Meds to treat bipolar disorder


Mood Stabilizers as a Treatment for Bipolar Mania

Written by WebMD Editorial Contributors

In this Article

  • Which Bipolar Medicine Is Best?
  • What Is Mood-Stabilizing Medication?
  • Other Mood-Stabilizing Medicines
  • Medicines for Bipolar Depression
  • Will the Medicine Work for Me?
  • Medication Tips
  • Side Effects of Bipolar Drugs
  • Stick to Your Treatment

If you have bipolar disorder, the right medications can be like a pair of eyeglasses. Bipolar disorder distorts your view of yourself and the world, but the medications can help you to see things clearly again.

Medications are an essential part of a treatment plan. They won’t cure you, but they will help you keep your moods in balance so you can do the things you need and want to do.

Which Bipolar Medicine Is Best?

Doctors use many types of drugs to treat bipolar disorder. Some fight the extreme highs of mania and others treat the lows of depression. You might take one drug at a time or a few at the same time.

The best bipolar medicine is the one that works best for you. Work with your doctor to decide on the medication plan that helps you the most.

You may keep taking these medications for years or decades, even if it’s been a long time since your last manic or depressive episode. This is called maintenance therapy and helps prevent recurrence of symptoms.

What Is Mood-Stabilizing Medication?

Mood stabilizers are medicines that treat and prevent highs (mania) and lows (depression). They also help to keep your moods from interfering with work, school, or your social life.

Examples include:

  • Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
  • Divalproex sodium (Depakote)
  • Lamotrigine (Lamictal)
  • Lithium
  • Valproic acid (Depakene)

Some of these drugs are known as anticonvulsants, which are also used to treat seizure disorders, including carbamazepine, lamotrigine, and valproic acid.

Not all of these drugs have the same effects, though. Some (such as lithium) are better at treating mania. Others (such as lamotrigine) may be more useful for depression.

Keep in mind that the term "mood stabilizer" can be misleading. If you take one, your mood can still change during the day. These medicines treat full episodes of mania or depression that last for several days or weeks at a time.

Other Mood-Stabilizing Medicines

Drugs called antipsychotic medications are also common in bipolar treatment plans. You can take them alone or with mood stabilizers to help with symptoms of mania. These drugs include:

  • Haloperidol (Haldol)
  • Loxapine (Loxitane) or loxapine inhaled (Adasuve)

Today, doctors may prescribe newer antipsychotic drugs, including:

  • Aripiprazole (Abilify)
  • Asenapine (Saphris)
  • Cariprazine (Vraylar)
  • Lumateperone (Caplyta)
  • Lurasidone (Latuda)
  • Olanzapine (Zyprexa)
  • Olanzapine/samidorphan (Lybalvi)
  • Quetiapine fumarate (Seroquel)
  • Risperidone (Risperdal)
  • Ziprasidone (Geodon)

Medicines for Bipolar Depression

Most of the time, doctors will start bipolar disorder treatment by prescribing a mood-stabilizing drug like lithium. But the FDA has approved some medicines for bipolar depression, too:

  • Fluoxetine combined with olanzapine (Symbyax)
  • lumateperone (Caplyta)
  • Lurasidone (Latuda). You might take it alone or with lithium or valproic acid.
  • Quetiapine fumarate (Seroquel)

For some people, traditional antidepressants may trigger a manic episode. Because of this risk, your doctor should keep track of you closely if you take one.

Will the Medicine Work for Me?

Your doctor can’t predict how well a particular bipolar medication will work for you. You may need to try several different kinds and different doses to figure out the right approach. And that can take time.

It can be frustrating, but don't give up. Eventually, you and your doctor should be able to find a prescription that works for you.

Medication Tips

If you have bipolar disorder, taking your medication should be part of your routine. Take it at the same time every day. It's easier to remember if you do it along with another daily activity, like brushing your teeth, eating breakfast, or getting into bed. A weekly pillbox can help you see if you've missed a dose.

Be sure to talk to your pharmacist or doctor about the best time of day to take your bipolar medications. Some are best if you take them in the morning or at bedtime and others with meals or after meals.

Make sure you know what to do if you accidentally miss a dose. Ask your doctor. Don't assume that doubling up is a good idea.

