How To Treat Bipolar Depression

Is Bipolar Disorder Ever Considered Cured

This is not clear at this time. Although the condition responds to treatment in most cases, bipolar disorder is generally seen as a chronic disease that may come and go for many years.

Your child will need to follow the treatment plan outlined by her care team, and any changes should be carefully discussed among all members of her treatment team.

What Medication Is Best For Bipolar Depression

For patients with bipolar disorder, medication will likely be a part of ones treatment plan. Medication can bring mania and depression under control and prevent relapse once mood has stabilized. As people with diabetes need to take insulin to stay healthy, taking medication for bipolar disorder helps maintain a stable mood.

Treatment for bipolar depression has come a long way in a short while. Not so long ago, patients were given sedatives and medications with numerous side effects. Today, mood-stabilizing drugs are a mainstay treatment for bipolar disorder. Doctors may prescribe lithium, an antimanic drug, or an antipsychotic drugor a combination of bothto alleviate symptoms of depression without triggering a manic episode.

Natural Therapies For Bipolar Depression

When combined with prescribed medication, these alternative approaches may help you better manage the symptoms of bipolar disorder.

Bipolar disorder requires managing two distinct categories of symptoms. Manic symptoms may include impulsive behavior, excessive irritability, and anxiety, while depressive symptoms may include a low mood, poor appetite, and emotional indifference, according to the National Institute of Mental Health. Though there aren’t many complementary or alternative medicine remedies for manic behavior, a few non-prescription therapies may help alleviate depression. Most people who have bipolar disorder spend the majority of their time depressed rather than manic, notes the National Institutes of Health.

But just because CAM therapies exist doesn’t mean that people with bipolar disorder should throw away their antidepressants. “Bipolar is a very serious, lifelong disorder,” says Philip Muskin, MD, professor of psychiatry at Columbia University Medical Center in New York City. “If you need an antidepressant, you should take it. These other types of therapies are additional or complementary rather than alternative.”;

The complementary and non-pharmacological treatments that have shown some benefit for the depressive side of bipolar disorder are:

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Masterclass: How To Treat Treatment

This masterclass is for the layperson who has to deal with the realities of bipolar depression treatment either as a patient or as one who cares about a patient. Treatments from medication to psychotherapy to neuromodulation therapies will be covered. Time will also be set aside for a live question-and-answer session.

When you leave this masterclass, youll be able to identify the standard treatments for bipolar depression and outline the treatments that are used for harder-to-treat cases. This masterclass is for honest and open talk about bipolar disorder lets get real about bipolar disorder.

If youre having a hard time with your bipolar depression treatment, this masterclass is for you.

Finding The Right Bipolar Disorder Medication

It can take a while to find the right bipolar medication and dose. Everyone responds to medication differently, so you may have to try several bipolar disorder drugs before you find the one that works for you. Be patient, but dont settle for a bipolar medication that makes you feel lousy, either.

Once youve discovered the right bipolar disorder drug or drug cocktail, it may still take time to determine the optimal dose. In the case of mood stabilizing medications such as lithium, the difference between a beneficial dose and a toxic one is small. Frequent office visits to re-evaluate your medication needs and careful monitoring of symptoms and side effects will help you stay safe.

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What Are The Symptoms Of Bipolar Disorder

The changing mood states do not always follow a set pattern, and depression does not always follow manic phases. A person may also experience the same mood state several times before experiencing the opposite mood. Mood changes can happen over a period of weeks, months, and sometimes even years.

An important aspect of the mood changes are that they are a departure from the persons regular self and that the mood change is sustained for a long period of time. It may be many days or weeks in the case of mania and many weeks or months in the case of depression. Shorter periods of mania or depression may be an indicator of more severe episodes in the future but are usually not enough to diagnose a person with bipolar disorder.

The severity of the depressive and manic phases can differ from person to person and in the same person at different times. Symptoms of mania include:

• Excessive happiness, hopefulness, and excitement
• Sudden changes from being joyful to being irritable, angry, and hostile
• Restlessness
• Rapid speech and poor concentration
• Increased energy and less need for sleep
• High sex drive

Patients with depression can also become psychotic and hear things or have delusions.

Family And Psychosocial Issues

• References

Significant issues for the patient and family members include the stigma that is frequently associated with mental illness and the need for support and education. Because patients with bipolar disorder lose judgment early in the course of the illness and often engage in high-risk behavior, family members may be interacting with the legal system, the police and the health care system simultaneously. Guilt, anger, grief and ambivalence are frequent feelings among family members as they cope with the difficulties.

