What Is The Outlook Of Bipolar Disorder
The prognosis for bipolar disorder is often poor unless its properly treated. Many people with bipolar disorder who receive appropriate treatment can live fulfilling and productive lives.
Bipolar disorder results in approximately nine years reduction in expected life span, and as many as1 in 5 people with bipolar disorder commit suicide. An estimated 60% of all people with bipolar disorder have drug or alcohol dependence.
This is why its essential to seek medical care and stay committed to treatment for bipolar disorder.
Regular and continued use of medication can help reduce episodes of mania and depression. By knowing how to recognize the symptoms and triggers of these episodes, theres a better chance for effective treatment and finding coping methods that may prevent long periods of illness, extended hospital stays and suicide.
What Is Bipolar Depression
Bipolar depression, or bipolar disorder , is a mental health condition that causes extreme mood swings such as emotional highs and lows .
When individuals become depressed, they may feel sad or hopeless and lose interest or pleasure in most activities. When their mood shifts to mania or hypomania, they may feel euphoric, full of energy, or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.
There are three types of bipolar disorder. All three types involve evident changes in mood, energy, and activity levels.
- Bipolar I disorder defined by manic episodes that last at least seven days or by severe manic symptoms that require immediate hospital care. Typically, depressive episodes occur as well
- Bipolar II disorder defined by a pattern of depressive episodes and hypomanic episodes but not the full-blown manic episodes that are typical of Bipolar I disorder
- Cyclothymic disorder defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least two years
Learn About Your Bipolar Disorder Medication
When starting a new medication, educate yourself about how to take it safely. Questions to ask your doctor about any new prescription include:
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Take The Bipolar Depression Test
When done, print the bipolar depression test and share the results with your doctor.
1. Do you experience extreme mood changes going from extremely happy to extremely sad?
Yes Sometimes No
2. Do you have anyone in your family who has been diagnosed with bipolar disorder?
Yes No
3. Do you experience periods where you feel any of the following :
Persistent sad, anxious or “empty” feelings Feelings of hopelessness and/or pessimism Feelings of guilt, worthlessness and/or helplessness Irritability, restlessness Loss of interest in activities or hobbies once pleasurable, including sex Fatigue and decreased energy Difficulty concentrating, remembering details and making decisions Insomnia, earlymorning wakefulness, or excessive sleeping Overeating, or appetite loss Thoughts of suicide, suicide attempts Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment
4. Have you ever experienced any of these symptoms for a period of at least one week?
Elevated mood Anger
What Is The Best Treatment For Bipolar Depression
Medical subject headings: Copyright
One of the challenges facing clinical psychiatry is how to treat bipolar depression effectively.1 Surprisingly, its neurobiology and rational decisions about its treatment remain somewhat of a mystery. Recent findings have even called into question the role of traditional antidepressants in bipolar depression when other classes of drugs may be more effective first-line treatments for this illness.2 Setting aside the thorny question of whether antidepressants induce manic switches or rapid cycling, it seems worthwhile to consider recent clinical studies and try to make sense of their implications for the neurobiology of bipolar depression.
Treating bipolar depression with antidepressants remains a popular option in clinical practice and published guidelines. Most clinicians choose the drug or class of drugs, usually selective serotonin reuptake inhibitors and bupropion, that is most effective and best tolerated.1 However, the recently published results from the STEP-BD project found no benefit to adding an antidepressant compared with placebo to a mood stabilizer in a large naturalistic sample of patients with bipolar I and II disorders.2 This intriguing finding certainly questions whether antidepressants, a common intervention for bipolar depression, are effective in the treatment of this remarkably disabling and difficult-to-manage condition.
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Preferred Reporting Items For Systematic Reviews And Meta
The current study relied on a scoping review approach. The current study is not intended as a comprehensive or systematic review of the literature. Therefore, the current study was not registered with international prospective register of systematic reviews .
All articles included in this review were accessed using PubMed, the Harrell Health Sciences Library or the NIH ClinicalTrails.gov database. This review considered for inclusion studies that were published at the time of the database search, printed in English and related to adult bipolar disorder.
What Are The Treatments For Bipolar Disorder
Bipolar disorder can be treated. It’s a long-term condition that needs ongoing care. People who have four or more mood episodes in a year, or who also have drug or alcohol problems, can have forms of the illness that are much harder to treat.
Treatment can make a huge difference. With a combination of things — good medical care, medication, talk therapy, lifestyle changes, and the support of friends and family — you can feel better. Bipolar disorder — or manic depression, as it is also still sometimes called — has no known cure. It is a chronic health condition that requires lifetime management. Plenty of people with this condition do well they have families and jobs and live normal lives.
Medication
Medication is the main treatment, usually involving the following:
-
Antidepressant-antipsychotic drugs, a combination of an antidepressant and a mood stabilizer
-
Anti-anxiety medications or sleep medicines, such as sedatives like benzodiazepines
It can take a while to find the right combination for you. You may need to try a few things before you and your doctor figure out what works best. Once you do, itâs important to stay on your medication and talk with your doctor before stopping or changing anything.
