Bipolar disorder treatment can help

Many people with bipolar actually have a type of bipolar called bipolar 2. This means that you don’t have full-blown manic symptoms, but you usually have some recurrent episodes of depression punctuated by brief periods of elevated mood. For many people, their “elevated mood” may not be that striking, and it may just be slightly higher than their typical, non-depressed mood. What is striking is the frequent depressive episodes throughout their life.

In fact, it’s thought that at least half of people diagnosed with depression actually have a depression that is more on the bipolar spectrum. It’s important to differentiate between the two because the medications that treat bipolar depression differ from those that treat classic depression. And in cases where medication would be particularly helpful, it’s important to choose the most effective options. 

Although about 3% of Americans meet the criteria for bipolar disorder, many more people have some symptoms of it but don’t meet the full criteria. Also, it’s thought that about half of people with depression have some degree of mood cycling. So symptoms of bipolar are actually very common without meeting the criteria for it.

All of us have shifts in our mood even through the course of a typical day. And these passing mood states don’t mean someone has bipolar disorder. However, healthy emotions are those that don’t control us. For instance, we may feel sad, but it doesn’t last very long and doesn’t interfere with our lives. Bipolar is a state where not only does someone feel sad, elevated, or mad, but the person also experiences a lot of other symptoms at the same time. Symptoms may include having low energy, feeling excessively guilty, not enjoying things they normally would, poor concentration, and changes in appetite or sleep.

During an elevated mood, the person might also experience racing thoughts, increased energy, distractibility, increased speech, or being super productive. When even a few of these symptoms happen together, your feelings begin to change your thought patterns and behaviors in unhelpful ways, and that makes it different than experiencing everyday emotions.

It depends. In milder symptoms, therapy and lifestyle changes can help someone gain control over mood swings. When symptoms begin to interfere with daily life more and more, it can make sense to combine medication with therapy. Especially in bipolar, compared to classic depression, medications often require adjustment to best treat the current episode a person is experiencing.

Working closely with a psychiatric provider becomes very important in living your healthiest life. Once symptoms are well controlled, it’s common to go into “maintenance mode” where medication doses can be decreased. In our practice, we always try to prescribe the lowest amount needed for treatment, increasing doses when symptoms emerge but then decreasing again when someone has improved.

There are many people who have one manic episode and never have another. Some of these people do begin to experience some early signs of mania. But they recognize the signs, reach out to their doctor or therapist, make some lifestyle changes, and are able to avert an episode. We treat many, many young people who have had quite distressing episodes in the past, but now know the specific strategies that keep them well. In fact, one of the most powerful strategies for treating bipolar is to stabilize sleep. Oftentimes, changes in sleep is one of the earliest symptoms in a coming episode and promptly noticing and taking steps to improve sleep can even help prevent episodes.