Bipolar Treatment Risks Around Pregnancy
Bipolar disorder itself does not appear to affect the safety of a pregnancy. However, some treatments can pose a risk to the unborn or breastfeeding baby. On the other hand, stopping treatment may increase the risk to the pregnant person.
In some cases, medications can worsen or trigger symptoms of bipolar disorder. For example, treating postpartum depression with antidepressants may increase the risk of psychosis, mania, and rapid cycling. In people with a family history of bipolar disorder, it may trigger the first symptoms.
It is crucial for a person and their doctor to weigh the risk of symptoms with the risk of adverse effects when developing a treatment plan. This may change before, during, and after pregnancy. For a person with severe symptoms, a doctor may recommend ECT, but experts recommend this only as a last resort.
Anyone with bipolar disorder who is considering pregnancy or pregnant should speak with their healthcare team, especially if bipolar symptoms are present.
When Does Bipolar Disorder Develop
People often describe themselves or others as bipolar when theyre happy one moment and sad the next. As with other mental health issues, the words are overused and often ascribed to regular everyday emotions and experiences.
However, theres more to bipolar disorders than mood swings. Bipolar disorder is a psychological disorder thats characterized by periods of extreme depression, manic episodes, and normal moods. Sometimes you may cycle through these episodes throughout a month, a few days, or even in a single 24-hour period.
Bipolar disorder is a mood disorder, which means it affects the way you feel and how your brain regulates your moods. Mental health issues like bipolar disorder are complex, and they can be difficult to diagnose. However, detecting the signs and symptoms early can help you get the treatment you need and to avoid some of the worst consequences of the disorder. But whos at risk, and when does bipolar disorder start? Learn more about bipolar disorder, who it affects, and when you should look for the signs.
How Psychologists Can Help
With treatment and through their own efforts, people with bipolar disorder can live rich, rewarding lives. Treatment for bipolar disorder usually includes a variety of strategies to manage the disease over the long term. Medications are typically an important part of treatment. Those medications may include mood stabilizers, antipsychotic medications, or antidepressants. Such medications usually need to be taken daily and regularly to be effective.;
Psychotherapy, too, is often an important part of treatment. In fact, in a recent report prepared for the Canadian Psychological Association, researchers reviewed numerous studies of bipolar disorder treatment and found that when psychotherapy is used in conjunction with medication, it can significantly reduce rates of relapsing into manic and depressive states, and also improve overall functioning and well-being . Psychologists can help people with bipolar disorder recognize and manage symptoms of the disease, change negative thought patterns and behaviors, manage daily routines, and improve relationships with family and friends. And psychologist-led interventions such as family-focused treatments can also help the relatives of people with bipolar disorder learn strategies for helping their loved one. To find a psychologist in your area, use APA’s Psychologist Locator Service.
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Bipolar Disorder Is Often Mistaken For ‘just’ Depression
People with bipolar disorder are frequently misdiagnosed as having only depression. In bipolar II disorder, the milder form, manic episodes are mild and can pass by unnoticed. Time spent with depression symptoms, meanwhile, outnumbers time spent with hypomanic symptoms by about 35 to one in people with bipolar II disorder.
Time spent with depression symptoms also usually outweighs time spent with mania symptoms in bipolar I disorder by about three to one, although the more severe mania in bipolar I generally is easier to identify.
Major depressive disorder — often referred to as unipolar depression — is different from bipolar disorder II — also called bipolar depression — in that unipolar depression has no intervals of hypomania while bipolar II does have intervals of hypomania.
Anyone evaluated for depression should also be evaluated for a lifetime history of manic or hypomanic episodes.
Can Lifestyle Habits Increase The Risk Of Bipolar Disorder
Lack of sleep increases the risk of having an episode of mania in someone with bipolar disorder. In addition, antidepressants, particularly when taken as the only medication, may also trigger a switch into a manic state.
Excessive use of alcohol or drugs can also trigger bipolar symptoms. Research has shown that about 50% of bipolar sufferers have a substance abuse or alcohol problem. Sufferers often use alcohol or drugs in an effort to reduce unpleasant feelings during low mood periods, or as part of the recklessness and impulsivity associated with manic highs.
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A Higher Risk Of Depression
In females, research suggests that bipolar II is more common than bipolar I. A person with bipolar II experiences depression and hypomania, a less extreme form of mania.
In females with bipolar disorder generally, depressive symptoms are more likely to be dominant. In fact, females with the condition are twice as likely to experience depression as males. Females are also more likely to experience psychosis with depression.