Women who are pregnant or breastfeeding should talk with their doctors about medications that are safe to take.
Psychotherapy, or “talk therapy,” is often recommended, too. There are several different types. Options can include:
Lifestyle changes may also help:
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Wellbutrin For Bipolar Disorder
Bipolar disorder is a challenging condition to live with because it is characterized by the opposite moods of mania and depression, both of which can be quite extreme and neither of which is optimal.
Antidepressants, including Wellbutrin, are widely used in managing depression in bipolar disorder. There are concerns when it comes to antidepressants and bipolar disease. One of these concerns is called phase switching, which is a shift in mood from depression to mania. This can be a serious problem because mania can result in impulsive or dangerous behavior. Studies show that Wellbutrin has the same risk of inducing phase shifting as that of most other antidepressants when it is used in bipolar disorder.
Wellbutrin may work to reduce depressive symptoms by inhibiting the reuptake of the neurotransmitters serotonin, dopamine and norepinephrine, and prolonging their action, which prevents depression.
How Can You Treat Bipolar Depression Effectively
One of the challenges facing clinical psychiatry is how to treat bipolar depression effectively. Surprisingly, its neurobiology and rational decisions about its treatment remain somewhat of a mystery. Recent findings have even called into question the role of traditional antidepressants in bipolar depression when other classes of drugs may be more effective first-line treatments for this illness.
Since finding the right drug and dose can be tricky, its important to work closely with a specialist and re-evaluate your medication regularly. Its also important to remember that taking medication is just one aspect of a successful treatment program. There are plenty of other steps you can take to manage your symptoms and even reduce the amount of medication required. Healthy lifestyle changes, self-help coping strategies, and exploring therapy are also important in coping with bipolar disorder symptoms and helping you live a full, productive life.
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What Are Bipolar Disorders
Bipolar disorder is a brain disorder that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic or depressive . People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.
People without bipolar disorder experience mood fluctuations as well. However, these mood changes typically last hours rather than days. Also, these changes are not usually accompanied by the extreme degree of behavior change or difficulty with daily routines and social interactions that people with bipolar disorder demonstrate during mood episodes. Bipolar disorder can disrupt a persons relationships with loved ones and cause difficulty in working or going to school.
Bipolar disorder is a category that includes three different diagnoses: bipolar I, bipolar II, and cyclothymic disorder.
People with bipolar I disorder frequently have other mental disorders such as anxiety disorders, substance use disorders, and/or attention-deficit/hyperactivity disorder . The risk of suicide is significantly higher among people with bipolar I disorder than among the general population.
Brain Stimulation Therapies For Treating Bipolar Disorder
If your condition doesn’t respond well to treatment with drugs, your doctor may recommend other treatments.
In ECT, your brain is treated with small electrical currents, which cause a short period of controlled seizure activity thats designed to affect the levels of certain neurotransmitters . ECT can be used to treat both manic and depressive episodes.
In TMS, small magnetic pulses are applied to your brain to stimulate nerve cells that control mood regulation. TMS is primarily used to treat depressive episodes.
Both of these approaches typically involve multiple treatments.
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Symptoms Of Bipolar Depression
According to Dr. Daramus, someone who is experiencing an episode of bipolar depression may have all the symptoms of major depressive disorder .
The symptoms of bipolar depression may include:
- Feelings of sadness
- Changes in appetite and weight
- Insomnia or hypersomnia
- Thoughts of self-harm or suicide
A depressive episode can last for several days or weeks and the person may experience symptoms every day, for most of the day.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
Is Lithium Safe For Everyone
Lithium is safe to take if youre under a doctors close supervision and if youre in a stable environment where you can take the medication consistently.
Although lithium the metal is often used to make batteries, the lithium carbonate used in lithium drugs has a different ionic charge. Your body absorbs lithium in a similar way to how it absorbs sodium, which is also an alkaline metal.
Lithium is not safe for children under the age of 7 or for pregnant or breastfeeding women. Lithium is also not safe if you have the heart condition Brugada syndrome.
Lithium can interact with quite a long list of medications, including many other psychotropic drugs. Discuss all medications youre taking, including over-the-counter drugs and supplements, with your doctor.
Dosing for lithium varies according to your age, weight, and medical history. This medication should be taken with care, and only according to your doctors specific instructions.
Oral lithium comes in capsules, a liquid solution, and extended-release tablets.
It can take several weeks for lithium to start to take effect when using it to treat bipolar depression. A standard dose of oral lithium for an adult is 600900 milligrams, taken two or three times per day.
To protect you from side effects and make sure youre not getting too much medication, your doctor will draw blood to monitor your lithium levels.
- excessive drowsiness
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Is Electroconvulsive Therapy A Viable Treatment For Bipolar Depression
Guidelines from the American Psychiatric Association suggest that ECT is an appropriate and sometimes preferred treatment for depressed bipolar patients who have psychotic symptoms or a very high risk for suicidal behavior. In addition, ECT may benefit women who are pregnant and suffer with severe bipolar depression or mania.
