Bipolar Disorder

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Bipolar Disorder

What is Bipolar Disorder?

Bipolar is a mental disorder, which is associated with mood swings, it may also be referred to as manic depression. These mood swings can range from deep depressive lows to very high manic highs. A psychiatrist is someone who treats bipolar disorders.

Bipolar disorder is typically a combination of genetics, environment, and altered brain structure (even chemistry can play a role).

A person may exhibit symptoms on the “high side” such as:

  • High energy
  • Reduced need for sleep
  • Lost sense of reality

On the “low side” such as:

  • Low energy
  • Low/No motivation
  • Loss of interest in daily activities

Why is bipolar so hard to diagnose?

Bipolar is often an overlooked condition, which can take years to diagnose – and more awareness is needed. One reason it can take so long to recognize is how challenging it is to obtain a full and accurate history of someone’s mental health, which is a key part of any psychiatric assessment. This can be for several reasons.

For a start, it can be hard for someone with bipolar to be able to accurately recall their moods and when they happened. Depressive and manic states make it hard to remember the detail of what you experienced. Anyone with a mental health illness will know how hard it is to verbalize their symptoms and experiences and therefore be able to clearly describe them to a clinician.

People may express how feelings of being unworthy, bad, or wrong can be lead to them holding back when speaking to a clinician, or even from seeking help at all, “It’s really important to be able to speak with the individual’s family, partner or close friend to understand another more objective view on the symptoms, but unfortunately this isn’t always possible. Sadly, people with bipolar often feel shame or embarrassment with their symptoms and this becomes an additional barrier to diagnosis.”

What is Bipolar Disorder? What is Manic Depression?

The four key points a psychiatrist uses in bipolar disorder evaluation will include:

  1. Physical Examination
  2. Psychiatric Assessment
  3. Mood Charting
  4. Compare symptoms with criteria for bipolar disorder or manic depression.

While other physicians may prescribe medication which treats bipolar disorder, they may or may not be trained to identify and treat bipolar disorder the way a psychiatrist would. Medication should be used in conjunction with other therapies.

Bipolar disorder is something you should treat immediately and through a psychiatrist. Bipolar disorder or manic depression can be treated and with proper treatment you can live a full and healthy life. We have multiple locations throughout Orange County and we may continue treatment through telemed.

There are things you may do on your own to combat bipolar disorder. These may include yoga, acupuncture, massage, natural supplements, even exercise and diet changes may help. However, medicine prescribed by a psychiatrist have been shown to have a greater value in combating manic depression. Also, when you see a psychiatrist they not only will use medical training, but many years of real world experience to work with you – and, yes, we encourage you to ask what steps you may take on your own to “ween” off the need for medication.

Mood stabilizers, antipsychotics, antidepressants, and antidepressant-antipschotic medication are very effective at treating symptoms of bipolar disorder. It is also important to look at further treatment, including: psychotherapy, substance abuse treatment, treatment programs, and self-management solutions.

In our experience medication works for most people. Dosages may need to be adjusted or a medication monitoring program may be implemented (sometimes our body metabolizes one drug better than another).

There is no known cure for bipolar disorder / manic depression. Through behavior therapy, mood stabilizers, and other medication you may live a much more stable life. We recommend a patient continue to see a psychiatrist even when bipolar is not present, because it does have a high recurrent rate. Avoiding alcohol and recreational drugs is a must. Psychotherapy (talk therapy) may also help to keep your depression at bay.

There are numerous tests online and people are willing to give their opinion – however, the only real test is to be seen by a psychiatrist trained in bipolar disorder. You may have something different as the symptoms may be similar to another mental health issue, or you may have multiple disorders. Knowing you have bipolar disorder is one thing, treating it is another.

With locations throughout Orange County, we are here to help.

There are two types of Bipolar Disorder / Manic Depression.

  1. Bipolar I – A person has manic episodes. This includes changes in behavior outside normal behavior. The manic episodes may last most of the day and may last a week or more. The person may have so extreme symptoms they need to be hospitalized.
  2. Bipolar II – Most common. There are depressive symptoms, however the manic symptoms are usually less severe. Usually the one who has bipolar II disorder does not see it, feel it, or realize they are going through it.

The only way to know if you have a bipolar disorder is to see a psychiatrist.

Bipolar disorder is a lifelong mental health issue. It is important you build a lifelong relationship with a psychiatrist who is specifically trained in dealing with manic depression. Episodes may come and go, but bipolar tends to come back again and again.

Every patient is different, also, it is crucially important to understand every patient metabolizes medication differently. Expect to possibly see a medication management program to be implemented, as dosages and even medications may change.

Examples of medications may include:

  1. Mood Stabilizers:  Lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
  2. Antipsychotics:  Olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris)
  3. Antidepressants (only to be taken when mood stabilizer has been added):  SSRI’s -fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). SNRI’s – duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq) and levomilnacipran (Fetzima). Atypical antidepressants:  trazodone, mirtazapine (Remeron), vortioxetine (Trintellix), vilazodone (Viibryd) and bupropion (Wellbutrin SR, Wellbutrin XL, others). Tricyclic antidepressants:  imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin and desipramine (Norpramin). MAOIs:  tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan)

Psychiatry Disorders

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  • The diagnosis of bipolar disorder is based on standardized criteria.
  • Children as young as 6 can be diagnosed with bipolar disorder.
  • Children and adults may experience fast mood swings between depression and mania.
  • More than 30% of bipolar patients can expect a full recovery.  
  • Alcoholism and drug abuse can cause bipolar.
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