Because depressive symptoms tend to be dominant, females with bipolar disorder often receive an incorrect diagnosis of depression.
Symptoms Of Clinical Depression
Although there are different types of depression, which can have unique characteristics, there are some symptoms that most people with depression feel at one time or another, such as:
- Feeling profoundly sad, hopeless, or empty
- Getting angry, irritated, or frustrated easily
- Sleeping too much or having insomnia
- Poor concentration or trouble focusing
- Not feeling hungry or overeating
- A lack of interest in hobbies, work, socializing
- Low or no sex drive
- Self-harm, suicidal thoughts or attempts
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 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.
Typically, a person must have symptoms every day for two weeks or longer to be diagnosed with depression.
People with depression may also be likely to have comorbid anxiety disorders. People with bipolar disorder can experience anxiety as well, including generalized anxiety disorder .
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Coping With Bipolar Disorder
Living with bipolar disorder can be challenging, but there are ways to help make it easier for yourself, a friend, or a loved one.
- Get treatment and stick with itrecovery takes time and its not easy. But treatment is the best way to start feeling better.
- Keep medical and therapy appointments, and talk with the provider about treatment options.
- Take all medicines as directed.
- Structure activities: keep a routine for eating and sleeping, and make sure to get enough sleep and exercise.
- Learn to recognize your mood swings.
- Ask for help when trying to stick with your treatment.
- Be patient; improvement takes time. Social support helps.
Remember, bipolar disorder is a lifelong illness, but long-term, ongoing treatment can help control symptoms and enable you to live a healthy life.
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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How Do Doctors Treat It
Although there’s no cure for bipolar disorder, treatment can help stabilize moods and help the person manage and control symptoms. Like other teens with long-lasting medical conditions , teens with bipolar disorder need to work closely with their doctors and other medical professionals to treat it.
This team of medical professionals, together with the teen and family, develop what is called a treatment plan. Teens with bipolar disorder will probably receive medication, such as a mood stabilizer, from a psychiatrist or other medical doctor. A psychologist or other type of counselor will provide counseling or psychotherapy for the teen and his or her family. Doctors will watch the symptoms closely and offer additional treatment advice if necessary.
Brain Structure And Function
Researchers are learning that the brain structure and function of people with bipolar disorder may be different from the brain structure and function of people who do not have bipolar disorder or other psychiatric disorders. Learning about the nature of these brain changes helps doctors better understand bipolar disorder and may in the future help predict which types of treatment will work best for a person with bipolar disorder. At this time, diagnosis is based on symptoms rather than brain imaging or other diagnostic tests.
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How Do I Know If I Am Bipolar
Identifying bipolar disorder is very strategic because there are behavioral explanations that first need to be ruled out. Since the disorder is more commonly seen in teenage years than perhaps someone in their 40s, somebody might be inclined to gloss over symptoms as typical teenage behavior.
If the behavior of manic highs continues to be repeated over time with potentially dangerous consequences or depressed periods lasting longer than two weeks, a visit to a medical professional is in order. A routine physical including blood work can rule out other physical contributors and a full mental wellness evaluation can be performed.
Common Signs & Symptoms of Mania
- Showing intense happiness or silliness for a long time
- Having a very short temper or seeming extremely irritable
- Talking very fast or having racing thoughts
- Having an inflated sense of ability, knowledge, and power
- Doing reckless things that show poor judgment
These symptoms may be more manic and an episode may require hospitalization until the person can be stabilized, as in bipolar I.
Common Signs & Symptoms of Depression
- Feeling very sad or hopeless
- Feeling lonely or isolating themselves from others
- Eating too much or too little
- Having little energy and no interest in usual activities
- Sleeping too much
Who Is At Risk Of Bipolar Disorder
More than 10 million Americans have bipolar disorder. Bipolar disorder affects men and women equally, as well as all races, ethnic groups, and socioeconomic classes.
Although men and women appear to be equally affected by bipolar disorder, rapid cycling is seen more often in women. Women also tend to experience more depressive and mixed state episodes than do men. A man’s first experience with bipolar disorder may be in a manic state; women tend to first experience a depressive state.
Bipolar disorder can present itself at any age, but typically, onset occurs around age 25.
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What Is The Treatment For Mania Hypomania And Depression
You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence website.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at:
The NHS doesnt have to follow these recommendations. But they should have a good reason for not following them.
