Bipolar Disorder (Manic Depression): Symptoms & Treatment

Bipolar disorder is a chronic mood disorder that causes intense shifts in mood, energy levels and behavior. Manic episodes are the main sign ... ComingtoaClevelandCliniclocation?Visitation,maskrequirementsandCOVID-19information Home / HealthLibrary / Disease&Conditions BipolarDisorder Bipolardisorderisachronicmooddisorderthatcausesintenseshiftsinmood,energylevelsandbehavior.Manicandhypomanicepisodesarethemainsignofthecondition,andmostpeoplewithbipolardisorderalsohavedepressiveepisodes.Theconditionismanageablewithmedications,talktherapy,lifestylechangesandothertreatments. Appointments866.588.2264 Appointments&Locations RequestanAppointment Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith BipolarDisorder Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith BackToTop Overview Whatisbipolardisorder? Bipolardisorder(formerlyknownasmanic-depressiveillnessormanicdepression)isalifelongmooddisorderandmentalhealthconditionthatcausesintenseshiftsinmood,energylevels,thinkingpatternsandbehavior.Theseshiftscanlastforhours,days,weeksormonthsandinterruptyourabilitytocarryoutday-to-daytasks. Thereareafewtypesofbipolardisorder,whichinvolveexperiencingsignificantfluctuationsinmoodreferredtoashypomanic/manicanddepressiveepisodes.However,peoplewithbipolardisorderaren’talwaysinahypomanic/manicordepressivestate.Theyalsoexperienceperiodsofnormalmood,knownaseuthymia. Manicepisodes AkeyfeatureofbipolarIdisorderismanicepisodes.TomeetthecriteriaforbipolarIdisorder,youmusthavehadatleastonemanicepisodeinyourlifeforatleastaweekwithorwithouteverexperiencingadepressiveepisode. Maniaisaconditioninwhichyouhaveaperiodofabnormallyelevatedorirritablemood,aswellasextremechangesinemotions,thoughts,energy,talkativenessandactivitylevel.Thishighlyenergizedlevelofphysicalandmentalactivityandbehaviorisachangefromyourusualselfandisnoticeablebyothers. Peoplewhoareinmanicstatesmayindulgeinactivitiesthatcausethemphysical,socialorfinancialharm,suchassuddenlyspendingorgamblingextremeamountsofmoneyordrivingrecklessly.Theyalsooccasionallydeveloppsychoticsymptoms,suchasdelusionsandhallucinations,whichcancausedifficultiesindistinguishingbipolardisorderfromotherdisorderssuchasschizophreniaorschizoaffectivedisorder. PeoplewithcertaintypesofbipolarsuchasbipolarIIdisorderexperiencehypomania,whichisalesssevereformofmania.Itdoesn’tlastaslongasmanicepisodesanditdoesn’tinterferewithdailyfunctioningasmuch. Depressiveepisodes Duringadepressiveepisode,youexperiencealowordepressedmoodand/orlossofinterestinmostactivities,aswellasmanyothersymptomsofdepression,suchas: Tiredness. Changesinappetite. Feelingsofworthlessnessandhopelessness. Whyisbipolardisordernolongercalledmanic-depressiveillness? Inthelastfewdecades,themedicalworld,especiallythefieldofpsychiatry,hasintentionallymadeashiftfromusing“manic-depressiveillness”or“manicdepression”todescribebipolardisorder.Thereareseveralreasonsforthisshift,including: Healthcareprovidersusedtouse“manicdepression”todescribeawiderangeofmentalhealthconditions.Asmentalhealthconditionclassificationsystems,includingtheDiagnosticandStatisticalManualofMentalDisorders(DSM),havebecomemoresophisticated,thenewterm“bipolardisorder”allowsformoreclarityindiagnosis. There’salotofstigmaandnegativityassociatedwiththeterms“manic”and“mania,”especiallyduetotheuseof“maniac.”Similarly,peopleusetheterm“depression”casuallytodescribeperiodsofsadnessthatdon’tqualifyasclinicaldepression.Using“bipolardisorder”takesthefocusawayfromthesetwowords.