Side Effects of Bipolar Drugs

Like any drug, bipolar medicines can cause some side effects. They vary depending on which medications you use. These side effects can include:

  • Nausea
  • Tremors
  • Hair loss
  • Sexual problems
  • Weight gain
  • Liver damage
  • Kidney damage
  • Diarrhea
  • Belly pain
  • Skin reaction

Some medications can affect how well your liver works or the amount of white blood cells or platelets you have. You may need regular tests to make sure that you're staying healthy. The antipsychotic drug ziprasidone (Geodon) is linked to a rare but serious skin reaction called DRESS syndrome (drug reaction with eosinophilia and systemic symptoms).

Many side effects will go away after a few weeks of treatment. If you still feel bad after that, see your doctor. Don't assume you have to just live with the side effects. Your doctor may be able to change your dose, give you another medicine to control the side effects, or try a different medication altogether.

Stick to Your Treatment

Medications for bipolar disorder are powerful drugs, and you must take them exactly as your doctor recommends. Don't stop taking a medicine without your doctor's approval. It can be dangerous.

When you're feeling good, you might decide that you want to stop taking your medication. But that's a bad idea unless your doctor agrees. Treatment only during mood episodes may not be enough to prevent symptoms from coming back. In most people, maintenance treatment between mood episodes makes mania and depression happen less often and makes them less severe. If you're feeling good now, that's likely because your medication is working. So stick with it.

Bipolar Disorder Guide

  1. Overview
  2. Symptoms & Types
  3. Treatment & Prevention
  4. Living & Support

What’s Next for Bipolar Treatment?

In this Article

By Paula Zimbrean, MD, as told to Hallie Levine

Over the last 2 decades, there have been huge advancements in the treatment of bipolar disorder. We’ve learned that there are several types: bipolar I, bipolar II, and cyclothymic. All present differently and require different treatments.

We’ve gotten better at teasing out if symptoms are truly due to bipolar disorder or something else. And we’ve developed groundbreaking new treatments that are easier on the body and make it possible for people with bipolar disorder to live full lives. Here’s what I’m most excited about.

We’ve moved away from lithium.

A study published in the American Journal of Psychiatry looked at data collected over 2 decades -- from 1997 to 2016 -- and found that patients today are much more likely to be prescribed an antipsychotic or an antidepressant medication than a mood stabilizer like lithium. There’s no doubt lithium is an important drug

when it comes to bipolar disorder, and it’s very effective. But it carries a risk of side effects, especially at high doses, including both kidney and thyroid disease. I’ve worked with patients who took lithium for many years who eventually required kidney transplants. The good news is today we know much more about lithium and how it works, so when we do need to use it, we prescribe much lower doses.

Over the last couple of decades, we’ve also realized that some of the anticonvulsant medications, such as carbamazepine, lamotrigine, and valproate are effective ways to treat the mania from bipolar disorder. At the same time, a group of drugs known as second-generation antipsychotics became available, too. These medications, which include aripiprazole, cariprazine, lumateperone,olanzapine, quetiapine, and risperidone, among others, carry lower risk of side effects than earlier antipsychotics. These side effects include weight gain, elevated cholesterol and blood sugar levels, and tardive dyskinesia -- stiff, jerky movements of the face and body.

There are even more of these being approved. Some seem to carry a much lower risk of side effects such as weight gain or elevated cholesterol or blood sugars. Some also appear less likely to interact with other medications, which is something I worry about daily as a prescriber.

There are more long-term medications.

Another important step forward has been the availability of long-acting atypical antipsychotics. These drugs play an important role in treating bipolar disorder, since there’s often a high rate of noncompliance. But medications such as aripiprazole monohydrate and risperidone are now available as long-acting injectables, given in your doctor’s office every 2 weeks or once a month. This is much more acceptable to people with bipolar disorder, especially those who are active and don’t want to think about taking a pill every single day. Research shows these long-term injectables improve recovery outcomes. People are more likely to stick to treatment and gain control of symptoms. Hopefully, we will see more and more of them in the future.

We’re shifting toward gene therapy.

We know there are specific genes associated with your risk of developing bipolar disorder. Just this past year, the largest genetic study of bipolar disorder thus far was able to identify 64 different spots on the genome that raise your odds of bipolar disorder. But we’re not quite there yet when it comes to making the leap that modifying certain genes will cure the disease. The hope is eventually we’ll be able to apply what’s known as precision medicine to bipolar disorder. Ideally, we’ll analyze a patient’s gene to figure out which targeted treatments and therapies they’ll most benefit from, just like we do for patients with other conditions, such as breast cancer.