Family members must be educated about possible relapses, what to look for and how to handle different situations. The recklessness that accompanies mania can have devastating consequencesincluding sexually transmitted diseases, financial ruin, traumatic injuries and accidents. Risk-taking causes significant distress to patients and families, and such behavior is a problem for which family physicians, psychiatrists and mental health professionals can intervene with appropriate medical, preventive, educational and social strategies .23 Initial intervention includes education for the patient and family, including informational pamphlets, videos and involvement in support and patient advocacy groups.

Psychosocial Issues to Address in the Acute and Maintenance Phases of Bipolar Disorder

Acute phase

Adapted with permission from Steering Committee. Treatment of bipolar disorder. The Expert Consensus Guideline Series. J Clin Psychiatry 1996;57:388.

Acute phase

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Who Experiences Bipolar Disorder

Bipolar disorder usually begins in older teens and young adults, with at least half of all cases appearing before age 25. Children and adolescents, however, can develop this disease in more severe forms and often in combination with attention deficit hyperactivity disorder . Some studies have indicated that bipolar depression is genetically inherited, occurring more commonly within families.

While bipolar disorder occurs equally in women and men, women are more likely to meet criteria for bipolar II disorder. Women with bipolar disorder may switch moods more quickly this is called “rapid cycling.” Varying levels of sex hormones and activity of the thyroid gland in the neck, together with the tendency to be prescribed antidepressants, may contribute to the more rapid cycling seen in women. Women may also experience more periods of depression than men.

An estimated 60 percent of all people with bipolar disorder have drug or alcohol dependence. It has also been shown to occur frequently in people with seasonal depression and certain anxiety disorders, like post-traumatic stress disorder .

What About Psychotherapy For Help With Bipolar Depression

Along with medications for bipolar depression, patients may benefit from ongoing psychotherapy. This one-on-one therapy combines interpersonal psychotherapy with behavioral techniques to help patients learn how to more effectively manage interpersonal problems, stay on their medications, and normalize their lifestyle habits. The STEP-BD study mentioned earlier found that in addition to medications, adding a structured psychotherapy — such as cognitive behavioral therapy, interpersonal/social rhythm therapy, or family-focused therapy — can speed up treatment response in bipolar depression by as much as 150%.

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What Is The Best Treatment For Bipolar Depression

Medical subject headings:

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. 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. 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. 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.

Are Antidepressants Used To Treat Bipolar Depression

While antidepressants are effective treatment for people with major depressive disorder, they are not always as effective for bipolar depression, and generally should not be given alone in people with bipolar I disorder. When antidepressants are given alone to someone with bipolar disorder, there’s a risk the drug might ignite a manic episode in some patients. Knowing this, most doctors may avoid using antidepressants as monotherapy for bipolar depression.

A very large randomized study sponsored by the National Institute of Mental Health called the Systematic Treatment Enhancement Program for Bipolar Disorder showed that mood stabilizers alone produced a stable improvement only in about 1 in 4 people with bipolar depression, and surprisingly, adding an antidepressant to the mood stabilizer did not boost improvement further. The STEP-BD study underscored the need to find treatments other than mood stabilizers or antidepressants for bipolar depression.

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Facts About Manic Depression

• 5.7 million American adults have bipolar disorder, according to the National Institute of Mental Health.
• Manic depression/bipolar disorder usually appears in the late teens and early adult years . Its much rarer among children and those over 65 years old.
• At least half of all cases of manic depression start before age 25, although for some children symptoms can appear before the teenage years.
• Normally this condition persists through someones lifetime, especially if the person;doesnt seek treatment, but symptoms can be well-managed through lifestyle changes, therapy and sometimes medication.
• Up to 90 percent of people with manic depression have to be hospitalized at some point, especially those not managing their symptoms well; 75 percent need to be hospitalized at least two to three times.
• Bipolar disorder can sometimes be confused with anxiety disorders, clinical depression, schizophrenia and even learning disabilities like ADHD .
• Research shows that between 19941995 and 20022003 in the U.S., there was an;increase in doctor office visits regarding manic depression of nearly 40-fold for children! Adult visits also doubled during this time.

What Else You Can Do

Treatment for bipolar disorder most often requires a multiprong approach, said Dr. Samuel. Along with taking your medications and attending regular therapy sessions, things like establishing a healthy sleep schedule and cutting down or eliminating drug and/or alcohol use can help.

Lifestyle changes like adding regular aerobic exercise may lessen depression and anxiety in some people. Anaerobic exercisesuch as weightlifting, yoga, and Pilatesmight also help reduce stress, which can trigger mood swings.

