Sunday, June 16, 2024

How To Beat Bipolar Depression

Listen To Soothing Music

Bipolar Disorder: Treatment and Preventing Relapse | Dr Patrick McKeon

The soothing power of music is well-established. It affects our emotions and can be an extremely effective stress management tool.

Soothing music can slow the pulse and heart rate, lower blood pressure and decrease the levels of stress hormones, and distract us from our worries. Research shows that listening to music can help a person with clinical depression or bipolar disorder get through their worst, lowest moods.

When people are feeling stressed and overwhelmed, there is a tendency to avoid actively listening to music. Perhaps because it feels like a waste of time when theres so much to do and to worry about. But adding music to our day is a small effort that can produce great rewards since our productivity actually increases when stress is reduced.

To incorporate music into a busy life, try playing CDs in the car, or listen while doing other necessary tasks like bathing or getting ready for the day. Take portable music with you when walking the dog, or listen to music instead of watching TV to wind down before bed.

Learn About Bipolar Disorder

If you are struggling with bipolar disorder, you are not alone. It is also important to know that there are resources available to help understand what you are experiencing and what to expect with treatment. If you struggle with bipolar disorder, you can ask your mental health professional questions, read books by and for people with bipolar disorder, and seek out articles about coping strategies for managing symptoms. Educating yourself is an important step in removing any potential shame or stigma around a bipolar diagnosis.

Treatment Of Alcohol And Substance Use Disorder

The commonest co-morbidity of bipolar disorder is alcohol or substance use disorder. Patients appear more likely to present with dysphoric manic states and so bipolar disorder should be considered in the differential diagnosis of such presentations. The co-morbidity is often present at the first episode.

It is now a clinical consensus that alcohol and substance use co-morbidity should not be seen as a secondary phenomenon that will remit with treatment of the bipolar disorder. The treatment of alcohol and substance use disorder should be planned in its own right. Contemporary approaches are summarized in another BAP guideline and will not be repeated at length here.

Thus, we support NICEs recommendation to Discuss the use of alcohol, tobacco, prescription and non-prescription medication and illicit drugs with the person, and their carer if appropriate. Explain the possible interference of these substances with the therapeutic effects of prescribed medication and psychological interventions.

It will be helpful to clarify the treatment target choosing from among assisted withdrawal, reduction, relapse prevention or maintenance of controlled drinking. In very heavy drinkers, even modest reductions in consumption will significantly reduce the potential physical harms.

It may be helpful also to specify caffeine use and treat its reduction as a valid target in sensitive patients.

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Recommended Fruits For Bipolar Disorder

Fruits can be a great way to get some natural sweetness in ones diet. However, people with bipolar disorder need to be careful with grapefruit. This citrus fruit tends to interact with many prescription drugs for bipolar disorder. The furanocoumarins interfere with the medications, causing higher concentrations than normal in patients blood. In terms of the best fruit for people with this condition, berries rank high. They contain lots of antioxidants that are good for brain, heart, and gut health. Plus, they mix well into a variety of breakfast recipes, desserts, and snacks. Bananas improve serotonin, which might help some patients.

Lamotrigine In Bipolar Depression Augmentation

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In various clinical trials lamotrigine use as an augmentation agent was explored for bipolar disorder with depressive episodes not responsive to typical mood stabilizers. In a randomized, double-blind, 7-week pilot trial, lamotrigine augmentation was compared with citalopram augmentation for bipolar I and II depression . Total MADRS score difference was significant for both lamotrigine and citalopram. compared lamotrigine, risperidone, and inositol in a 16-week, randomized, equipoise-stratified study in subjects with bipolar I or II disorder. Although no significant difference was found between groups for primary outcome, subjects in lamotrigine group remained in the randomized phase significantly longer compared to other groups. in an 8-week, multicenter, double-blind, randomized, placebo-controlled trial studied lamotrigine augmentation to lithium in non-lithium responding subjects, for treating bipolar depression. This study evaluated efficacy of lithium plus lamotrigine for the treatment of acute bipolar depression. MADRS score change was significantly different between groups. Further, subjects were more responsive in lithium plus lamotrigine treated group compared to placebo. In a recent study, reported that in treatment-resistant depressive plasma lamotrigine concentration of 12.7 mol/L may be a threshold for better therapeutic response.

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Early Treatment May Require Judicious Complex Combinations To Achieve And Maintain Remission

Many texts and treatment guidelines emphasize the use of monotherapy as a sufficient approach to bipolar disorder. However, in controlled studies of pharmacoprophylaxis, remission is rarely achieved with monotherapy, and more complex regimens typically need to be utilized and further studied. Viral load in HIV/AIDS cannot be reduced to negligible levels without triple antiviral therapy, and the complexity of pharmacological treatment required to maintain bipolar disorder patients requires further study. As in HIV/AIDS, more complex combination treatments targeting different transmitter systems may be required.

Comprehensive Treatment For Bipolar Disorder

A comprehensive treatment plan for bipolar disorder aims to relieve symptoms, restore your ability to function, fix problems the illness has caused at home and at work, and reduce the likelihood of recurrence.