There are drugs to treat unwanted side effects.

One of the reasons people don’t stick to their medication regime is because of side effects like weight gain or tardive dyskinesia. But we’re learning that there are other drugs we can give them to counter these side effects. For example, we now often use metformin to help reverse rises in blood sugar, or the anticonvulsant drug topiramate to offset weight gain. While you never want to give patients too many prescriptions, these drugs can ward off some of the adverse effects that make it hard for some people to take antipsychotic medication long term. Eventually, we hope pharmacies will be able to combine two to three different drugs to maximize a treatment’s effectiveness and reduce the risk of side effects.

Nondrug therapies are on the rise.

Electroconvulsant treatment can be effective for bipolar disorder that hasn’t responded to medications. It’s when an electric current is sent through the brain to cause a controlled seizure. But it requires general anesthesia and has side effects such as confusion, headache, and nausea. Now, researchers are studying whether transcranial magnetic stimulation (TMS), a noninvasive procedure that uses magnetic fields to stimulate brain nerve cells, is effective. Early research is promising, especially for the depressive stages of bipolar disorder.

© 2022 WebMD, LLC. All rights reserved.

SOURCES:

Paula Zimbrean, MD, associate professor of psychiatry, Yale School of Medicine, New Haven, CT.

American Journal of Psychiatry: “20-Year Trends in the Pharmacologic Treatment of Bipolar Disorder by Psychiatrists in Outpatient Care Settings.”

The Psychiatrist: “Long-Acting Injectable Antipsychotic Medication Plus Customized Adherence Enhancement in Poor Adherence Patients with Bipolar Disorder.”

Nature Genetics: “Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology.”

Brain and Behavior: “Clinical applications of transcranial magnetic stimulation in bipolar disorder.”

What is the treatment for bipolar disorder? - Bipolar.su

Translation of a chapter from the book “Life with Bipolar Disorder. A guide for people with bipolar disorder and their families”


This chapter will discuss medications that are commonly used to treat bipolar disorder.

It is important for you, as an active participant in the treatment, to know the purpose of the therapy, the effect of the drugs, the appropriate dosage of the drug, possible side effects, as well as how and at what time to take the drugs (dosing regimen). This information will help you and your psychiatrist find the drugs that are best for you. Please discuss your concerns about medications with your doctor. He will dispel your fears and, if necessary, help you cope with the side effects of therapy or find an alternative method of treatment.

Do I need to take medication?

Many people have mixed feelings about taking medication; in an ideal world, they would prefer not to accept them. However, numerous studies have proven the beneficial effects of medications in the treatment and prevention of depressive and manic episodes. You can think of drugs like mood stabilizers and antidepressants as things that can help you feel better and take control of your life.

What is the treatment for bipolar disorder?

The following sections describe four types of medications used to treat bipolar disorder: mood stabilizers (normothymics), antidepressants, antipsychotics (neuroleptics), and tranquilizers (anxiolytics, anti-anxiety drugs). These drugs represent the main groups of drugs for the control of bipolar disorder, they are used individually or in combination. Other medications may also be used to treat other symptoms.

Before we describe these groups of drugs, their purposes and side effects in more detail, we would like to share information about the names of these drugs.

Drugs are often classified according to the purpose for which they were first approved (licensed) for use in the US, although many drugs have many additional uses in addition to those already approved. For example, doctors use antidepressants to treat anxiety disorders and tranquilizers to treat insomnia. For this reason, it is very important to understand the purpose of prescribing a medication, and not just know its name. This makes it easier to see the situation when you are asked about your medicines, because people only see and understand the names. For example, a family member may ask why you are taking medication for an anxiety disorder if you have bipolar disorder. Similar questions may arise when you order medicines at a pharmacy, when you communicate with friends or relatives, when you just meet with a doctor. If you have questions about medications, be sure to talk to your psychiatrist before changing anything.