Medicine For Bipolar Disorder
Several medicines are available to help stabilise mood swings.
These are called mood stabilisers and include:
- anticonvulsant medicines
- antipsychotic medicines
If you’re already taking medicine for bipolar disorder and you develop depression, your GP or specialist will check the dose. If you are not taking the right dose, they may change it.
Episodes of depression are treated slightly differently in bipolar disorder. This is because the use of antidepressants alone may lead to a hypomanic relapse. If you are given antidepressants, these are often used alongside a mood stabiliser.
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How Does Lamotrigine Work
Lamotrigine delays the time between mood changes and manic or depressive states in people with bipolar disorder by decreasing the intensity of irregular electrical activity in the brain. People with bipolar disorder are at high risk of experiencing recurrent and relapsing episodes of mood change. Maintenance treatment with lamotrigine helps reduce the risk by preventing or delaying these recurrences and relapses.
Many clinicians think that lamotrigine helps achieve and sustain even moods over time by virtue of its antidepressant properties, rather than anti-manic properties, says Dr. Goldberg. It works with mood stabilizers like lithium and divalproex, but its not interchangeable with these drugs and cannot be used in their place.
Also, the efficacy of lamotrigine appears to be similar to the effects of lithium yet is better tolerated compared to lithium.
Lamotrigine is used over time as a preventative medication. Clinical trials that looked at lamotrigines potential for treating acute episodes of mania found no difference between the medication and placebo. ²
Medication For Bipolar Versus Unipolar Depression
How are bipolar and unipolar depression different?
Bipolar disorders are a group of disorders characterised by episodes of depression and mania or hypomania. Bipolar disorders described in the DSM-5 include bipolar I disorder involving severe depression and mania, bipolar II disorder involving depression and hypomania , and cyclothymic disorder involving many mood swings, with hypomania and depressive symptoms occurring often and fairly constantly.
Major depressive disorder characterised in the DSM-5 involves five of the following symptoms to be present and represent a change from previous functioning. At least one of the symptoms must be either depressed mood or loss of interest or pleasure, with no history of mania. Depressed mood most of the day, nearly every day Diminished interest/pleasure in all, or almost all, activities most of the day, nearly every day A change of more than 5% of body weight in a month or decrease/increase in appetite Insomnia or hypersomnia
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Proven Pharmacological Treatment Options
Despite the devastating impact of bipolar depression on life, there has been a dearth of knowledge about its underlying etiology and the development of therapeutic strategies especially in its acute phase . Today, we only have three different approved agents to choose from: OFC, quetiapine , and lurasidone . Table 2 summarizes the proven studies of above three agents in acute bipolar depression .
Medication For Bipolar Disorder
NYU Langone psychiatrists often prescribe medication to manage bipolar disorder as well as coexisting mental health conditions, such as attention deficit hyperactivity disorder, or ADHD. Our experts choose a medication based on your symptoms.
Schedule an Appointment
Medication can be a short or long term treatment option for bipolar disorder, depending on your symptoms and response to treatment. Often, medication is used in conjunction with behavioral therapy or psychotherapy. A medication consultation with an NYU Langone psychiatrist enables you to ask questions about your treatment and discuss any concerns.
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Bipolar Disorder Medication Alone Is Not Enough
Bipolar medication is most effective when used in combination with other bipolar disorder treatments, including:
Therapy. People who take medication for bipolar disorder tend to recover much faster and control their moods much better if they also get therapy. Therapy gives you the tools to cope with life’s difficulties, monitor your progress, and deal with the problems bipolar disorder is causing in your personal and professional life.
Exercise.Getting regular exercise can reduce bipolar disorder symptoms and help stabilize mood swings. Exercise is also a safe and effective way to release the pent-up energy associated with the manic episodes of bipolar disorder.
Stable sleep schedule. Studies have found that insufficient sleep can precipitate manic episodes in bipolar patients. To keep symptoms and mood episodes to a minimum maintain a stable sleep schedule. It is also important to regulate darkness and light exposure as these throw off sleep-wake cycles and upset the sensitive biological clock in people with bipolar disorder.
Healthy diet.Omega-3 fatty acids may lessen the symptoms of bipolar disorder. Weight gain is a common side effect of many bipolar medications, so it’s important to adopt healthy eating habits to manage your weight. Avoid caffeine, alcohol, and drugs as they can adversely interact with bipolar medications.
When To Contact A Doctor
A person should contact a doctor if they are experiencing worsening symptoms or side effects when taking medication for bipolar disorder.
The doctor may make occasional adjustments by changing a medication or reducing the dose to manage severe side effects. They will also monitor how a persons symptoms improve with each adjustment.
If a person does not see immediate changes after starting treatment for bipolar disorder, they do not need to worry. It may take a while for them to start seeing significant improvements.
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