A comprehensive bipolar treatment plan involves:

Medication. Medication is the cornerstone of bipolar disorder treatment. Taking a mood stabilizing medication can help minimize the highs and lows of bipolar disorder and keep symptoms under control.

Psychotherapy. Therapy is essential for dealing with bipolar disorder and the problems it has caused in your life. Working with a therapist, you can learn how to cope with difficult or uncomfortable feelings, repair your relationships, manage stress, and regulate your mood.

Education. Managing symptoms and preventing complications begins with a thorough knowledge of your illness. The more you and your loved ones know about bipolar disorder, the better able youll be able to avoid problems and deal with setbacks.

Lifestyle management. By carefully regulating your lifestyle, you can keep symptoms and mood episodes to a minimum. This involves maintaining a regular sleep schedule, avoiding alcohol and drugs, eating a mood-boosting diet, following a consistent exercise program, minimizing stress, and keeping your sunlight exposure stable year-round.

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The Programme Comprises Eight Modules:

  • What is bipolar disorder?
  • Relapse prevention and early intervention
  • Treatments
    • Free access to the eight online modules
    • Convenience and flexibility – participate in the programme when you want to
    • A “Personal Portfolio” of information you entered as you worked through the programme
    • Additional support via an online forum moderated by Bipolar UK

    Relapse Prevention Trial Designs

    Bipolar Moods: Treatment and Preventing Relapse | Dr Patrick McKeon

    These studies are required by The European Medicines Agency as proof of continuing efficacy for drugs shown to be effective in short-term studies of acute illness. They offer a further proof of acute efficacy since they take patients who have recovered while taking a particular active treatment and randomize to continue that treatment or be switched to placebo. If patients on placebo relapse to the same pole as the index episode, this is taken as further evidence that the drug worked acutely.

    If these studies are extended over one or even two years, there must be a point at which we can infer further that the drug-placebo difference represents prevention of new episodes. Since there is no clear discontinuity in the boundary between preventing relapse of the original episode and the prevention of new episodes, perhaps they are essentially different sides of the same coin? Relapse prevention studies have been interpreted in that way in previous BAP guidelines. However, it is recognized that much of the difference between active treatment arms and placebo are due to early events, and dropout rates tend to be very high. Retention of patients in a 1-2 year study may be as low as 10%. Hence, interpretation of such studies, except in relation to acute efficacy may be questionable.

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    Why Managing Bipolar Disorder Can Feel Overwhelming

    Approximately 5.7 million U.S. adults live with bipolar disorder annually. If youve spent years managing bipolar disorder symptoms without a diagnosis, youre not alone.

    The Depression and Bipolar Support Alliance also reports that the majority of people living with bipolar disorder go more than several years without a diagnosis, and some may manage symptoms on their own for up to 10 years.

    Managing bipolar disorder can feel overwhelming. Between mood episodes you may still experience an array of emotions, and there may be consequences to deal with in your relationships, finances, and professional life.

    There might be events or situations that trigger your symptoms. You might not know why you feel better or worse today than you did the day before.

    Thankfully, there are ways to help manage bipolar disorder day-in and day-out.

    Medication Treatment For Bipolar Disorder

    Most people with bipolar disorder need medication in order to keep their symptoms under control. When medication is continued on a long-term basis, it can reduce the frequency and severity of bipolar mood episodes, and sometimes prevent them entirely. If you have been diagnosed with bipolar disorder, you and your doctor will work together to find the right drug or combination of drugs for your needs. Because everyone responds to medication differently, you may have to try several different medications before you find one that relieves your symptoms.

    Check in frequently with your doctor. Its important to have regular blood tests to make sure that your medication levels are in the therapeutic range. Getting the dose right is a delicate balancing act. Close monitoring by your doctor will help keep you safe and symptom-free.

    Continue taking your medication, even if your mood is stable. Dont stop taking your medication as soon as you start to feel better. Most people need to take medication long-term in order to avoid relapse.

    Dont expect medication to fix all your problems. Bipolar disorder medication can help reduce the symptoms of mania and depression, but in order to feel your best, its important to lead a lifestyle that supports wellness. This includes surrounding yourself with supportive people, getting therapy, and getting plenty of rest.

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    What Legal Rights Does Someone With Bipolar Disorder Have At Work

    Legally, you dont have to tell your employer any of your health information, unless you could put others at risk.

    While generally people are more open today about discussing mental illness, theres still a stigma. Its not right, but people may treat you differently if they know you have a psychiatric condition and this may include the people you work with.

    On the other hand, there are many people who are understanding of mental health conditions and the challenges they can cause at work. For this reason, in some cases it can actually be helpful for you to share your bipolar diagnosis with your boss and the human resources department.

    If those who work with you are aware of your condition, they may be more likely to accommodate you in ways that will reduce your workplace stress and make your overall working experience more enjoyable.

    No one can discriminate you for living with bipolar disorder in the workplace. This is illegal.