“Bipolardisorder”ismoreofaclinical,medicaltermandlessemotionallyloadedthan“manicdepression.” Theterm“manicdepression”excludesthecyclothymicorhypomanic(bipolarIIdisorder)versionsofthecondition. Whatarethetypesofbipolardisorder? Therearefourtypesofbipolardisorder,including: BipolarIdisorder:PeoplewithbipolarIdisorderhaveexperiencedoneormoreepisodesofmania.MostpeoplewithbipolarIwillhaveepisodesofbothmaniaanddepression,butanepisodeofdepressionisn’tnecessaryforadiagnosis.Thedepressiveepisodesusuallylastatleasttwoweeks.TobediagnosedwithbipolarI,yourmanicepisodesmustlastatleastsevendaysorbesoseverethatyouneedhospitalization.PeoplewithbipolarIcanalsoexperiencemixedstates(episodesofbothmanicanddepressivesymptoms). BipolarIIdisorder:PeoplewithbipolarIIexperiencedepressiveepisodesandhypomanicepisodes.Buttheyneverexperienceafullmanicepisodethat’scharacteristicofbipolarIdisorder.Whilehypomaniaislessimpairingthanmania,bipolarIIdisorderisoftenmoredebilitatingthanbipolarIdisorderduetochronicdepressionbeingmorecommoninbipolarII. Cyclothymicdisorder(cyclothymia):Peoplewithcyclothymicdisorderhaveachronicallyunstablemoodstate.Theyexperiencehypomaniaandmilddepressionforatleasttwoyears.Peoplewithcyclothymiamayhavebriefperiodsofnormalmood(euthymia),buttheseperiodslastfewerthaneightweeks. Otherspecifiedandunspecifiedbipolarandrelateddisorders:Ifapersondoesn’tmeetthediagnosticcriteriaforbipolarI,IIorcyclothymiabuthasstillexperiencedperiodsofclinicallysignificantabnormalmoodelevation,it’sconsideredotherspecifiedorunspecifiedbipolardisorder. What’sthedifferencebetweenborderlinepersonalitydisorderandbipolardisorder? Whileborderlinepersonalitydisorder(BPD)andbipolardisorderhavesimilarsymptomsandareoftenconfusedforeachother,they’redistinctconditions. BPDinvolvesalongstandingpatternofabrupt,moment-to-momentswingsinmoods,behaviorandself-imagethatareoftentriggeredbyconflictsininteractionswithotherpeople.Nonsuicidalself-injuryisalsocommoninBPDbutnotinbipolardisorder. BipolardisorderisdifferentfromBPDbecauseitinvolvesdistinct,longer-lastingepisodesofmania/hypomaniaand/ordepression.Severalthingscantriggermanicordepressiveepisodes,suchassleepchanges,stress,medicationsandsubstanceuse. Whodoesbipolardisorderaffect? Bipolardisordercanaffectanyone.Theaverageageofonsetis25years,but,morerarely,itcanstartasearlyasearlychildhoodoraslateasinyour40sor50s. Althoughbipolardisorderaffectspeopleassignedfemaleatbirth(AFAB)andpeopleassignedmaleatbirth(AMAB)inequalnumbers,theconditiontendstoaffectthemdifferently. PeopleAFABwithbipolardisordermayswitchmoodsmorequickly.Whenpeoplewithbipolardisorderexperiencefourormoremanicordepressiveepisodesinayear,thisiscalled“rapidcycling.”Varyinglevelsofsexhormonesandthyroidhormones,togetherwiththetendencyforpeopleAFABtobeprescribedantidepressants,maycontributetothemorerapidcyclinginthispopulation. PeopleAFABwithbipolardisordermayalsoexperiencemoreperiodsofdepressionthanpeopleAMAB. Howcommonisbipolardisorder? Bipolardisorderaffectsapproximately5.7millionadultAmericansorabout2.6%oftheU.S.population. SymptomsandCauses