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Help With Bipolar Disorders

Curated and updated for the community by APA

Bipolar disorders are brain disorders that cause changes in a person’s mood, energy and ability to function. Bipolar disorder is a category that includes three different conditions — bipolar I, bipolar II and cyclothymic disorder.

People with bipolar disorders have extreme and intense emotional states that occur at distinct times, called mood episodes. These mood episodes are categorized as manic, hypomanic or depressive. People with bipolar disorders generally have periods of normal mood as well. Bipolar disorders can be treated, and people with these illnesses can lead full and productive lives.

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  • Oct 30, 2020
Putting a Care Plan in Place Before a Mental Health Crisis

A Psychiatric Advance Directive (PAD) can be useful tool to help people with serious mental illness plan ahead and have more control over their treatment during a time of crisis. However, they can only be effective when they are prepared in advance and implemented when needed. A PAD (sometimes called a mental health advanced directive) is a legal document that includes a list of instructions and preferences that the individual wishes to be followed in case of a mental health crisis.

  • Nov 06, 2019
Treatments are Available for the So-called Winter Blues

As we move toward winter with shorter daylight hours and falling temperatures, many people begin to feel the cloud of seasonal depression. Seasonal affective disorder (SAD) is a form of depression that occurs seasonally, typically in the winter months. SAD is not just the winter blues – SAD is a subtype of major depressive disorder. It can also occur during summer, but it is much less common that time of year.

  • Nov 19, 2018
Managing Holiday Anxiety and Depression

You may be feeling a build-up of anxiety this holiday season. Thoughts of all the events and gatherings with family, coworkers and friends may fill you with anticipation along with a little angst.

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How quickly does a person with bipolar disorder shift between highs and lows?

It depends. Mood shift frequency varies from person to person. A small number of patients may have many episodes within one day, shifting from mania (an episode where a person is very high-spirited or irritable) to depression. This has been described as “ultra-rapid cycling.” More

Does having one manic episode necessarily mean you will have more and will have depressive episodes?

Not necessarily. Studies have shown that approximately 10 percent of patients have a single episode only. However, the majority of patients have more than one. The number of episodes within a patient’s lifetime varies. Some individuals may have only two or three within their lifetime while others may have the same number within a single year. Frequency of episodes depends on many factors including the natural course of the condition as well as on appropriate treatment. Not taking medication or taking it incorrectly are frequent causes of episode recurrence. More

Can someone with bipolar disorder be treated without medication?

Although it is possible that during the natural course of the illness individual patients may get well without any medication, the challenge is that it is impossible to identify or determine beforehand who those fortunate patients are. Although some patients don’t get well or just have partial response to the best available treatments, on average — and for the vast majority of patients — the benefits of medications outweigh the risks. More

What is a “mixed episode?”

The term “mixed episode” was changed to “mixed features” in the last edition of the Diagnostic and Statistical Manual (DSM-5) published by the American Psychiatric Association in 2013. The new term may apply to either episodes of mania with additional symptoms of depression or the opposite, episodes of depression with additional symptoms of mania. The overall idea is that the presence of both symptoms of mania and depression can exist at the same time. Symptoms of mania include elated or irritable mood, decreased need to sleep or racing thoughts. Symptoms of depression can include depressed mood, impaired sleep and feelings of hopelessness or worthlessness. More

Could my child have bipolar disorder?

It is possible for children to have bipolar disorder. This mental illness occurs in approximately 1 to 3 percent of the general population, and studies have shown that bipolar disorder has a genetic component. However it is also possible for bipolar disorder to appear in someone who has no family history of the disease. More

What can family members do to support a person with bipolar disorder?

Outcomes are always better when there is a strong family support network. Think of bipolar disorder as any other severe medical condition. However, also note that in many severe psychiatric conditions, patients may not be aware that they are ill. They may minimize the severity of their condition. The result of these factors may be that patients will not follow through on their treatment. In very severe cases, there may be instances of a lack of behavioral control where family members may not be able to look after their loved ones. In those cases, assistance from providers or even law enforcement agents may be necessary. More

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About the Expert:

Mauricio Tohen, M.D., Dr.PH, M.B.A.
University Distinguished Professor and Chairman, Department of Psychiatry and Behavioral Sciences
University of New Mexico Health Sciences Center

Chelsea's Story

Chelsea was a 43-year-old married librarian who came to an outpatient mental health clinic with a long history of depression. She described being depressed for a month since she began a new job. She had concerns that her new boss and colleagues thought her work was poor and slow, and that she was not friendly. She had no energy or enthusiasm at home. Instead of playing with her children or talking to her husband, she watched TV for hours, overate and slept long hours.

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Editor's Choice

OCT 1 2020

The impact of caffeine consumption on clinical symptoms in patients with bipolar disorder: A systematic review
MDLinx

Overall, the findings suggest there may be some correlation between the quantities of caffeine that individuals with bipolar disorder consume and the severity of symptoms experienced. In patients with bipolar disorder, acute increases in caffeine consumption may precede the occurrence of manic symptoms, possibly via a direct stimulant effect, influencing sleep patterns; the metabolism of lithium or other medications may also be impacted, although higher caffeine intake could also be due to an ongoing manic relapse or a prodromal sign.

SEPT 23, 2020

ECT for Bipolar Disorder: Across-the-Board Symptom Relief    
Medscape

Electroconvulsive therapy (ECT) appears to improve all clinical features of bipolar disorder (BD), leading to high remission rates and reducing suicide risk by more than 80%, new research suggests. In the largest single-center study of the treatment to date, Italian investigators assessed all patients with BD who were admitted to their unit over a 13-year period. Results showed response rates to ECT of more than 80% for symptoms such as motor hyperactivity, grandiosity, excitement, and tension.

SEPT 11, 2020

Understanding the symptoms, causes, and triggers of rapid cycling in bipolar disorder
Insider

Rapid cycling is a symptom of some bipolar patients that causes them to cycle through four or more episodes a year.  It may be caused by substance abuse, severe life stressors, or trauma. Stopping medication, using antidepressants, and sleep disturbances can trigger rapid cycling.
An average of 12% to 24% of people with bipolar disorder experience rapid cycling, and it is more common in women and children with the disorder. 

Resources

Additional Resources and Organizations

Depression and Bipolar Support Alliance

International Bipolar Foundation

International Society for Bipolar Disorders

Mental Health America

National Alliance on Mental Illness

Physician Reviewed

Ranna Parekh, M.D., M.P.H.
January 2017