What medications are recommended?
Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.
The mood stabilisers we talk about in this factsheet are:
- Lithium
- Certain benzodiazepine medication
Mania and hypomaniaYou should be offered a mood stabiliser to help manage your mania or hypomania. Your doctor may refer to your medication as antimanic medication.
If you are taking antidepressants your doctor may advise you to withdraw from taking them.
You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:
- Haloperidol
- Quetiapine
- Risperidone
If the first antipsychotic you are given doesnt work, then you should be offered a different antipsychotic medication from the list above.
If a different antipsychotic doesnt work, then you may be offered lithium to take alongside it. If the lithium doesnt work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication.
Sodium Valproate shouldnt be given to girls or young women who might want to get pregnant.
Bipolar I And Bipolar Ii Are The Most Common Types With Two Main Differentiators:
- Bipolar I: A person may experience a manic episode of extreme highs lasting around seven days or requiring hospitalization. This may or may not be followed by an extremely depressed period lasting around two weeks.
- Bipolar II: A person may experience a less-intense version of mania called hypomania, which is not as severe as bipolar I. A depressive episode may occur before or after the hypomania. This depressive state can be severe and one condition of bipolar is not more or less serious than another.
- Cyclothymic disorder. This type of disorder can occur when the mania or depression episode lasts longer than two years.
- Other: This type of disorder could be rooted in substance use disorder affecting mood or other health concerns.
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Bipolar Symptoms In Children: Presentation
Every childs symptoms differ, but during a manic phase, you may see signs like:
- Acting hyper, exuberantly happy, or incredibly silly behavior seemingly at random and in a way that is unusual to the childs personality
- Talking quickly or switching topics mid-sentence
- Hyperfocusing on a single subject or project that seems to come out of nowhere
- Erupting in extreme upset when obstacles arise or they are told no
- Highly imaginative; coming up with complex storylines
- Angering quickly and becoming violent over small slights
- Not feeling tired or requiring much sleep, and showing little interest in napping, resting, or going to bed at night; getting up frequently during the night
- Becoming preoccupied with sex or sexual thoughts; talking about sex at inappropriate times
- Acting on sexual desires in public, dangerous, or age-inappropriate ways; masturbating excessively or engaging in risky sex at a young age
- Seeing or hearing things that arent there
During a depressive phase, you might see symptoms like:
- Acting unusually weepy and sad
- Complaining of frequent stomachaches and headaches
- Sleeping longer than usual
- Eating too little or too much; might gain or lose weight very rapidly
- Showing little interest in regular activities
- Talking about being a bad child, or wondering aloud if everyone hates them
- Becoming preoccupied with death; talking about suicide or, for very young children, how it would be better for everyone if they went away forever or were never born
How Do I Get Help If I Think I Have Bipolar Disorder
The usual first step to getting help is to speak to your GP.
It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.
Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:
- depression, and
- ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.
They might refer you to a psychiatrist at your local NHS community mental health team .
Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.
Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.
Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
You can find more information about:
- NHS mental health teams by clicking here.
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What Are The 4 Types Of Schizophrenia
There are actually several different types of schizophrenia depending on the person’s symptoms, but generally, the main types of schizophrenia include paranoid schizophrenia, catatonic schizophrenia, disorganized or hebephrenic schizophrenia, residual schizophrenia, and undifferentiated schizophrenia.
Does Bipolar Disorder Run In Families
Numerous studies have found that people with bipolar often have at least one close relative with depression or bipolar disorder.
Children who have one parent with the disorder have about a 10%-25% chance of developing the disorder themselves; children with two parents with the disorder have a 10%-50% chance. If a non-identical twin sibling has the disorder, the chance that another sibling will have it is about 10%-25%.
Studies of identical twins have shown that genetics are not the only factor in determining who is at risk for bipolar disorder. Because identical twins share all the same genes, if bipolar disorder were purely hereditary, then all identical twins would share the disorder.
However, it has been found that if one identical twin has bipolar disorder, the chances of the other twin also having bipolar disorder ranges from 40% to 70%. It is important to note that bipolar disorder can show itself in different forms in individuals in the same families.
Scientists believe that bipolar disorder is not likely caused by any one single gene but more likely multiple genes, each contributing only a small amount to the vulnerability, acting together in combination with other environmental factors such as stress, lifestyle habits, and sleep. Scientists are working to identify these genes in the hopes that this will help doctors to better diagnose and treat the disorder.
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