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Bipolar Disorder

This mental disorder causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. Mental health treatments are essential for getting bipolar disorder under control and keeping it there.
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Mood swings? Mania? Depressive episodes? You may need a psychiatric evaluation.

Bipolar disorder goes beyond merely being moody. What characterizes bipolar disorder is changes in activity levels and sleep patterns, periods of intense emotion, and unusual behaviors that could have dangerous or undesirable effects.

This mental illness can take someone from casually playing video games to scaling the side of a building to escape imaginary enemies that feel all too real.

Episodes of mania may come with an impulsivity that has you buying new cars for everyone at your favorite restaurant, despite being unable to afford buying new cars for everyone at your favorite restaurant. It could mean being highly productive and creative at work, often not sleeping for weeks, gaining admiration of everyone around you – only to lose all credibility when that mania crosses into psychosis. As mania resolves, a period of depression can follow that causes unrelenting fatigue, extreme sadness, and suicidal thoughts.

Even if you have not engaged in behavior on that level, the underlying experience may strike you as familiar: rapid cycling between high highs and low lows. If so, getting a psychiatric evaluation can be the first step to getting mental health treatment that you need. Bonmente’s mental health professionals can administer a bipolar disorder test that forms the basis of a diagnosis.

Formerly known as manic depression, bipolar disorder has three types:

  • Bipolar I: involves a manic episode that lasts for at least one week
  • Bipolar II: more depressive symptoms and less severe manic episodes, if present
  • Cyclothymia: combines depressive and hypomanic symptoms, but the symptoms are not severe enough to meet the clinical threshold for the above two disorders.
Icon quote
Bipolar disorder can be a great teacher. It’s a challenge, but it can set you up to be able to do almost anything else in your life.
– Carrie Fisher

What causes bipolar disorder?

As with most psychiatric disorders, the exact cause of bipolar disorder is still unknown. It appears to result from a mix of physical, social, and environmental factors.

Some evidence suggests that an imbalance of neurotransmitters can lead to bipolar disorder. Too much norepinephrine can trigger manic episodes and too little norepinephrine has a link to depression.

Beyond brain chemistry, there appears to be a genetic link to bipolar disorder, as it does run in families.

Other triggers include physical illness, lack of sleep, and stressful life situations (such as abuse, the death of a loved one, or a relationship ending).

What are the symptoms of bipolar disorder?

Bipolar disorder symptoms are wide-ranging, which is typical of mood disturbances. Bipolar episodes can have a mixed presentation, with symptoms of mania and symptoms of depression. In many cases, it is the people around you who notice your change in mood and your symptoms before you do.

In mania, you’re on the top of a mountain. Symptoms include feeling wired or elated, with endless energy. You may be irritable or have racing thoughts and talk about a lot of different topics in rapid succession. You may feel like you don’t need to stop what you’re doing to eat or sleep. Feelings of grandiosity, of being god-like or exceptionally important and powerful, can also be a symptom of mania.

Depressive episodes, in contrast, feel like you just fell down the mountain to rock bottom. You may feel intense sadness, anxiety, worthless, or hopeless. Despite feeling restlessness, you may have trouble falling asleep, and when you do manage to sleep you either oversleep or undersleep. Concentration and decision-making may be difficult, leaving you feeling like you have nothing to say.

Are you worried you may have bipolar disorder?

The Mood Disorder Questionnaire (MDQ) is a brief, self-report screening instrument that can identify patients likely to have bipolar disorder.

PLEASE NOTE: This self-test is not a replacement for professional evaluation. If you are experiencing symptoms of bipolar disorder, please call us at 310-360-7200 for an appointment.
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How is bipolar disorder treated?

There is no cure for bipolar disorder, but managing this mental health condition is possible. Effective treatments can successfully contain the condition and regulate the patient’s mood. At bonmente, you can get telepsychiatry treatment for bipolar disorder.

Psychotherapy is an excellent tool for helping patients gain insight into their disease and learn skills to manage symptoms.

Medications may also be necessary to treat bipolar disorder. Medication plans vary depending on the symptoms that are present. It can take some trial and error to find an optimal combination for a patient, and adjustments may need to be made over time.

Fortunately, there are a number of medications, and though it may take some time to dial it in, most patients are able to manage bipolar disorder with good medication compliance and therapy as indicated. Below are some common medications to promote mood stability in people with bipolar disorder.

If an episode of mania or depression becomes so severe that it leads to psychosis or places a patient at risk of suicide, hospitalization may be necessary.

Mood stabilizers

  • lithium (Lithobid)
  • valproic acid (Depakene)
  • divalproex sodium (Depakote)
  • carbamazepine (Tegretol, Equetro, others)
  • lamotrigine (Lamictal)

Antipsychotics

  • aripiprazole (Abilify)
  • asenapine (Saphris)
  • cariprazine (Vraylar)
  • clozapine (Clozaril)
  • lumateperone (Caplyta)
  • lurasidone (Latuda)
  • olanzapine (Zyprexa)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)
  • ziprasidone (Geodon)

Antidepressants

Since antidepressants can trigger mania, oftentimes prescriptions are in combination with a mood stabilizer or antipsychotic.

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

Antidepressant-antipsychotic

  • Symbyax is a combination medication that is part antidepressant (fluoxetine) and part antipsychotic (olanzapine). It works to treat depression and stabilize mood.

Anti-anxiety medications

  • Benzodiazepines are one example of this kind of medication, which may be a short-term prescription for improving sleep and anxiety issues.

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