What Kind Of Doctorstreat Bipolar Disorder
There are many medications for treating bipolar disorder, so a psychiatrist, who is best qualified to identify which drugs work best for a specific patient, should oversee treatment. A psychiatrist is a type of medical doctor with specialized training in mental health care.
Primary care doctors are general medical doctors who obtain some training in mental health during medical school and residency. They often provide basic or initial assessment and medication treatment for common mental health problems such as depression or anxiety. Bipolar disorder is often misrecognized as “just” depression and usually a medical doctor who is not trained as a psychiatrist will refer patients with bipolar disorder to a psychiatrist or other mental health professional for more specialized care.
Psychologists and some mental health counselors can provide psychotherapy, or talk therapy, another critical part of treatment. Through therapy, people can develop coping methods that prevent long periods of illness, extended hospital stays, and suicide. They also are uniquely qualified to perform psychological and neuropsychological testing, which can help clarify diagnoses, learning and educational problems, developmental problems, and other behavioral or emotional problems.
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Bipolar Disorder In Adults
Bipolar disorder, also known as manicdepressive illness, is a medical condition that causes a person to experience intense mood swings that alternate between depression and mania. These extreme shifts in mood can disrupt a persons day-to-day life and interfere with relationships, job performance, and social behavior if not treated.
Although bipolar disorder is a chronic, or long term, condition, it can be treated. Many people with the condition lead productive and fulfilling lives. NYU Langone Psychiatry Associates is home to nationally renowned psychiatrists who specialize in treating bipolar disorder. As part of our Mood Disorders Consultation Service, our experts provide ongoing care as frequently as necessary, and for as long as needed.
Pediatric specialists at NYU Langones Child Study Center diagnose and treat bipolar disorder in children.
Symptoms That Lead To A Diagnosis
If youre suffering from any kind of mental health disorder, its important that you identify and understand your symptoms in order for our doctors to correctly diagnose you. Bipolar disorder consists of both manic and depressive episodes that create an unstable mood.
Mania can be extreme changes in mood, or you can have hypomania which is typically less severe. Symptoms of mania include:
Difficulty sleeping Extreme energy Increased self-esteem Difficulty concentrating Racing thoughts
On the opposite end of the spectrum, depression can change your emotional highs to hopeless lows. If you have bipolar disorder with depression, symptoms you may experience include:
Fatigue Sadness Decreased energy Overeating or loss of appetite Suicidal thoughts
Our team at Boston MindCare take a detailed history to decipher your symptoms and give you a definitive diagnosis. With that, we can also form a customized treatment plan for you.
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The Side Effects Of Bipolar Disorder Medication
One of the challenges associated with medication for bipolar disorder is the potential for a wide variety of side effects, some of which may be serious.
In addition to their potential for side effects, many of the drugs used to treat bipolar disorder can interact with birth control pills or may have health implications for women who are pregnant or might become pregnant. If you’re using birth control, are pregnant, or are planning to become pregnant, talk to your doctor before starting any medication for bipolar disorder.
Lithium For Bipolar Disorder
Carbamazepine is also sometimes prescribed to treat episodes of mania. It can be prescribed if lithium is ineffective or unsuitable for you.
Valproate can be used to treat episodes of mania and is typically a long-term method of treatment. It can be prescribed if lithium is ineffective or unsuitable for you. However, if you could become pregnant your doctor shouldn’t offer you valproate unless there is a pregnancy prevention programme in place, as it carries significant risks to your baby.
Lamotrigine has antidepressant effects and is licensed to treat severe depression in bipolar disorder. NICE guidelines recommend that it is not used to treat mania. If you are pregnant and taking Lamotrigine, NICE recommends you are checked regularly.
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What Are Mood Episodes
People with bipolar disorder experience periods of unusually intense emotion, changes in energy and activity levels, and uncharacteristic behaviors. These distinct periods are called mood episodes.
There are three main mood episodes:
Some people can even experience symptoms of depression and mania at the same time . This is called a mixed episode.
Unspecified Or Other Specified Bipolar And Related Disorders
In some cases, a person may experience symptoms of bipolar disorder that do not fit into the other three types.
In such cases, they may receive a diagnosis that doctors call unspecified bipolar disorder and related disorders or other specified bipolar and related disorders. This will depend on the type, duration, and severity of their symptoms.
People with bipolar disorder may not realize that their moods and behavior are disrupting their lives and the lives of their loved ones.
Because of this, people who have bipolar disorder often do not get the medical attention and treatment they require. This is especially true during their euphoric manic periods.