Mood Stabilizers (Mood Stabilizers)

The purpose of using mood stabilizers is to keep your mood within the normal range. While experts believe that mood stabilizers are the best group of medications for treating bipolar disorder, the term "mood stabilizer" is scientifically ambiguous. There is a mutual agreement among experts that lithium (trade name Sedalite), valproic acid + sodium valproate (Depakine), lamotrigine (Lamiktal), carbamazepine (Tegretol) and olanzapine (Zyprexa) are stabilizers moods. Each of these drugs has been shown to be effective in treating and/or preventing mania and/or depression in two or more studies. There are many studies showing that lithium is effective both in treating manias and depressions and in preventing their relapses. Several studies have proven the effectiveness of lamotrigine for the treatment of bipolar disorder and two studies have shown its ability to prevent relapses, especially in recurrent (repeated) depressive phases. Olanzapine has shown excellent ability in combating acute mania and also has some antidepressant effect and is particularly useful in preventing relapse of mania.

Other medicines also have mood stabilizing properties.

To be called a mood stabilizer, a drug must: (1) work for mania, depression, or prevent relapse, and (2) not cause mood swings or abrupt transitions from one state to another. Drugs occasionally used by doctors as mood stabilizers also include verapamil (Isoptin), oxcarbazepine (Trileptal), and ω-3-polyunsaturated fatty acids (PUFAs), however, the benefits of their use are considered to be not fully proven. None of these medicines have been studied in bipolar disorder or received approval from the main regulatory body in the United States, the Food and Drug Administration (FDA).

All medicines can cause side effects. Your goal is to work with a psychiatrist to find the mood stabilizer that will best protect you or help you recover from an episode of depression or mania without uncomfortable side effects.

Antidepressants

A wide range of antidepressants can be used to control depressive episodes of bipolar disorder. However, their use should be monitored very carefully, as some patients go from depression to mania (so-called "phase inversion") when treated with antidepressants. In other words, an antidepressant used to control depression can cause mania. In contrast, some bipolar patients who take antidepressants do not experience a switch to mania, but instead suffer from worsening depression or more depressive episodes. For this reason, regular and ongoing communication with your doctor is essential to ensure that the prescribed treatment does not worsen your general condition. Your psychiatrist will watch for manic symptoms, but he/she will not be able to do his job without your help and members of your support group.

Talk to your doctor about how you feel. If during treatment with antidepressants you feel restless, excessive talkativeness, have trouble sleeping, and have a rush to run, "jump" thoughts - immediately report these symptoms to your psychiatrist. While the mood swings can be pleasant, you don't want these symptoms to turn into a full-blown mania. Remember that mania is a disease that causes problems in your life. To keep your life and your ability to achieve your goals under control, report early symptoms of mania or hypomania to your doctor. Through monitoring, antidepressant treatment can be a valuable addition to your recovery.

Table 3.1 lists some antidepressants. You will notice that some antidepressants are listed first because these drugs were originally developed to treat depression specifically in bipolar disorder and reduce the possibility of mania, unlike older drugs.

Antipsychotics (neuroleptics)

Antipsychotics were originally developed as a treatment for hallucinations and delusions in schizophrenia. However, antipsychotics have been shown to have specific anti-manic properties even in patients without evidence of psychosis. Antipsychotics are often prescribed for a manic episode and may be helpful in cases of disorganized behavior, confused thinking, as well as hallucinations.

A common property of these drugs is the ability to block the receptors of a neurotransmitter called dopamine. Too much dopamine in the brain can contribute to manic symptoms. You will often hear the term "neuroleptics" from doctors - this is an outdated name for antipsychotics.

Older antipsychotics, also called “typical antipsychotics,” include chlorpromazine (Aminazine), haloperidol, zuclopenthixol (Clopixol), flupentixol (Fluanxol), trifluoperazine (Triftazine), and a lot others. They are powerful blockers of dopamine receptors. They are useful in cases of acute mania. Unfortunately, they can often cause side effects that worsen their tolerability. At the beginning of the course of treatment with such drugs, patients may experience muscle stiffness, tremors in the limbs, sometimes restlessness, restlessness and agitation. Long-term use of typical antipsychotics is often associated with a potentially irreversible side effect known as tardive dyskinesia (TD), a disorder characterized by repetitive, involuntary, purposeless muscle contractions, especially of the tongue and facial muscles.

