Managing bipolar disorder starts with getting clear answers on your treatment options. In this HealthCentral article, Mindpath Health’s Julian Lagoy, MD, discusses questions to discuss with your clinician about bipolar disorder treatment.
If you’ve just been diagnosed with bipolar disorder, you’re bound to have a million questions. This mental health disorder marked by extreme mood swings requires the right treatment plan to manage the manic and depressive episodes and lead a healthy, rewarding life. It can take time to find the combination of meds, therapies, and lifestyle changes that works for you. By asking your doc the right questions about bipolar disorder treatment, you can start on the path to managing your condition from a place of awareness and empowerment.
Do I really need medication?
“You can help manage bipolar disorder with alternative therapies, but if you’re not on the right medication, your risk of becoming manic is significantly higher than someone on appropriate medication,” says Julian Lagoy, MD, a psychiatrist with Mindpath Health. The most common medications prescribed to treat bipolar disorder are mood stabilizers.
How do mood stabilizers work?
Manic episodes of bipolar are characterized by hyperactive, impulsive behavior, while depressive phases can make it difficult to do even the simplest things. Mood stabilizing drugs regulate both the high (mania) and low (depression) of bipolar disorder by decreasing abnormal activity in the brain. While some people experience signs of improvement quickly, in other cases it can take up to several months to establish whether the mood-stabilizing drug is effective. Mood stabilizers are designed to be taken daily on a long-term basis.
How do antipsychotics work?
Some people with bipolar disorder experience psychotic symptoms, like delusions and hallucinations. Antipsychotics address these symptoms, and because they have mood-stabilizing properties, they’re often prescribed for people with bipolar disorder who don’t have psychotic symptoms. Antipsychotics tend to take effect within hours, so doctors often prescribe them along with mood stabilizers, which take longer to kick in. It’s thought that overactivity of dopamine (the “feel-good” hormone) is a factor in psychotic symptoms, and antipsychotics block this action.
Can I take antidepressants for bipolar disorder?
There’s controversy around using antidepressants to treat bipolar disorder because they’ve triggered manic episodes in a small percentage of people with the condition. Even so, general practice guidelines for clinicians recommend prescribing antidepressants for bipolar disorder only for the short-term.
What side effects might I experience?
Like any drugs, medications that are used to help control manic and depressive episodes come with side effects. For instance, side effects of antipsychotics include tremors, muscle spasms, involuntary movements, dry mouth, sore throat, and weight gain. The mood stabilizer lithium can cause sedation or confusion, loss of appetite, diarrhea, vomiting, dizziness, and excessive thirst. Be sure to keep a record of any side effects that you experience, and let your doctor know if you don’t think your meds are working for you.
Are there any long-term effects of my condition?
If you don’t control your bipolar disorder symptoms with medication, you may experience disturbed eating or sleeping patterns, suicidal thoughts, or long periods of feeling hopeless or helpless. Some studies have found a link between bipolar disorder and a higher risk for thyroid disease, heart disease, chronic pain, and anxiety disorders. If you have bipolar, seeking treatment is an important first step.
What psychological therapies might help?
Your doctor might suggest therapy in addition to medication. Paired with meds, psychotherapy, such as cognitive behavioral therapy or interpersonal and social rhythm therapy, can offer benefits. With cognitive behavioral therapy, you can learn to identify distorted thoughts that often contribute to depressive or hyper-positive states, reject or change them, and respond in productive ways. Interpersonal and social rhythm therapy helps patients achieve a steady, structured rhythm, including going to sleep, waking up, eating, and exercising regularly, so they can create healthy routines and improve relationships.
Could my bipolar go away on its own?
Processing a bipolar disorder diagnosis and weighing treatment options can be overwhelming. But you should never leave this condition untreated. “Bipolar disorder is a major illness and stressor on the brain if not treated correctly, and may cause brain damage over time,” says Dr. Lagoy. You also need to be careful not to abruptly discontinue any meds your doctor has prescribed for bipolar disorder. Take your meds as prescribed, and don’t make any changes without your doctor’s direction.