Whatarethesignsandsymptomsofbipolardisorder? ThedefiningsignofbipolarIdisorderisamanicepisodethatlastsatleastoneweek,whilepeoplewithbipolarIIdisorderorcyclothymiaexperiencehypomanicepisodes. Butmanypeoplewithbipolardisorderexperiencebothhypomanic/manicanddepressiveepisodes.Thesechangingmoodstatesdon’talwaysfollowasetpattern,anddepressiondoesn’talwaysfollowmanicphases.Apersonmayalsoexperiencethesamemoodstateseveraltimes—withperiodsofeuthymiainbetween—beforeexperiencingtheoppositemood. Moodchangesinbipolardisordercanhappenoveraperiodofweeks,monthsandsometimesevenyears. Animportantaspectofthemoodchangesisthatthey’readeparturefromyourregularselfandthatthemoodchangeissustainedforalongtime.Itmaybemanydaysorweeksinthecaseofmaniaandmanyweeksormonthsinthecaseofdepression. Theseverityofthedepressiveandmanicphasescandifferfrompersontopersonandinthesamepersonatdifferenttimes. Signsandsymptomsofmanicepisodes Somepeoplewithbipolardisorderwillhaveepisodesofmaniaorhypomaniamanytimesthroughouttheirlife;othersmayexperiencethemonlyrarely. Signsandsymptomsofamanicepisodeinclude: Excessivehappiness,hopefulnessandexcitement. Suddenandseverechangesinmood,suchasgoingfrombeingjoyfultobeingangryandhostile. Restlessness. Rapidspeechandracingthoughts. Increasedenergyandlessneedforsleep. Increasedimpulsivityandpoorjudgment,suchassuddenlyquittingyourjob. Makinggrandandunattainableplans. Recklessandrisk-takingbehavior,suchasdrugandalcoholmisuseandhavingunsafeorunprotectedsex. Feelinglikeyou’reunusuallyimportant,talentedorpowerful. Psychosis—experiencinghallucinationsanddelusions(inthemostseveremanicepisodes). Mostofthetime,peopleexperiencingamanicepisodeareunawareofthenegativeconsequencesoftheiractions.Withbipolardisorder,suicideisanever-presentdanger—somepeoplebecomesuicidalinmanicepisodes,notjustdepressiveepisodes. Ifapersonishavinganintensemanicepisode,especiallyifthey’reexperiencinghallucinationsanddelusions,theymayneedtobehospitalizedtoprotectthemselvesandothersfrompossibleharm. Signsandsymptomsofhypomania Somepeoplewithbipolardisorderhavemildermanic-likesymptoms.Thisiscalledhypomania.Withhypomania,youmayfeelverygoodandfindthatyoucangetalotdone.Peoplewithhypomaniacanoftenfunctionwellinsocialsituationsoratwork. Youmaynotfeellikeanythingiswrongduringahypomanicepisode.Butyourfamilyandfriendsmaynoticeyourmoodswingsandactivitylevelchangesandthinkthatthey’reunusualforyou.Afterhypomania,youmightexperienceseveredepression. Signsandsymptomsofdepressiveepisodes Thesymptomsofdepressiveepisodesinbipolardisorderarethesameasthoseofmajordepression.Theyinclude: Overwhelmingsadness. Lowenergyandfatigue. Lackofmotivation. Feelingsofhopelessnessorworthlessness. Lossofenjoymentofthingsthatwereoncepleasurableforyou. Difficultyconcentratingandmakingdecisions. Uncontrollablecrying. Irritability. Increasedneedforsleep. Insomniaorexcessivesleep. Achangeinappetite,causingweightlossorgain. Thoughtsofdeathorsuicide(suicidalideation). Ifyou’reexperiencingsuicidalideation(thoughtsofsuicide),it’simportanttoseekimmediatecare.Call911ortheNationalSuicidePreventionLifelineat1.800.273.8255.Someonewillbeavailabletotalkwithyou24hoursaday,sevendaysaweek. Signsandsymptomsofamixedepisode