Newer antipsychotic drugs are now available for the treatment of mania, called atypical antipsychotics. Clozapine ("Azaleptin", "Klozasten") was the first synthesized drug of this class. This class also includes risperidone (Rispolept), ziprasidone (Zeldox), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify), asenapine (Safris) and some others. Like the older drugs, they also block dopaffin receptors, but are less powerful than typical antipsychotics. Atypical antipsychotics also block certain receptors on another neurotransmitter called serotonin. Antipsychotics with a combination of dopamine and serotonin blockade generally cause fewer side effects and are better tolerated by patients. They are often used in combination with mood stabilizers to treat acute mania.

Standard practice after recovery is to reduce the dose of the antipsychotic. Be that as it may, some patients begin to experience manic symptoms soon after the dosage is reduced. In this case, they are prescribed antipsychotics on an ongoing basis to contain the relapse of mania. Therefore, antipsychotic drugs can be considered as the drugs of choice for the treatment of acute mania, as well as drugs for the prevention of mania and psychotic symptoms.

Tranquilizers (anxiolytics, anti-anxiety agents)

Anxiety is a symptom that often accompanies episodes of depression and mania. In addition, sleep problems are also common in depression, hypomania, and mania. Benzodiazepines are the most commonly used tranquilizers. These include lorazepam (Lorafen), clonazepam, diazepam (Relium, Sibazon), alprazolam, chlordiazepoxide (Elenium), and phenazepam. They are used to quickly reduce anxiety and insomnia. Benzodiazepines may also control early symptoms of hypomania. All these drugs can cause addiction, physical and psychological dependence, especially when taken uncontrolled. The potential for abuse is greater for potent drugs that are rapidly absorbed into the bloodstream, such as alprazolam. The incidence of abuse is somewhat less with the milder, longer-acting benzodiazepines (eg, chlordiazepoxide, diazepam).


See also: How Bipolar Disorder Is Treated: Questions for a Psychiatrist

Most antidepressants can also reduce anxiety, but this usually takes several weeks of continuous use. In addition, as discussed earlier, they may cause worsening of bipolar disorder in some patients.

Finding the right dosage

The effectiveness of treatment depends on the correct selection of drugs and finding the right dosage for you. Finding the right dose for you will be easier if you are taking your medications as prescribed by your doctor and regularly informing him of the effect of medicines on your body. Tables 3.1, 3.2, and 3.3 provide information on approximate dosages for mood stabilizers, antidepressants, and antipsychotics. Only the original trade names of the drugs are indicated (many of the drugs have analogues containing the same active substance). Please note that depending on your condition, your doctor may prescribe dosages outside of those listed in the table. These limits are indicative so that you can take an active part in the discussion of dosages with your doctor.


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Summary

Treatment of bipolar disorder: what methods and drugs do doctors use?

Modern psychiatry is represented by new generation drugs, innovative approaches in psychotherapy. They are used in bipolar disorders. Patients should not be treated as if they were depression or schizophrenia - the drug regimen is selected depending on the phase and condition of the patient. If we are talking about depression, antidepressants are selected, if about mania, they are contraindicated, anxiolytics and sedatives are prescribed.

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Bipolar personality disorder is quite complex in terms of the treatment of the disease. Building a therapy strategy can only be entrusted to an experienced psychiatrist. In no case should patients self-medicate, as this may lead to a worsening of the condition. Treatment is primarily medical, but psychotherapy and lifestyle changes are also recommended. The treatment regimen is selected by the doctor individually, depending on the characteristics of the course of the disease and the psychotype of the patient. Abuse of antidepressants or refusal to take medications with a temporary improvement in well-being can lead to complications, so the patient should be constantly under the supervision of the attending physician.

Treatment of bipolar disorder: what methods and drugs do doctors use?

If you or someone close to you suffers from bipolar disorder, don't delay seeking qualified help. The sooner you start treatment, the higher your chances of success. Timely and effective treatment of bipolar disorder relieves its symptoms, reduces the frequency and intensity of mood swings, and helps to live a normal life. In a previous article on bipolar disorder, I have already looked at the general aspects of this disorder. Today's post is entirely dedicated to the treatment of bipolar disorder. In this regard, before you start reading, I will answer the most common question: Can bipolar disorder be cured on its own? The short and simple answer is NO! You can greatly help the treatment, make the process easier and more effective, but nothing more. For non-believers, I'll explain why. If the fact of the disease is established, then it manifested itself through the symptoms. Symptoms are what we see. Therefore, the disease takes over the mind, since we see its manifestations. If a person could suppress the manifestation of symptoms by willpower, then no one would ever know about any disease, that is, it would not exist. Any person experiences different emotions from time to time, but as long as he can control them, he is mentally healthy. If emotions take over and control the consciousness of a person, he is sick. How can a sick person fight on his own with what he cannot control? - No way! In this case, it is impossible to do without outside help.