Tracking your moods, treatments, sleep patterns, and life events can help you and your health care providers treat your bipolar disorder over time. Smartphone apps that collect self-reports, self-ratings, and activity data, can easily be shared with therapists and health care providers. Information about your feelings, mood swings, anxiety, and depression can help you and your doctor identifies triggers and patterns that can help treatment.Among some of the best apps are:

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How Do The Cns Depressants Help With Bipolar Disorder Depression

Central nervous system depressants, which include the benzodiazepines, act on neurotransmitters to slow down normal brain function. CNS depressants are commonly used to treat anxiety and sleep disorders and may be an effective alternative or adjunctive therapy in some bipolar patients with acute mania.

Some commonly used benzodiazepines include clonazepam , lorazepam , alprazolam , and diazepam . These drugs all can be addictive and can cause sluggish thinking. They generally should be used only to treat agitation or sleep problems during the acute phase of the illness and not as long-term medications. They typically should be tapered off rather than stopped abruptly, in order to minimize the risk of drug withdrawal.

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

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What Is Bipolar Disorder

Bipolar disorder, also called “manic-depressive” disease, is a mental illness that causes people to have high and low moods. People with this illness have periods of feeling overly happy and joyful or of feeling very sad or feeling normal. Because of the highs and the lows or two poles of mood the condition is referred to as “bipolar disorder. However, patients moods may not necessarily follow a cyclic pattern, and sometimes the highs and lows can be experienced at the same time . The hallmark of bipolar illness is the occurrence of the manic episode. In fact, by definition, to meet the criteria for bipolar disorder, patients must have at least one manic episode in their lifetime with or without ever experiencing a depressive episode.

The word hypomania or manic describes the periods when the person feels overly excited and confident. These feelings can quickly turn to confusion, irritability, anger, and even rage. The word depressive describes the periods when the person feels very sad or depressed. Because the symptoms are similar, sometimes people with bipolar depression are incorrectly diagnosed as having major depression. This is why it is especially important to screen for mania.

Most individuals with bipolar disorder spend three times the amount of time in depressed phases than in manic phases.

Bipolar Depression With Anxiety: What Treatments Work

Bipolar depression with anxiety is a common combination. About 75 percent of people with bipolar II disorder have at least one anxiety disorder . Anxiety disorders like generalized anxiety disorder , social anxiety disorder, and panic disorder are the most common disorders that occur alongside bipolar II disorder; further, symptoms of these anxiety disorders are more likely to flare during a period of bipolar depression than an episode of mania. Given that bipolar depression with anxiety occurs quite frequently, its important to know more about these conditions, how this combination can affect people, and what treatments work. ;

Anxiety greatly influences someones experience with bipolar depression, including the symptoms they experience and how they respond to treatment. Both disorders worsen each other. Episodes of depression and anxiety are longer and more severe than when they occur on their own. The long-term outlook is worse, too, largely because it can be harder to treat comorbid anxiety and bipolar depression.

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Bipolar Depression With Anxiety: Symptoms And Effects

Bipolar depression and anxiety bring out the worst in each other, making things very difficult if you are dealing with both conditions. As a result, you might experience symptoms like heightened worry and fear, anxiety attacks, and more severe depression.

These two co-occurring disorders create undesirable effects that interfere in life, such as:

• Avoiding people, situations, and events that increase anxiety
• Deepened depression due to isolation created by anxious avoidance
• A dark view of the world because of depressions negative thought patterns
• Increased worry, fear, and agitation because of this dark worldview
• Increased likelihood of substance abuse
• Suicidal ideation, action

Anxiety disorders are difficult to live with. So, too, is bipolar depression. Unfortunately, when they occur together, treatment is more difficult than it is for each one separately. While difficult, its not impossible. Treatment is available, and with patience, you can find the right approach for your bipolar depression with anxiety. ;

How Does It Affect People

Bipolar disorder affects both men and women. For many people, the first symptoms show up in their early twenties. However, research has shown that the first episode of bipolar disorder is occurring earlier: It often shows up in adolescence, and even children can have the disorder.

Recent research suggests that kids and teens with bipolar disorder don’t always have the same behavioral patterns that adults with bipolar disorder do. For example, kids who have bipolar disorder may experience particularly rapid mood changes and may have some of the other mood-related symptoms listed below, such as irritability and high levels of anxiety. But they may not show other symptoms that are more commonly seen in adults.

Because brain function is involved, the ways people with bipolar disorder think, act, and feel are all affected. This can make it especially difficult for other people to understand their condition. It can be incredibly frustrating if other people act as though someone with bipolar disorder should just “snap out of it,” as if a person who is sick can become well simply by wanting to.

Bipolar disorder isn’t a sign of weakness or a character flaw; it’s a serious medical condition that requires treatment, just like any other condition.

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