What is bipolar depression?
The word "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.
Most individuals with bipolar disorder spend more time in depressed phases than in manic phases.
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 ("The highs"):
Some patients can become psychotic, seeing and hearing things that aren't there and holding false beliefs from which they cannot be swayed. In some instances they see themselves as having superhuman skills and powers, or think they are god-like.
The symptoms of bipolar depression are the same as those of major depression and include:
Who experiences bipolar disorder?
While bipolar disorder occurs equally in women and men, 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 (PTSD).
What causes bipolar disorder?
How is bipolar disorder diagnosed?
If you or someone you know is experiencing symptoms of bipolar disorder, seek the advice of your family healthcare provider or a psychiatrist. A referral may then be made to an appropriate mental health expert.
A thorough medical evaluation should be performed. Your doctor will ask questions about your personal and family history of mental illness. You may also be asked to complete a depression-screening questionnaire -- a series of structured questions that you will be asked to answer verbally or in writing.
What are the treatments?
There are many medications available to treat depression. In 2004, Symbyax, a combination of the antipsychotic olanzapine and the antidepressant fluoxetine, became the first drug specifically approved to treat bipolar depression.
Lithium (brand names Eskalith, Lithobid, Lithonate), a mood-stabilizing drug, is the most commonly prescribed medicine for people with bipolar disorder. It has proven helpful in controlling mood swings in both directions from mania to depression and from depression to mania. Lithium will reduce symptoms of mania within two weeks of starting therapy, but it may take weeks to months before the condition is completely controlled. Thus, other drugs like antipsychotic drugs or antidepressant drugs may also be used to help control symptoms.
Common side effects of lithium include:
Thyroid and kidney problems are a concern, so your doctor will monitor the function of your thyroid and kidneys as well as monitor the levels of lithium in your blood since levels can easily become too high. Anything that lowers the level of sodium in the body, such as switching to a low-sodium diet, heavy sweating, fever, vomiting or diarrhea may cause a buildup of lithium in the body and toxicity. Be aware of these conditions and alert your doctor if you are on lithium and experience them.
The following are signs of a lithium overdose. Call your doctor immediately or go to the nearest emergency room if you experience:
Valproate (Depakote), an antiseizure medicine, is also effective for controlling mania. It is highly effective for people with rapid-cycling bipolar disorder. The drug has some side effects, can cause inflammation of the liver and can decrease the amount of platelets (blood cells needed for blood to clot) that the body makes so your doctor will monitor levels of Depakote as well as liver function and platelet counts.
Common side effects of valproate include:
Other antiseizure medicines often used to treat bipolar disorder include carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurontin), and topiramte (Topamax).
Most people with bipolar disorder take more than one medication. Along with the mood stabilizer -- either lithium or an anticonvulsant, they may take a medication for agitation, anxiety, insomnia, or depression.
What can I expect after treatment?
Can bipolar disorder be prevented?
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