    If you decide to tell your employer about your health condition, Mental Health Works and the National Alliance on Mental Illness have resources to help you have that conversation.

    Sometimes youll be able to find a great job by yourself but if youre having trouble, it can be very helpful for you to seek professional assistance.

    Some free and low-cost sources of help include:

    • vocational rehabilitation

    What Help And Resources Are Available For People Who Need Support Or Further Advice

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    GP or Psychiatrist

    The most important help out there is to talk to a doctor or mental health professional as this is the first step in identifying Bipolar Disorder. During this process, people may have a physical evaluation to rule out any other conditions which might be causing their symptoms. If no other illness is present, doctors conduct a comprehensive mental health evaluation.

    For more advice:

    • Bipolar UK

    Support Groups:

    It is important to know you are not alone. Having a support group sharing helpful ideas may help. Here are some of the support groups that people may consider:

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    Other Ways To Help Someone With Bipolar Disorder

    You can also support your loved one by:

    Learning about bipolar disorder. Learn everything you can about the symptoms and treatment options. The more you know about bipolar disorder, the better equipped youll be to help your loved one and keep things in perspective.

    Encouraging the person to get help. The sooner bipolar disorder is treated, the better the prognosis, so urge your loved one to seek professional help right away. Dont wait to see if they will get better without treatment.

    Being understanding. Let your friend or family member know that youre there if they need a sympathetic ear, encouragement, or assistance with treatment. People with bipolar disorder are often reluctant to seek help because they dont want to feel like a burden to others, so remind the person that you care and that youll do whatever you can to help.

    Showing patience. Getting better takes time, even when a person is committed to treatment. Dont expect a quick recovery or a permanent cure. Be patient with the pace of recovery and prepare for setbacks and challenges. Managing bipolar disorder is a lifelong process.

    The importance of support in bipolar disorder recovery

    People with bipolar disorder do better when they have support from family members and friends. They tend to recover more quickly, experience fewer manic and depressive episodes, and have milder symptoms.

    Sticking To A Treatment Plan

    Effectively managing bipolar disorder is the best way to reduce irritability and anger.

    Working with a doctor on a treatment plan that includes a combination of psychotherapy and medication is often the most effective way to manage bipolar disorder.

    Once both parties agree on a treatment plan, consistency is key. Sticking to treatments in the long-term may reduce how frequent or severe mood episodes are.

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    Be An Active Participant In Your Treatment

    When you receive treatment, make sure that youre playing an active role in whatever that plan is. Take the time to learn about the disorder, understand all the ways in which it impacts you and ask questions.

    A big part of figuring out how to deal with bipolar disorder is getting to know yourself. Learn more about your specific symptoms and see if you can identify any situations or triggers that you might need to avoid.

    Once you learn more about bipolar and yourself, you can be a collaborator along with your doctor or therapist to plan your treatment. Be someone who asks questions and shares your concerns. If you have a treatment provider you arent comfortable collaborating with or talking to honestly, its okay to find someone different who can be a better partner with you on your journey.

    What Are The Best Medications Treatments For Bipolar Depression

    Understanding bipolar disorder

    The best medications for bipolar depression are those that decrease symptoms of depression without inducing a manic or hypomanic episode. These medications can improve depression while keeping moods stable. Non-pharmaceutical treatments for bipolar depression have the same goals in mind, but additionally, they help people deal with the challenges, frustrations, and limitations of the disorder while developing coping skills to live well despite episodes of bipolar depression.

    Bipolar depression treatment is usually a long-term approach. Mood stabilization, symptom reduction, and the development of coping strategies is best done with a combination of medication and psychotherapy.

    Medication and psychotherapy are the primary approaches to treat bipolar depression however, other treatments exist that can augment medication and therapy. These include complementary treatments like light therapy, brain stimulation procedures, peer support, and lifestyle changes.

    Given the importance of medication in treating bipolar depression, lets look at some of the best medications, some which you or a loved one might be prescribed.

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    Stick To A Healthy Routine

    When you feel depressed, its easy to get into bad habits.

    You may not feel like eating even when youre hungry, or you may continue eating even when youre full.

    The same goes for sleeping. When youre depressed, youre more likely to sleep too little or too much.

    Unhealthy eating and sleeping habits can make your depression symptoms worse. So a healthy daily routine can make it easier to maintain good habits.

    Consider adopting these healthier habits:

    • Eat meals and snacks at set times throughout the day.
    • Increase your intake of vegetables, lean proteins, and whole grains.
    • Get seven to nine hours of sleep each night.
    • Wake up and go to bed at the same times every day.

    What Is The Number One Cause Of Depression

    Depression doesnt stem from a single source alone. As this study explains, theres no one pathway to it. Some factors that may increase your chances of developing depression include the chemical makeup of your brains, a history of depression in your family, and/or an experience of loss or death. Going through challenges or conflict in your life and having a history of abuse can also bring on depressive episodes. Some medical conditions cancer, Parkinsons disease, diabetes, chronic pain, ADHD and insomnia all have links to depression, as does substance use.

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