People with bipolar disorder are more likely to seek help when they experience a depressive episode.
Because of this, the doctor may incorrectly diagnose the person with depression instead.
Once a doctor diagnoses someone with bipolar disorder, they should see their doctor often to evaluate how well any prescription medications are working. Also, a doctor may recommend that a person with bipolar disorder talk regularly with a mental health professional.
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Signs That You May Need Bipolar Disorder Treatment With Priory
You dont need to feel alone. Bipolar disorder is a relatively common mental health condition, which around 1 in 100 people will be diagnosed with. We can help you to understand what you are going through, by addressing your specific, unique symptoms.
Previously known as manic depression, bipolar disorder is characterised by extreme mood swings. These can range from excessive energetic highs, known as mania, to the extreme lows of depression. Episodes of these can last for anywhere between several weeks and several months.
You may be wondering how to spot the signs of bipolar disorder. Here are some key symptoms of both depressive and manic episodes, which demonstrate the conditions contrasts:
- Feelings of extreme sadness and unhappiness
- Losing interest in activities you previously enjoyed
- Low self-esteem
- Increased energy and desire to be active
- Racing thoughts and talking quickly
- Not needing as much sleep
- Unrealistic beliefs about your own abilities
If you are experiencing extreme symptoms like these, seek advice from your GP. You can see a more extensive list of bipolar disorder symptoms. The patterns of bipolar mood swings vary from person to person.
Some people experience only a handful of bipolar episodes during their lifetime others go through many episodes. While bipolar disorder can be diagnosed at any age, you will most likely have experienced symptoms during your teens. Bipolar disorder is rarely diagnosed in middle age or later life.
What Treatment Could Help Me Manage A Current Episode
Your treatment for a bipolar usually depends on what kind of episode you’re experiencing.
During depressive episodes:
- Your doctor is likely to offer you medication. This might be new medication or a change to your current bipolar medication.
- Your doctor might offer you a structured psychological treatment that’s used to treat depression, such as cognitive behavioural therapy .
During manic or hypomanic episodes:
- Your doctor is likely to offer you medication. This might be new medication or a change to your current bipolar medication.
- Your doctor is unlikely to offer a talking treatment if youre currently experiencing a manic or hypomanic episode.
See our pages depression or hypomania and mania for more information on these treatments, and tips for taking care of yourself.
When my mood dips, CBT helps me to cope to some extent, but it doesnt really help me get out of this state and it doesn’t prevent the mood swings thats what my medication does.
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Well Which One Do I Have
If you think that you or someone you love is living with some form of bipolar disorder, the first step is to reach out to your primary doctor or a mental health professional.
It can help to keep a journal of your symptoms to bring to your first appointment. Knowing your specific symptoms, when they happen, and any possible triggers can help your clinician answer questions and give you a more accurate diagnosis.
Think about how often your symptoms pop up, and for how long they stick around.
If your mood episodes and changes are frequent and intense, you may have bipolar I disorder. If your symptoms are less severe, but still significantly impact your life, you may have bipolar II disorder or cyclothymia.
That said, there are other mental health conditions that have overlapping symptoms. Between that, the additional specifiers, and your overall uniqueness, the best way to get answers is to reach out for an evaluation.
Seeing a mental health professional is the first step toward figuring out a treatment plan for bipolar disorder no matter what type you have. With the right tools, strategies, and meds, you can successfully manage your condition and live well.
Once youve received a diagnosis, your treatment plan might involve:
- medications
Antipsychotics For Bipolar Disorder
You are most likely to be prescribed an antipsychotic if you have an episode of mania or severe depression in which you experience psychotic symptoms, such as hearing voices. However, some antipsychotics are increasingly prescribed even if you haven’t had psychotic symptoms, as their side effects might be less unpleasant, and they’re safer in pregnancy.
The National Institute for Health and Care Excellence treatment guidelines recommend the following antipsychotics:
- haloperidol
- olanzapine
- quetiapine
- risperidone
If your first antipsychotic doesn’t work, you should be offered a different one from the list above. If the second antipsychotic doesn’t work you may be offered lithium to take together with an antipsychotic.
If you’re prescribed an antipsychotic, you’ll need to have regular health checks with your doctor.
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What Is The Best Medication For Me
You need to discuss this with your doctor, but there are some general principles.
- Lithium is usually the first choice sodium valproate a second choice, although it can also be prescribed with lithium. Olanzapine can be tried if lithium and sodium valproate have not helped.
- Quetiapine can also be used, particularly where someone remains depressed between manic episodes8.
