Most people with bipolar disorder struggle with taking medication routinely and often provide various excuses for noncompliance such as negative side effects, diminished sex drive, forgetfulness, and not accepting their diagnosis.
Often these same individuals must try several medications before discovering which works best for them.
According to the National Institute of Mental Health (NIH), bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes unusual shifts in a person’s mood, energy, activity levels, and concentration. These shifts can make it difficult to carry out day-to-day tasks.
Finding the right medication(s) can be one of the trickiest parts in treating bipolar related mood swings. Thus, a combination of therapy, medication(s), and lifestyle changes are recommended.
NIH estimates that 2.8% of adults in the United States have bipolar disorders: Either bipolar 1, bipolar 2 or cyclothymic disorder. The major difference between forms of the disorder is how extreme the mood swings are and how long they last. In all types, there are periods between manic or depressive episodes when symptoms lessen or people feel stable. (https://www.samhsa.gov/serious-mental-illness/bipolar)
- Bipolar I Disorder: chronic mood swings that go from very high manic states to severe depressive episodes.
- Bipolar II Disorder: mood swings that go from high to low, but the highs are less extreme and are called hypomanic states. The depressive episodes may be just as severe as those in Bipolar I disorder.
- Cyclothymic Disorder: chronic mood swings (both highs and lows) that are not as long, severe, or frequent as those experienced in bipolar I or II disorder.
“It’s important to note that bipolar disorder is a different experience for every person, each with their own complexities,” says Gagandeep Singh, MD, a psychiatrist at Banner Behavioral Health Hospital. “It can differ from person to person and have different levels of symptoms.” (bannerhealth.com)
Medications prescribed and dosage are generally based on the individual’s symptoms regardless of the type of bipolar and may include:
Mood stabilizers. In addition to lithium (Lithobid), other mood stabilizers are valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
- Antipsychotics. Psychiatric care providers may add an antipsychotic medication along with a mood stabilizer. Examples include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda), cariprazine (Vraylar) or asenapine (Saphris). Your provider may prescribe some of these medications alone or along with a mood stabilizer.
- Antidepressants. To help manage depression, patients may need an antidepressant. Because an antidepressant can sometimes trigger a manic episode, it needs to be prescribed along with a mood stabilizer or antipsychotic in bipolar disorder.
- Antidepressant-antipsychotic. The medication Symbyax which has been approved by the Food and Drug Administration combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer.
Bipolar disorder may worsen with age or over time if the condition is left untreated. As time goes on, a person may experience episodes that are more severe and more frequent than when symptoms first appeared.
Taking any kind of medication on a regular basis involves effort and discipline. This is especially true for those with bipolar as routine and structure are extremely important.
While medication is definitely helpful and an important tool in treating bipolar disorder, diet, exercise, proper sleep and psychotherapy such as cognitive behavioral therapy (CBT) can also help keep symptoms at bay. CBT can help individuals to better process negative thinking, learn about personal triggers and how to avoid and navigate through them. (bannerhealth.com)
The depressive phase of bipolar disorder is often very severe, and suicide is a major risk.
Bipolar disorder may sound like a serious diagnosis, but with the right tools, support and a commitment to being healthy, it is manageable. Not only can someone live a normal life with bipolar disorder, they can live a full and rewarding life.