Thesymptomsofamixedepisodeincludebothmanicanddepressivesymptomstogether.Duringamixedepisode,youhavethenegativefeelingsandthoughtsthatcomewithdepressionbutalsofeelagitated,restlessandhighenergy. Peoplewhoexperiencemixedepisodesoftendescribeitastheworstpartofbipolardisorder. Whatcausesbipolardisorder? Scientistsdon’tyetknowtheexactcauseofbipolardisorder. Buttheydobelievethere’sastronggenetic(inherited)component.Bipolardisorderisconsideredoneofthemostheritablepsychiatricconditions—morethantwo-thirdsofpeoplewithbipolardisorderhaveatleastoneclosebiologicalrelativewiththecondition.However,justbecauseyouhaveabiologicalrelativewithbipolardisorder,doesn’tnecessarilymeanyou’llalsodevelopit. Otherfactorsthatscientiststhinkcontributetothedevelopmentofbipolardisorderinclude: Changesinyourbrain:Researchershaveidentifiedsubtledifferencesintheaveragesizeoractivationofsomebrainstructuresinpeoplewithbipolardisorder.However,brainscanscan’tdiagnosethecondition. Environmentalfactorsliketraumaandstress:Astressfulevent,suchasthedeathofalovedone,aseriousillness,divorceorfinancialproblemscantriggeramanicordepressiveepisode.Becauseofthis,stressandtraumamayalsoplayaroleinthedevelopmentofbipolardisorder. Scientistsarecurrentlyperformingresearchtodeterminetherelationshipthatthesefactorshaveinbipolardisorder,howtheymayhelppreventitsonsetandwhatroletheymayplayinitstreatment. DiagnosisandTests Howisbipolardisorderdiagnosed? Todiagnosebipolardisorder,yourhealthcareprovidermayusemanytools,including: Aphysicalexam. Athoroughmedicalhistory,whichwillincludeaskingaboutyoursymptoms,lifetimehistory,experiencesandfamilyhistory. Medicaltests,suchasbloodtests,toruleoutotherconditionsthatcouldbecausingyoursymptoms,suchashyperthyroidism. Amentalhealthevaluation.Yourhealthcareprovidermayperformtheevaluation,ortheymayreferyoutoamentalhealthspecialist,suchasapsychologistorpsychiatrist. Tobediagnosedwithbipolardisorder,youmusthaveexperiencedatleastoneepisodeofmaniaorhypomania.MentalhealthprovidersusetheDiagnosticandStatisticalManualofMentalDisorders(DSM)todiagnosethetypeofbipolardisorderapersonmaybeexperiencing. Todeterminewhattypeofbipolardisorderyoumayhave,yourmentalhealthproviderassessesthepatternofsymptomsandhowmuchtheyaffectyourlifeduringthemostsevereepisodes. Peoplewithbipolardisorderaremorelikelytoalsohavethefollowingmentalhealthconditions: Anxiety. Attention-deficit/hyperactivitydisorder(ADHD). Post-traumaticstressdisorder(PTSD). Substanceusedisorders/dualdiagnosis. Becauseofthis,aswellasthefactthatmemoryisoftenimpairedduringmaniasopeoplecan’trememberexperiencingit,itcanbedifficultforhealthcareproviderstoproperlydiagnosepeoplewithbipolardisorder. Peoplewithbipolardisorderwhoareexperiencingaseveremanicepisodewithhallucinationsmaybeincorrectlydiagnosedwithschizophrenia.Bipolardisordercanalsobemisdiagnosedasborderlinepersonalitydisorder(BPD). Becauseofthis,it’simportanttobehonestandthoroughwhenexplainingallofyoursymptomsandexperienceswhentalkingwithyourhealthcareprovider.Itcanalsobehelpfultoincludealovedonewhomaybeabletoprovideadditionaldetailsaboutyourmentalhealthhistoryinyourdiscussionswithyourprovider. ManagementandTreatment