- Lamotrigine may be suggested for bipolar II disorder or bipolar depression, but not for mania.
- Sometimes a combination of these drugs is needed.
Much depends on how well you get on with a particular medication. What suits one person may not suit another.
Lithium reduces your chance of relapse by 3040%8, but the more manic episodes youve had, the more likely you are to have another one.
| Number of previous manic episodes | Chance of having another episode in the next year |
|---|---|
| Not taking Lithium |
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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What Tests Will The Doctor Use To Make A Bipolar Diagnosis
Your doctor may have you fill out a mood questionnaire or checklist to help guide the clinical interview when they assesses mood symptoms. In addition, your doctor may order blood and urine tests to rule out other causes of your symptoms. In a toxicology screening, blood, urine, or hair are examined for the presence of drugs. Blood tests also include a check of thyroid stimulating hormone level, since depression is sometimes linked to thyroid function.
Mania And Mixed Depressive Episodes
Any antidepressant should be stopped. Haloperidol, olanzapine, quetiapine or risperidone can be used to treat a manic episode. If these do not work well, Lithium can be added.
Once the treatment has started, symptoms usually improve within a few days, but it may take several weeks for a full recovery. You should check with your doctor if you want to drive while taking this sort of medication.
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Who Will I See
You may see your GP at first, particularly if you have a depressive episode. But, if they make a diagnosis of bipolar disorder, they will have to refer you to a specialist a psychiatrist. NICE guidance suggest that mood-stabilisers need to be started by a specialist7, even if your care is later taken over by a GP.
When you see a psychiatrist, you will also meet other members of the community mental health team . They will be able to help with emotional support, information, psychological interventions, and help with sorting out practical matters.
Once any medication you are taking seems to established and effective, your GP can take over most of your care, although they will usually want you to stay in touch with a psychiatrist and the CMHT.
Getting An Accurate Diagnosis
Getting an accurate diagnosis is the first step in your bipolar disorder treatment. And it isnt always easy. The mood swings of bipolar disorder can be difficult to distinguish from other problems such as major depression, ADHD, and borderline personality disorder. For many people with bipolar disorder, it takes time and numerous doctor visits before the problem is correctly identified and treated.
Making the diagnosis of bipolar disorder can be tricky even for trained professionals, so its best to see a psychiatrist with experience treating bipolar disorder rather than a family doctor or another type of physician. A psychiatrist specializes in mental health and is more likely to know about the latest research and treatment options.
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How To Cope With Side Effects
What to do about:
- feeling or being sick take lithium with or after a meal or snack. It may also help if you do not eat rich or spicy food. If you are being sick, take sips of water to avoid dehydration.
- diarrhoea drink plenty of fluids to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
- a dry mouth and/or a metallic taste in the mouth try sugar-free gum or sweets, or sipping cold drinks. If this does not help, talk to your pharmacist or doctor. Try not to have drinks with a lot of calories in as this might also mean you put on weight.
- slight shaking of the hands talk to your doctor if this is bothering you or does not go away after a few days. These symptoms can be a sign that the dose is too high for you. Your doctor may change your dose or recommend taking your medicine at a different time of day.
- feeling tired or sleepy as your body gets used to lithium, these side effects should wear off. If these symptoms do not get better within a week or two, your doctor may either reduce your dose or increase it more slowly. If that does not work you may need to switch to a different medicine.
- weight gain try to eat well without increasing your portion sizes so you do not gain too much weight. Regular exercise will help to keep your weight stable and help you feel better.
Drugs To Treat Bipolar Disorder
Bipolar disorder medications
If you have bipolar disorder, youll need to be treated on an ongoing basis. In fact, you should be seeing a mental health professional regularly, even if you feel fine. Treatment usually includes a combination of medication and talk therapy.
Psychiatrists typically recommend medications as initial treatment to control symptoms as quickly as possible.
Once symptoms are under control, youll receive maintenance treatment to reduce the risk of relapse. Maintenance treatment also reduces the chance of minor shifts in mood developing into mania or depression.
Several types of medications are used to treat bipolar disorder. These include mood stabilizers, antidepressants, and drugs that relieve anxiety. Your doctor may prescribe one or a combination of medications for maximum effect.
Finding the right medication or combination of medications will take some trial and error. You may need to change medications due to side effects.
It can take up to eight weeks to see the full effects of each medication. Usually, only one medication is changed at a time. This helps your doctor to better monitor and identify which one isnt working.
The following types of medications are used to treat bipolar disorder.
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