Charlotte, NC
Dinesh Sangroula, MD
Mike is a 28-year young student who works part-time as a microbiology researcher. He has been working overtime recently and has not slept in a few days. He has also not been able to focus on his research. Mike was depressed last year and had been taking antidepressants for a while. He is suspected of having bipolar disorder.
Bipolar disorder is a mood disorder with two phases to the illness. One is the manic/hypomanic or the ‘up’ phase, and the other is the depressive or ‘down’ phase. Bipolar disorder is different from unipolar depression, where there are recurrent episodes of depression without any elevated or irritable mood episodes, indicating bipolar disorder.
However, it can be treated like any other chronic illness (such as diabetes or hypertension). People with bipolar disorder must receive proper diagnosis and treatment from a psychiatrist as soon as it is suspected.
In a manic phase, people have more than their usual level of energy and can present as one or more of the following:
A depressive phase is where a person has low levels of energy and can present with one or any of the following symptoms:
There are three types of bipolar disorder;
Bipolar disorder is usually first diagnosed in the late teen years or early adulthood. Your doctor will take a detailed medical history and a physical examination to look for other causes of symptoms and to see if other psychiatric diagnoses apply to you. Your primary care doctor will conduct a mental health evaluation or provide a referral to a trained mental health care provider (such as a psychiatrist, psychologist, or clinical social worker) if they think you may have bipolar disorder.
As the symptoms of bipolar disorder are variable, it may be difficult to diagnose bipolar disorder right away. Your psychiatrist might talk to family members and friends to see if there are any behavioral changes or symptoms they may have noticed.
A diagnosis of bipolar disorder starts with you. You must talk to your doctor or licensed mental health care provider. This is the first step for your mental health issues treatment.
Like any other chronic illness, such as diabetes or high blood pressure, bipolar disorder usually requires lifelong treatment. The treatment plan usually includes a combination of medication and psychotherapy called ‘talk therapy.’ Do not stop medications on your own if your symptoms subside and you start feeling better. Poor adherence to your medication plan might aggravate symptoms or increase the frequency of both manic and depressive episodes.
Continuous treatment is necessary to prevent relapse of manic or depressive symptoms, improve overall health, and maximize the quality of life. Since there is a high risk of suicide in people diagnosed with bipolar disorders, your doctor will assess you for suicidal risk and manage the disorder accordingly. This is why regular follow-ups with your psychiatrist are very important to manage your symptoms and continue your treatment.
Medications like mood stabilizers and second-generation (‘atypical’) antipsychotics are generally used to treat bipolar disorder. Your mental health provider will use several drugs, alone or in combination with each other, to treat bipolar disorder.
Lithium is a commonly prescribed and effective medication that works as a mood stabilizer. Your doctor will check your blood levels for lithium regularly. You might have harmful side effects if lithium rises to more than expected levels. Your doctor may order blood tests like thyroid function, urea, creatinine, and blood calcium levels, and an Electrocardiogram (to measure the heart’s electrical activity).
The side effects of lithium may vary from nausea and vomiting to severe symptoms like tremors, confusion, or slurred speech. Your doctor may ask you if you are taking medications like pain meds (NSAIDs) and medicines for hypertension (Thiazides and ACE inhibitors), as their concurrent use with lithium will cause its toxicity. If you are planning a baby, women are asked to stop lithium or start on other medication as the use of lithium may cause congenital heart defects in the baby, commonly known as the Ebstein anomaly.
Your doctor may prescribe an antidepressant medication to treat depressive episodes in bipolar disorder. Treatment plans may include medications that help with sleep or anxiety.
Since all medication used in treating bipolar disorder might give you some adverse effects, your doctor will discuss your medications’ safety profile before prescribing them.
Your doctor will need to tailor your treatment regimen based on your needs, risk factors, and other comorbid illnesses.
Please note that your psychiatrist may need to try several different medications before finding the best fit for you.
Psychotherapy (also known as ‘Talking Therapy’) can play an imperative role in the treatment plan for people with bipolar disorder. This therapy supports, educates, and guides people with bipolar disorder and their families on how to live with it and manage its symptoms. Psychotherapy involves techniques to better equip people to identify and change troubling emotions, thoughts, and behaviors.
While it can be challenging to live with bipolar disorder, you can certainly live a regular life with it if it is treated properly. The following tips can better equip you to handle the symptoms of bipolar disorder:
