar Disorder

What is the anxiety of bipolar disorder like? Patients describe it as agitation, and sometimes that is quite obvious: their foot bounces on the floor while we talk they pick at their nails sometimes they cant even bear to sit still and will get up and pace around the office during our interview. But sometimes the agitation is only inside: patients experience too much energy inside my skin, like theyre going to explode, and usually their thoughts are going very fast . However, when this is severe, people may not experience that fast thinking, but instead just an extremely disorganized thinking not being able to keep their mind on one thing for more than a few seconds, not being able to accomplish anything. Of course that can make anxiety worse as people recognize that they are really ill with something that is not obvious to anyone else, yet they are not really functioning either. How do you explain that to someone?

When this kind of anxiety is present with other manic symptoms like irritability, it can create an awful experience people feel desperate to get out of. Fortunately there are very good medication approaches to this which can help within an hour. Olanzapine/Zyprexa has a special role here, in my view.

Symptoms Of Bipolar Disorder

Bipolar disorder has three different variations: bipolar I, bipolar II, and cyclothymia. Bipolar disorder exists on a spectrum.

Bipolar I is defined by the following symptoms:

• Periods of experiencing mania for at least one week. Mania is marked by feelings of elation, grandiosity, irritability, and/or extreme energy
• The disturbance is sufficient to cause marked impairment or require hospitalization
• Depressive episodes generally occur along the course of the illness

Remember, you dont have to experience all of these symptoms to experience bipolar I.

Bipolar II is defined by the following symptoms:

• Hypomania, which consists of less pronounced mania symptoms, for at least 4 days
• Intermittent depressive episodes that last for at least two weeks and severely impact daily functioning

Cyclothymia is defined by the following symptoms:

• Experiencing hypomanic symptoms that do not constitute a hypomanic episode over a 2-year period
• Experiencing depressive symptoms that do not constitute a major depressive episode over a 2-year period

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What Is The Difference Between Depression And Bipolar Disorder

Depression and bipolar disorder are two mood disorders that have many similarities. However, they have key differences that are essential to understand for the sake of effective treatment.

Mental health is becoming more of a mainstream topic, an incredible advancement that normalizes the experiences of many. As such, isnt uncommon to hear someone say theyre feeling depressed.

However, clinical depression, also known as major depressive disorder, isnt just feeling sad. It is a persistent feeling of hopelessness and emptiness, losing interest in things that used to excite you, and several other symptoms including changes in sleep, appetite, and thinking.

• Persistent feeling of hopelessness and emptiness

• Changes in appetite, sleep, thinking

• Significant fatigue

• May cause impairment or require hospitalization

• May have feelings of extreme energy when manic

Similarly, some may casually say theyre bipolar because theyre feeling a wide range of moods. But bipolar disorder is marked by episodes of mania or hypomania and depression that significantly impact your life.

Read on to learn more about the symptoms, causes, and treatment for these two disorders.

Does Anxiety Cause Manic Episodes

Theres no evidence to suggest manic episodes are directly caused by anxiety, though the two states can have similar symptoms of agitation and hypervigilance.

They may be so similar it can be challenging to differentiate if the symptoms youre experiencing are anxiety versus bipolar disorder mania.

While anxiety may not cause mania, insomnia regularly seen among those living with an anxiety disorder is considered to be a significant trigger for mania episodes.

Research from 2016 has also noted that folks may be just as likely to experience anxiety after a manic episode as they are preceding a depressive episode.

Anxiety disorders are characterized by persistent, excessive anxiousness and fear almost every day for at least 6 months.

How your symptoms present can differentiate between which type of anxiety you may be experiencing.

The most common anxiety disorders include:

Living with bipolar disorder suggests you experience extremely high and low mood shifts.

Elevated, agitated moods are known as episodes of mania, or, in a less severe form, hypomania.

Low moods are categorized as periods of depression.

The three primary forms of bipolar disorder are:

Managing anxiety and bipolar disorder often requires the guidance of a mental health professional.

A clinician can help determine the best course of treatment for both conditions symptoms.

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Therapy For Anxiety And Bipolar Depression

Therapy, both individual and family, is helpful in bipolar depression and anxiety treatment. Individual therapy lets you address challenges and create coping skills. Family therapy does this, too, but its done as group therapy with the entire family present. Both help people improve the quality of their lives. Some types of therapy that have been shown to help include:

• Relaxation training
• Interpersonal and Social Rhythm Therapy

Medication and therapy are effective treatment approaches for managing bipolar depression with anxiety. While finding the right treatment isnt always a quick, easy process, it is possible to do so. You can minimize the effects of these disorders and live a quality life.