Howisbipolardisordertreated? Treatmentcanhelpmanypeople,includingthosewiththemostsevereformsofbipolardisorder.Aneffectivetreatmentplanusuallyincludesacombinationofthefollowingtherapies: Psychotherapy(talktherapy). Medications. Self-managementstrategies,likeeducationandidentifyingtheearlysymptomsofanepisodeorpossibletriggersofepisodes. Helpfullifestylehabits,suchasexercise,yogaandmeditation.Thesecansupport,butnotreplace,treatment. Othertherapies,suchaselectroconvulsivetherapy(ECT)incasesthatarepoorlyresponsivetomedicationorwhererapidcontrolofsymptomsisnecessarytopreventharm. Bipolardisorderisalifelongcondition,sotreatmentisalifelongcommitment.Itcansometimestakeseveralmonthstoyearsbeforeyouandyourhealthcareproviderfindacomprehensivetreatmentplanthatworksbestforyou.Althoughthiscanbediscouraging,it’simportanttocontinuetreatment. Episodesofmaniaanddepressiontypicallycomebackovertime.Betweenepisodes,manypeoplewithbipolardisorderdon’thavemoodchanges,butsomepeoplemayhavelingeringsymptoms.Long-term,continuoustreatmentcanhelpmanagethesesymptoms. Ifyouhaveothermentalhealthconditionsinadditiontobipolardisorder,suchasanxietyorADHD,itcanbemoredifficulttotreattheconditions.Forexample,theantidepressantshealthcareprovidersprescribetotreatobsessive-compulsivedisorder(OCD)andthestimulantstheyprescribetotreatADHDmayworsensymptomsofbipolardisorderandmayeventriggeramanicepisode. Again,eventhoughitmaybedifficulttotreattheseconditions,it’snotimpossible.Besuretostaycommittedtofindingatreatmentplanthatworksforyou. Whattypesoftherapyareusedtotreatbipolardisorder? Psychotherapy,alsocalled“talktherapy,”canbeaneffectivepartofthetreatmentplanforpeoplewithbipolardisorder. Psychotherapyisatermforavarietyoftreatmenttechniquesthataimtohelpyouidentifyandchangetroublingemotions,thoughtsandbehaviors.Workingwithamentalhealthprofessional,suchasapsychologistorpsychiatrist,canprovidesupport,educationandguidancetoyouandyourfamily. Differenttypesoftherapyforbipolardisorderinclude: Psychoeducation:Psychoeducationisthewaymentalhealthprofessionalsteachpeopleabouttheirmentalhealthconditions.Asbipolardisorderisacomplexcondition,learningabouttheconditionandhowitcanaffectyourlifecanhelpyouandyourlovedonesmanageandcopewithitbetter. Interpersonalandsocialrhythmtherapy(IPSRT):Thistherapyisdesignedtohelpyouimproveyourmoodsbyunderstandingandworkingwithyourbiologicalandsocialrhythms.IPSRTisaneffectivetherapyforpeoplewithmooddisorders,includingbipolardisorder.Itemphasizestechniquestoimprovemedicationadherence(takingyourmedicationregularly),managestressfullifeeventsandreducedisruptionsinsocialrhythms(day-to-daydifferencesinhabitualbehaviors).IPSRTteachesyouskillsthatletyouprotectyourselfagainstthedevelopmentoffuturemanicordepressiveepisodes. Family-focusedtherapy:Thistherapyisforadultsandchildrenwithbipolardisorderandtheircaregivers.Duringthistreatment,yourlovedoneswilljoinyouintherapysessionsofpsychoeducationregardingbipolardisorder,communicationimprovementtrainingandproblem-solvingskillstraining. Cognitivebehavioraltherapy(CBT):Thisisastructured,goal-orientedtypeoftherapy.Yourtherapistorpsychologisthelpsyoutakeacloselookatyourthoughtsandemotions.You’llcometounderstandhowyourthoughtsaffectyouractions.ThroughCBT,youcanunlearnnegativethoughtsandbehaviorsandlearntoadopthealthierthinkingpatternsandhabits. Whatmedicationsareusedtotreatbipolardisorder? Certainmedicationscanhelpmanagesymptomsofbipolardisorder.Youmayneedtotryseveraldifferentmedications,withguidancefromyourhealthcareprovider,beforefindingwhatworksbest. Medicationshealthcareprovidersgenerallyprescribetotreatbipolardisorderinclude: Moodstabilizers. Second-generation(“atypical”)neuroleptics(alsocalledantipsychotics). Antidepressants. Ifyou’retakingmedicationforbipolardisorder,youshould: Talkwithyourhealthcareprovidertounderstandtherisks,sideeffectsandbenefitsofthemedication. Tellyourhealthcareprovideraboutanyprescriptiondrugs,over-the-countermedicationsorsupplementsyou’realreadytaking. Tellyourhealthcareproviderrightawayifyou’reexperiencingconcerningsideeffects.Theymayneedtochangeyourdoseortryadifferentmedication. Rememberthatmedicationforbipolardisordermustbetakenconsistently,asprescribed. Moodstabilizersforbipolardisorder Peoplewithbipolardisordertypicallyneedmood-stabilizingmedicationtomanagemanicorhypomanicepisodes. Typesofmoodstabilizersandtheirbrandnamesinclude: Lithium(Eskalith®,Lithobid®,Lithonate®). Valproicacid(Depakene®). Divalproexsodium(Depakote®). Carbamazepine(Tegretol®,Equetro®). Lamotrigine(Lamictal®). Lithiumisoneofthemostwidelyprescribedandstudiedmedicationsfortreatingbipolardisorder.Lithiumisanaturalsaltandwillreducesymptomsofmaniawithintwoweeksofstartingtherapy,butitmaytakeweekstomonthsbeforethemanicsymptomsarefullymanaged.Becauseofthis,healthcareprovidersoftenprescribeotherdrugslikeantipsychoticdrugsorantidepressantdrugstohelpmanagesymptoms. Thyroidglandandkidneyproblemscansometimesdevelopwhentakinglithium,soyourhealthcareproviderwillmonitorthefunctionofyourthyroidandkidneys,aswellasmonitorthelevelsoflithiuminyourblood,aslevelscaneasilybecometoohigh. Anythingthatlowersthelevelofsodiuminyourbody,suchasswitchingtoalow-sodiumdiet,heavysweating,fever,vomitingordiarrheamaycauseatoxicbuildupoflithiuminyourbody.Beawareoftheseconditionsandalertyourdoctorifyou’reonlithiumandexperiencethem. Thefollowingaresignsoflithiumtoxicity(lithiumoverdose).Callyourhealthcareproviderimmediatelyorgotothenearestemergencyroomifyouexperience: Blurredvisionordoublevision. Irregularpulse. Extremelyfastorslowheartbeat. Difficultybreathing. Confusionanddizziness. Severetremblingorconvulsions. Passinglargeamountsofpee. Uncontrolledeyemovements. Unusualbruisingorbleeding. Neurolepticmedicationsforbipolardisorder Healthcareprovidersoftenprescribesecond-generationoratypicalneuroleptics(antipsychotics)incombinationwithamoodstabilizerforpeoplewithbipolardisorder.Thesemedicationshelpwithbothmanicanddepressiveepisodes. OnlyfourofthesedrugsareU.S.FoodandDrugAdministration(FDA)-approvedtohelptreatbipolardepression,including: Cariprazine(Vraylar®). Lurasidone(Latuda®). Olanzapine-fluoxetinecombination(Symbyax®). Quetiapine(Seroquel®). However,othermedications,suchasolanzapine(Zyprexa®),risperidone(Risperdal®)andaripiprazole(Abilify®),arecommonlyprescribedaswell. Antidepressantsforbipolardisorder Healthcareproviderssometimesprescribeantidepressantmedicationtotreatdepressiveepisodesinbipolardisorder,combiningtheantidepressantwithamoodstabilizertopreventtriggeringamanicepisode. Antidepressantsareneverusedastheonlymedicationtotreatbipolardisorderbecauseonlytakinganantidepressantdrugcantriggeramanicepisode. Whatarethesideeffectsofbipolardisordermedications? Sideeffectsofbipolardisordermedicationsarecommonandvarybymedication.It’simportanttotalkwithyourhealthcareprovideraboutwhatyoucanexpectwhentakingcertainmedications.It’salsoimportanttotellthemifyou’reexperiencingsideeffects. Neverstoptakingyourmedicationunlessyourhealthcareprovidertellsyoutodoso.Abruptlystoppingmedicationcancauseseveresideeffectsandtriggersevereepisodes. Themostcommonsideeffectsofbipolardisordermedicationsinclude: Weightgain. Metabolicdysregulation,includingabnormallipidlevels(dyslipidemia),highbloodpressure(hypertension)andhighbloodsugar(hyperglycemia). Drowsiness. Akathisia—feelingsofrestlessnessandagitationwithacompellingneedtomove,rockorpace. Whatothermedicaltreatmentsareusedforbipolardisorder? Othertreatmentoptionsyourhealthcareprovidermayconsiderfortreatingbipolardisorderinclude: Electroconvulsivetherapy(ECT):Thisisaprocedureinwhichabriefapplicationofanelectriccurrenttoyourbrain,throughyourscalp,inducesaseizure.It’smostoftenusedtotreatpeoplewithseveredepression.ECTisverysafeandhighlyeffectiveformedication-resistantdepressionoracutelife-threateningmania.It’sthebesttreatmentformaniainpeoplewhoarepregnant.ECTisusesgeneralanesthesia,soyou’llbeasleepduringtheprocedureandwon’tfeelanypain. Transcranialmagneticstimulation(TMS):Thistherapyinvolvesashortelectromagneticcoilthatpassesanelectriccurrentintoyourbrain.Healthcareproviderssometimesuseittotreatmedication-resistantdepression.It’sanalternativetoECT.TMSisn’tpainfulanddoesn’trequiregeneralanesthesia. Thyroidmedications:Thesemedicationscansometimesactasmoodstabilizers.StudieshaveshownpositiveresultsinreducingsymptomsinpeopleAFABwithhard-to-treat,rapid-cyclingbipolardisorder. Ketaminetreatment:Ketamine,ananesthetic,givenatlowdosesthroughanIV,hasbeenproventoprovideshort-termantidepressantandantisuicidaleffectsforpeoplewithbipolardisorder. Hospitalization:Thisisconsideredanemergencyoptioninbipolardisordercare.Itbecomesnecessarywhensomeoneisexperiencingaseveredepressiveormanicepisodeandthey’reanimmediatethreattothemselvesorothers. Whatlifestylechangescanhelpwithbipolardisorder? Yourhealthcareteamwilllikelyrecommendmakinglifestylechangestostoppatternsofbehaviorthatworsenthesymptomsofbipolardisorder.Someoftheselifestylechangesinclude: