The Role Of Medication In Bipolar Disorder Treatment
If you have bipolar disorder, medication will likely be a part of your treatment plan. Medication can bring mania and depression under control and prevent relapse once your mood has stabilized. You may not like the idea of taking bipolar medication long term, especially if youre struggling with unpleasant side effects. But just as a diabetic needs to take insulin in order to stay healthy, taking medication for bipolar disorder will help you maintain a stable mood.
Since finding the right drug and dose can be tricky, its important to work closely with a specialist and re-evaluate your medication regularly. Its also important to remember that taking medication is just one aspect of a successful treatment program. There are plenty of other steps you can take to manage your symptoms and even reduce the amount of medication required. Healthy lifestyle changes, self-help coping strategies, and exploring therapy are also important in coping with bipolar disorder symptoms and helping you live a full, productive life.
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.
What Is Bipolar Anxiety
Anxietyisarelativelywidespreadconditionbutbipolaranxietyisanentirelydifferentanimalfromnonspecificfeelingsofanxiousnessornervousness.Theanxietythatcomeswithabipolardiagnosiscanbeadistinctchallenge,andinthisarticlewe’regoingtotalkaboutwhatitmeanstobebipolar.We’lldiscusswhattheconditionhastodowithanxietyandwhatyoucanexpectifsomeoneinyourlifehasrecentlybeendiagnosed.
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Types Of Mood Stabilizing Medication
The oldest and most studied of mood stabilizers is lithium. However, many drugs that were first developed as anticonvulsants to treat epilepsy also act as mood stabilizers. These include carbamazepine, divalproex and lamotrigine. Gabapentin and topiramate are also anticonvulsants that may act as mood stabilizers, but they are usually given in addition to other medications.
Lithium
Lithium is found in nature in some mineral waters and is also present in small amounts in the human body.
Lithium is used to treat mania and to prevent further episodes of mania and depression.
Common side-effects of lithium include increased thirst and urination, nausea, weight gain and a fine trembling of the hands. Less common side-effects can include tiredness, vomiting and diarrhea, blurred vision, impaired memory, difficulty concentrating, skin changes and slight muscle weakness. These effects are generally mild and fade as treatment continues. If, however, any of these effects are severe, they should be reported to your doctor immediately. Thyroid and kidney function can be affected by lithium in some people and must be monitored regularly by your doctor.
Changing the amount of salt you use can also affect lithium levels: avoid switching to low- or no-salt diets.
Signs that the amount of lithium in the body is higher than it should be include severe nausea, vomiting and diarrhea, shaking and twitching, loss of balance, slurred speech, double vision and weakness.
Carbamazepine
Lamotrigine
Therapy For Anxiety And Bipolar Depression
Therapy, both individual and family, is helpful in bipolar depression and anxiety treatment. Individual therapy lets you address challenges and create coping skills. Family therapy does this, too, but its done as group therapy with the entire family present. Both help people improve the quality of their lives. Some types of therapy that have been shown to help include:
- Relaxation training
- Interpersonal and Social Rhythm Therapy
Medication and therapy are effective treatment approaches for managing bipolar depression with anxiety. While finding the right treatment isnt always a quick, easy process, it is possible to do so. You can minimize the effects of these disorders and live a quality life.
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Anxiety And Bipolar Disorder
Everybody feels anxious at times, and it’s only natural to have mood swings in response to the daily ups and downs of living. For some people, however, periods of depression, restlessness, irritation, and anxiety may become so severe that they interfere with work, relationships, and the ability to function normally in society. These may be symptoms of bipolar disorder, anxiety disorder, or a combination of both disorders.
“It is very common to see an anxiety disorder coexisting with bipolar disorder,” says Carolyn M. Drazinic, MD, PhD, assistant professor in psychiatry, genetics, and developmental biology at the University of Connecticut Health Center in Farmington. “Anxiety disorders seen with bipolar disorder include generalized anxiety disorder , obsessive compulsive disorder , panic disorders, and social anxiety. We also frequently see social anxiety and attention deficit disorder beginning in childhood or adolescence associated with bipolar disorder in later years.”
Diagnosing Bipolar Disorder and Anxiety Disorder
Symptoms of depression that are seen in bipolar disease include lack of energy, guilt, sadness, worry, hopelessness, inability to concentrate, trouble sleeping, and thoughts of suicide. Findings that may indicate the existence of an anxiety disorder along with bipolar disorder include:
Treating Bipolar and Anxiety Disorders
Whats The Best Treatment For Comorbid Adhd/bipolar Mania
Current Psychiatry
Nick C. Patel, PharmD, PhDAssistant professor Departments of pharmacy practice and psychiatry University of Cincinnati Cincinnati, OH
Floyd R. Sallee, MD, PhDProfessor Department of psychiatry University of Cincinnati Cincinnati, OH
How to stabilize mood without worsening ADHD symptoms.
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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.
What Is The Best Medication For Bipolar Disorder
Mood stabilizers are typically considered the best medication for bipolar disorder.
However, treatment of bipolar disorder should be individually tailored to your symptoms, frequency of mood swings, and response to treatment. In addition to mood stabilizers, doctors may also prescribe atypical antipsychotics and antidepressants.