Overview of bipolar disorder and its treatment

Bipolar disorder is a lifelong condition. Its manifestations are always unpredictable, so "ups" and "downs" alternate without any apparent pattern. If treatment is delayed, these ups and downs can be devastating. The recurring episodes of manic and depressive phases that characterize the disease make it difficult to lead a normal, stable, and productive life. In a manic phase, you may be hyperactive and irresponsible; in a depressive phase, it may be difficult for you to do anything at all. Early diagnosis and treatment will undoubtedly help to avoid these problems. The success of treatment for bipolar disorder depends on a number of factors. Medications alone are not enough. In order to get the most out of your treatment, it is very important to educate yourself and educate yourself about your illness, communicate with doctors and psychologists, and provide yourself with a strong support system to lead a healthy lifestyle and stick to your treatment plan. The healing process for bipolar disorder is long and will not happen overnight. Like the mood swings of bipolar disorder, treatment too will have its ups and downs. Finding the right treatment will take time, and failures happen along the way. But with proper attention to the disease, as well as a consistent commitment to the desire to improve your condition, you can take control of the symptoms of bipolar disorder and live life to the fullest. What can you do to feel better? Know the difference between the symptoms of the disease and the characteristics of your psyche. The professionals you turn to for help can help separate your personality traits from the symptoms of the disease, which will allow you to recognize in which cases changes in your behavior are caused by the disease and which are not. To do this, you must be open and honest about your behavior, because you will have to monitor it in order to improve the recognition of episodes of bipolar disorder. · Educate your family members and involve them in the process of fighting the disease. Your loved ones can help identify symptoms and monitor your behavior. They will also motivate and support you, which will certainly allow you to deal with future crises much more effectively. · Lead a healthy lifestyle. A normal and healthy lifestyle, including regular sleep, a healthy diet, the absence of alcohol, drugs and risky behavior is one of the main conditions for recovery. Develop an individualized treatment plan. Talk to your doctor about your medications, especially side effects that may be bothering you. There are many options for drug exposure and there is always plenty to choose from. It is very important to consult with specialists before making any changes in the treatment process, from the set of medications used, the schedule for taking them, and ending with the daily routine.

Accurate diagnosis of bipolar disorder

Obtaining an accurate diagnosis is the first step in the successful treatment of bipolar disorder. This is not always easy to do. The mood swings of bipolar disorder can be difficult to distinguish from other mental health problems such as depression, ADHD (attention deficit hyperactivity disorder), or borderline personality disorder. For many people with bipolar disorder, it takes years and multiple visits to the doctor before the problem is identified and properly diagnosed. Correctly diagnosing bipolar disorder can be difficult even for qualified professionals, so it is better to consult a psychiatrist with experience in the treatment of bipolar disorder, and not just a psychotherapist in an outpatient clinic or a local doctor. An experienced psychiatrist who specializes in the treatment of bipolar disorder is likely to be much better informed about the latest research in the field and advanced treatments. He also probably maintains contact with other specialists, which will make your treatment more effective. What to expect from the diagnosis? A diagnostic evaluation for bipolar disorder typically consists of the following: · Psychiatric evaluation - a complete psychiatric history (data collection and medical history) will be taken by a medical specialist. You will answer questions about your symptoms, tell your history of concerns, any treatment you may have received in the past, and your family history of mood disorders. · Physical Examination and Investigations – There are no specific laboratory tests to detect bipolar disorder. But the doctor must take a medical history and conduct a series of tests to rule out diseases or medications that may be causing your symptoms. For example, screening for thyroid disorders is especially important, as thyroid problems can cause mood swings that mimic the symptoms of bipolar disorder. In addition to a psychiatric evaluation and physical exam, your doctor may talk to family and friends about your mood and behavior. Very often, people around you can give a more accurate and objective picture of your symptoms. Diseases and drugs that can mimic symptoms of bipolar disorder Thyroid disorders Corticosteroids Antidepressants Adrenal disorders (eg, Addison's disease, Cushing's syndrome) Anxiety drugs Drugs for Parkinson's disease Vitamin B12 deficiency Neurological disorders (e.g. epilepsy, multiple sclerosis)