Anxiety And Bipolar Depression: Treatment Options That Work

Each person dealing with bipolar depression and anxiety is unique. A treatment approach that works for one person might not work at all for another. While there isnt a single treatment that works for everybody, there is something for almost everyone. Its a matter of knowing and considering your options and working with your doctor to find the most effective approach to your mental health.

Effective treatment options for bipolar depression with anxiety include:

• Depression and anxiety medication, often a combination of different prescriptions
• Individual therapy

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The Importance Of Diagnostic Accuracy

Getting an accurate diagnosis has significant implications for treatment, and the appearance of some symptoms can be complex and misleading. For certain diagnoses, such as bipolar disorder, long observation periods and deeper investigation are needed to reveal complete symptomatology.

Some researchers have hypothesized that bipolar disorder is oftenmisdiagnosed as major depression, which accounts for a significant number of individuals resistant todepression treatments. Studies have revealed between43.9%57.4% of individuals diagnosed with major depression screened positively for mania symptoms, a primary feature of bipolar disorder. Given these odds, potential misdiagnosis can present a significant problem when considering treatment.

Using a treatment that is not recommended for a specific diagnosis may lead to less-than-ideal results and prolong the treatment process. But more importantly, some treatments may not be recommended because of safety issues, lack of adequate research support, or they may not have completed clearance or approval processes. Understanding these risks can help reduce unnecessary adverse impacts.

New Insights Into Major Depression And The Treatment Of Bipolar Depression

Finally, we conclude with three letters to the Editor that raise some concerns related to a paper that was published in the Journal earlier this year that reviewed the evidence for the use of ketamine and esketamine in treatment-resistant depression . These editorials, along with the response by Dr. Roger McIntyre , provide a lively back-and-forth on various issues relevant to the use of ketamine and esketamine. The concerns that were brought up include questioning where ketamine fits into the sequence of treatments for treatment-resistant depression, the importance of underscoring the abuse potential of ketamine, and the relative binding affinities of ketamine to mu opioid, NMDA, and kappa opioid receptors, since this may relate to ketamineâs mechanisms of action.

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Am I Bipolar Or Depressed

• Reducing Misdiagnosis

Bipolar disorder and depression share many of the same symptoms, but there are several key differences between the conditions. Depression and bipolar disorder are two distinct conditions that need to be treated differently.

It’s very important that a person gets the correct diagnosis so they can receive proper treatment. Unfortunately, it can be difficult to tell the difference between the conditions, and misdiagnosis can happen.

Difference Between Anxiety And Bipolar

Key Difference: Anxiety is a response to a stressor. It is a feeling of fear, unease, and worry. It can be rooted in any event that makes one feel frustrated, angry, or nervous. Bipolar disorder is a condition in which people experience extensive mood swings. A person may start of being happy and then go quickly to becoming sad or depressed.

Anxiety and Bipolar are two different types of medical conditions. Anxiety is the fear of certain situations or stress encountered during various circumstances, while bipolar is a disease that causes extensive mood swings. Though sometimes anxiety can occur in bipolar disorder, it is not always associated with that particular disease.

Anxiety is a response to a stressor. You feel anxious when you are stressed, for example when you have to take a test or give an interview, etc. Anxiety is a feeling of fear, unease, and worry. It can be rooted in any event that makes one feel frustrated, angry, or nervous. In small doses, it is healthy and useful, as it makes one alert and able to deal with the stressor. Usually when the stressor is removed or it is dealt with, the anxiety ends, sometimes it doesnt, which can lead to anxiety disorders. There are various different types of anxiety including existential anxiety, test and performance anxiety, stranger and social anxiety, generalized anxiety, trait anxiety, choice or decision anxiety and paradoxical anxiety.

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Bipolar Disorder And Depression

Bipolar disorder and major depressive disorder are mental health conditions that share some similar features. In some cases, people may confuse the two. However, they are separate disorders that require different treatment approaches.

Some of this misunderstanding may be attributed to the term bipolar depression, which is a name given to the depressive episodes that are a part of bipolar disorder. To understand the difference between bipolar and depression, each disorder must be examined on its own. Once a person understands both disorders separately, it becomes easier to identify differences between bipolar and depression.

Causes Of Bipolar Disorder

The exact cause of bipolar disorder is still unknown, however, there are risk factors that are known to make the development of bipolar disorder more likely.

A risk factor is something that increases the likelihood of developing a condition. First, bipolar disorder is known to have a strong genetic link, meaning if you have a history of bipolar in your family, you are at a higher risk for developing the disorder.

Childhood trauma can increase the risk of developing bipolar disorder to some degree. Stressful life events, like having a child or losing a parent, may be a trigger for a bipolar episode. Finally, bipolar disorder often co-occurs with substance use disorders.

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