- Mood stabilizers
- First line of treatment for most people with bipolar disorder, used to control both mania and depression
- Common examples are Lithobid and Depakote although quetiapine has also shown good efficacy is quetiapine
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What To Expect After A Diagnosis
Bipolar disorder can cause a lot of turmoil in someones life, Tu says. Medications can help improve the stability of an individuals mood, but this does not address underlying negative beliefs, fears, anxieties and trauma. All of these can still be present after someone is stabilized on medications. Some individuals need more support because of the toll the mental illness takes on their lives.
While theres a broad range of the severity of bipolar disorder, both Tu and Liang say theres a variety of ways to help people. For example, some people may require fewer medications but need more one-on-one therapy sessions. Whatever the treatment plan is, its also important to maintain your physical health as well by getting enough sleep, eating well, exercising and managing your stress.
Its important to remind yourself that while bipolar disorder is a long-term illness, the right treatment plan, support network and routine appointments with your doctors can help you live a full and healthy life.
Seattle Anxiety Specialists, PLLC is a private psychiatry and psychotherapy practice in downtown Seattle, providing evidence-based treatments and in-depth self-exploration for anxiety and conditions that create anxiety including phobias, depression, GAD, OCD, PTSD, ADHD, OCPD and bipolar.
Other Treatments For Mania
If your mania is severe, you may need to be in a hospital until your symptoms are under control. Electroconvulsive therapy may also be something your doctor considers.
Your doctor may change your medicine dose, or add or subtract medicine. For instance, they may stop antidepressants, or add an antipsychotic or another drug to lessen your symptoms.
You may also find that psychological therapy and a well-ordered daily routine help, along with your medicine.
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Treatment And Support At Priory Hospitals And Wellbeing Centres
At Priory, we support people with bipolar and anxiety disorders in many ways. Our outpatient services give you the opportunity to set up a series of hourly sessions with an experienced consultant, psychologist or therapist to help you better manage your symptoms in everyday life.
Our inpatient options are also available for those finding their co-morbid bipolar and anxiety symptoms particularly debilitating. During a hospital stay, you take part in a psychological group programme and attend regular sessions with an experienced consultant to help you learn ways to better manage the co-occurring disorders going forward.
Tips For Getting The Most Out Of Medication For Bipolar Disorder
Avoid antidepressants. The treatment for bipolar depression is different than for regular depression. In fact, antidepressants can actually make bipolar disorder worse or trigger a manic episode. Try mood stabilizers first and never take antidepressants without them.
Take advantage of natural mood stabilizers. Your lifestyle can have a huge impact on your symptoms. If you make healthy daily choices, you may be able to reduce the amount of medication you need. Mood stabilizers that dont require a prescription include keeping a strict sleep schedule, exercising regularly, practicing relaxation techniques, and developing a solid support system.
Add therapy to your treatment plan. Research shows that people who take medication for bipolar disorder tend to recover much faster and control their moods better if they also get therapy. Therapy gives you the tools to cope with lifes difficulties, monitor your progress, and deal with the problems bipolar disorder is causing in your personal and professional life.
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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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Psychological Therapy For Anxiety In Bipolar Spectrum Disorders: A Systematic Review
Anxiety is common in bipolar spectrum disorders and associated with poor outcomes.
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Combined CBT for anxiety and mood may reduce anxiety in bipolar spectrum disorders.
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CBT for comorbid anxiety disorders appears promising in pilot studies.
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Psychoeducation alone does not appear to reduce anxiety.
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Developing specific treatment protocols for bipolar anxiety may improve outcomes.
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How To Find Professional Help
To find a therapist, Fink recommended starting with your primary care provider, a local mental health association, a medical center with an outpatient psychiatry department, or an organization such as the Depression and Bipolar Support Alliance or National Alliance on Mental Health . If you have insurance, Fink also noted that its important to ask your insurance company about coverage and providers.
Because finding therapists who specialize in the above treatments can be tough, Brosse recommended asking therapists these questions: Can you tell me about your experience treating people with bipolar disorder? Im looking for a therapist who can help me learn all the ins-and-outs of my bipolar disorder, and can give me specific skills to help me better manage my moods and prevent relapse. Do you work in this way?
Finding the right therapist for you can take time. The key is to pick someone you feel comfortable with who has experience treating people with bipolar disorder. Keep in mind that its totally normal to work with several therapists before finding a therapist you like.
Learning To Recognise Triggers
If you have bipolar disorder, you can learn to recognise the warning signs of an approaching episode of mania or depression.
A community mental health worker, such as a psychiatric nurse, may be able to help you identify your early signs of relapse from your history.
This will not prevent the episode occurring, but it’ll allow you to get help in time.
This may mean making some changes to your treatment, perhaps by adding an antidepressant or antipsychotic medicine to the mood-stabilising medication you’re already taking.
Your GP or specialist can advise you on this.
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How Are Antipsychotic Medications Used In Treating Bipolar Depression
Studies have shown that some antipsychotic drugs can also treat bipolar depression.
Quetiapine is used for the short-term treatment of bipolar depression. Another option is olanzapine with fluoxetine .
The atypical antipsychotic lurasidone can be taken alone or with lithium or valproate for treating bipolar depression. Cariprazine , a treatment for bipolar disorder, may also be an off-label option.
These medications work by affecting receptors for chemicals in the brain that help regulate mood and behavior.
Your doctor will weigh the pros and cons of the available medications to help you get relief from the bipolar depression without the risk of mania or drug interactions.