Types of Bipolar Disorder

I have already covered the types of this disorder in the article Bipolar Disorder, which you can read if some of the terms are not clear to you. But in order not to refer those who know what is at stake to another publication, I will once again remind you of the types of bipolar disorder, only in more detail. Each type of bipolar disorder is defined by the nature of the episodes of mania and depression. Treatment may differ depending on the type of bipolar disorder you have been diagnosed with. · Bipolar I disorder (mania and depression) - Bipolar I disorder is the classic form of the disease and also the most typical type of bipolar disorder. It is characterized by at least one episode of mania or a mixed episode. The vast majority of people with bipolar I disorder also have at least one episode of depression, although this is not necessary for a diagnosis. · Bipolar II disorder (hypomania and depression) - full-blown mania does not appear here. Instead, the illness involves recurring episodes of depression and hypomania (a mild form of mania). In order to be diagnosed with Bipolar II, you must have had at least one episode of hypomania and one major depressive episode. If you have had a manic episode at least once in your life, your diagnosis will be changed to Bipolar I disorder. · Cyclothymia (hypomania and mild depression) - Cyclothymia is a mild form of bipolar disorder. Like any bipolar disorder, cyclothymia is made up of cyclical mood swings. However, the highs and lows are not severe enough to unambiguously qualify as mania or depression. For a diagnosis of cyclothymia, you must experience multiple episodes of hypomania and mild depression over at least a two year period. Since people with cyclothymia are at an increased risk of developing full-blown bipolar disorder, this form of the disease needs to be carefully screened for accurate and timely diagnosis.

Bipolar disorder or depression?

Bipolar disorder is often misdiagnosed as depression. One reason for this is that most people with bipolar disorder seek help when they are in the depressive phase of the illness. If a person is going through a manic phase, he rarely sees a doctor because he doesn't acknowledge that there is a problem. In addition, in people with bipolar disorder, a significantly greater percentage of the time is spent in depressive phases than in manic or hypomanic phases. Misdiagnosed, bipolar disorder is a potentially dangerous problem because the treatment for bipolar depression is different from that for regular depression. In fact, antidepressants used to treat regular depression can significantly worsen bipolar disorder. Therefore, it is very important to contact a specialist in a timely manner, who will help you understand what is really happening. Signs that your depression is really bipolar disorder: · Episodes of depression are recurring. · You had your first episode of depression before the age of 25. · You have a relative with bipolar I disorder. · When you are not depressed, your mood and energy levels are higher than those of most other people. · When you are depressed, you sleep a lot and overeat. Episodes of depression are short (less than 3 months). You lose touch with reality when you are depressed. · You have had a case of postpartum depression. · You have had episodes of mania or hypomania while taking antidepressants. · Your antidepressants stopped working a few months after you started taking them. · You have tried 3 or more antidepressants without success, but nothing worked for you.

Treatment options for bipolar disorder

If your doctor determines that you have bipolar disorder, they will offer treatment options and possibly prescribe medication. You may also be referred to other specialists for advice and development of an individual treatment plan.

Comprehensive Treatment for Bipolar Disorder

Comprehensive Treatment Plan for Bipolar Disorder aims to: Relieve symptoms Restore the ability to act and solve problems both at home and at work Reduce the chance of relapses A complete treatment plan includes: Medications - Medications are the backbone of the bipolar disorder treatment process. By taking stabilizing drugs, you minimize the "ups" and "downs" and retain the ability to manage the situation. · Psycho1therapy - necessary to deal with bipolar disorder and the problems that the disease has caused in your life. Working with a doctor, you will learn about how to deal with difficult or unpleasant emotions, reconnect with others, deal with stress, and learn how to manage your mood. · Education - Managing symptoms and preventing complications begins with an in-depth understanding of one's illness. Education is a key component of treatment. The more you and your loved ones know about bipolar disorder, the easier it will be to avoid problems and deal with setbacks. · Lifestyle changes – By carefully following a healthy lifestyle, you can minimize the impact of bipolar disorder symptoms. This includes maintaining a regular sleep pattern, avoiding alcohol and drugs, a consistent exercise program, avoiding conflict, avoiding stressful situations, and maintaining a positive mindset at all times. · Support – Life with bipolar disorder can be challenging, so having a strong support system can help change your outlook and increase positive motivation. Participation in a bipolar disorder support group will give you the opportunity to share your experiences and learn from those who have already gone through the stages that you are just going through now. The support of friends and family is also invaluable.

The role of medication in treating bipolar disorder

Most people with bipolar disorder need medication to keep their symptoms under control. Long-term drug treatment can reduce the frequency and severity of episodes of the disease, and sometimes prevent them completely. If you have been diagnosed with bipolar disorder, you and your doctor will work together to find the right drug or drug combination that is best for you. Because everyone reacts differently to medications, you may try a wide variety of medications before you find one (or group of medications) that relieves symptoms. Do not take it into your head to "get" medicines and take them - the consequences can be not just bad, but terrible · Visit your doctor regularly. It is important to have regular blood tests to ensure that the blood level of the drug is in the therapeutic range (sufficient for a therapeutic effect, but not so high as to aggravate the situation). Determining the exact dose of medication you need is a constant balancing act between too little and too much, so regular monitoring will help keep you from showing symptoms and keep you healthy. · Continue taking your medicines even if your mood is stable. Do not stop taking your medicines as soon as you start to feel better. Most people need to take medication on a regular basis to avoid relapses. · Don't expect medicines to solve all your problems. For bipolar disorder, medications can help reduce symptoms of mania and depression, but in order to feel better, it's important to lead a lifestyle that supports good health. This includes the support of others, therapeutic treatment and proper rest. · Be extremely careful with antidepressants. Studies show that antidepressants are not particularly effective in treating bipolar depression. In addition, they can cause mania or sudden and frequent jumps between depression and mania.

Psychotherapy as an important part of treatment

People who take drugs to treat bipolar disorder are much more likely to be cured if they also receive medical treatment. In therapy, you will learn how to deal with issues that cause symptoms of bipolar disorder, such as relationship issues and self-esteem. Therapy sessions will address other issues you struggle with, such as substance abuse or anxiety. Particularly useful in the treatment of bipolar disorder are the following three therapies: Cognitive Behavioral Therapy Interpersonal and Social Rhythm Therapy Family Therapy

Cognitive Behavioral Therapy

In Cognitive Behavioral Therapy sessions, you will learn about how your thoughts affect your emotions, and you will learn to change negative thought patterns into more positive ways of responding. In the treatment of bipolar disorder, the emphasis is on managing symptoms, avoiding relapse triggers, and dealing with problems that arise.

Interpersonal and social rhythm therapy

Interpersonal Therapy addresses the most pressing relationship issues to help you connect better with those around you. This type of treatment aims to reduce stress levels, and since stress is a trigger for bipolar disorder, interpersonal and social rhythmic therapy will help reduce mood swings, making them less frequent and less severe. In the treatment of bipolar disorder, interpersonal therapy is often combined with social rhythm therapy. It has been proven that people with bipolar disorder have an increased sensitivity to biological rhythms. In turn, biological rhythms can be easily disturbed by a mismatch between biorhythms and social rhythms. Social rhythm therapy focuses on stabilizing social rhythms such as sleeping, eating, working hours. When these rhythms are stabilized, the biological rhythms that control mood also remain stable.

Family therapy

Living with a person who suffers from bipolar disorder is very difficult, which leads to tension in family relationships. Family therapy is focused on solving these problems and is aimed at restoring a healthy and supportive home environment. Informing family members about the disease and teaching them how to deal with its symptoms is a major component of family therapy.

Alternative treatments for bipolar disorder

Most alternative treatments for bipolar disorder are actually complementary treatments, meaning they must be used in conjunction with medication, therapy, and lifestyle changes. Here are some useful additions: Day and Night Therapy — Like Social Rhythm Therapy, Day and Night Therapy focuses on the biological rhythms of people with bipolar disorder. This therapy offers assistance in organizing biorhythms by properly adjusting lighting at different times of the day to provide darkness when nighttime rest is needed and light when wakefulness is needed.


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