Quitdrinkingalcoholand/orusingrecreationaldrugsandtobacco:It’sessentialtoquitdrinkingandusingdrugs,includingtobacco,sincetheycaninterferewithmedicationsyoumaytake.Theycanalsoworsenbipolardisorderandtriggeramoodepisode. Keepadailydiaryormoodchart:Keepingtrackofyourdailythoughts,feelingsandbehaviorscanhelpyoubeawareofhowwellyourtreatmentisworkingand/orhelpyouidentifypotentialtriggersofmanicordepressiveepisodes. Maintainahealthysleepschedule:Bipolardisordercangreatlyaffectyoursleeppatterns,andchangesinyourfrequencyofsleepcaneventriggeranepisode.Prioritizearoutinesleepingschedule,includinggoingtosleepandgettingupatthesametimeseveryday. Exercise:Exercisehasbeenproventoimprovemoodandmentalhealthingeneral,soitmayhelpmanageyoursymptomsrelatedtobipolardisorder.Sinceweightgainisacommonsideeffectofbipolardisordermedications,exercisemayalsohelpwithweightmanagement. Meditation:Meditationhasbeenshowntobeeffectiveinimprovingthedepressionthat’spartofbipolardisorder. Managestressandmaintainhealthyrelationships:Stressandanxietycanworsenmoodsymptomsinmanypeoplewithbipolardisorder.It’simportanttomanageyourstressinahealthywayandtotrytoeliminatestressorswhenyoucan.Abigpartofthisismaintaininghealthyrelationshipswithfriendsandfamilywhosupportyou,andlettinggooftoxicrelationshipswithpeoplewhoaddstresstoyourlife. Prevention Canbipolardisorderbeprevented? Unfortunately,there’snoknownwaytopreventbipolardisorderbecausescientistsdon’tknowitsexactcause. Butit’simportanttoknowthesignsandsymptomsofbipolardisorderandtoseekearlyintervention. Outlook/Prognosis Whatistheoutlook(prognosis)ofbipolardisorder? Theprognosisforbipolardisorderisoftenpoorunlessit’sproperlytreated.Manypeoplewithbipolardisorderwhoreceiveappropriatetreatmentcanlivefulfillingandproductivelives. Bipolardisorderresultsinapproximatelynineyearsreductioninexpectedlifespan,andasmanyas1in5peoplewithbipolardisordercommitsuicide.Anestimated60%ofallpeoplewithbipolardisorderhavedrugoralcoholdependence. Thisiswhyit’sessentialtoseekmedicalcareandstaycommittedtotreatmentforbipolardisorder. Regularandcontinueduseofmedicationcanhelpreduceepisodesofmaniaanddepression.Byknowinghowtorecognizethesymptomsandtriggersoftheseepisodes,there’sabetterchanceforeffectivetreatmentandfindingcopingmethodsthatmaypreventlongperiodsofillness,extendedhospitalstaysandsuicide. LivingWith WhenshouldIseemyhealthcareprovideraboutbipolardisorder? Ifyou’vebeendiagnosedwithbipolardisorder,you’llneedtoseeyourhealthcareteamregularlythroughoutyourlifetomakesureyourtreatmentisworkingwellforyou.Thisteammayincludeyour: Primaryhealthcareprovider. Psychiatrist. Psychologistortherapist. Neurologist. WhenshouldIgototheemergencyroom(ER)forbipolardisorder? Ifyou’reexperiencinganyofthesesituations,it’sessentialtocall911orgettothenearestemergencyroom: Thoughtsofdeathorsuicide. Thoughtsorplansofhurtingyourselforothers. Experiencinghallucinationsanddelusions. Symptomsoflithiumtoxicity(overdose),suchasseverenauseaandvomiting,severehandtremors,confusionandvisionchanges. AnotefromClevelandClinic Bipolardisorderisalifelongillness.Butlong-term,ongoingtreatment,suchasmedicationandtalktherapy,canhelpmanageyoursymptomsandenableyoutoliveahealthy,purposefullife.It’simportanttoseeyourhealthcareteamregularlytomonitoryourtreatmentplanandsymptoms.Knowthatyourhealthcareprovidersandlovedonesaretheretosupportyou. Share Facebook Twitter LinkedIn Email Print Getuseful,helpfulandrelevanthealth+wellnessinformation enews ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. Policy RelatedInstitutes&Services NeurologicalInstitute TheNeurologicalInstituteisaleaderintreatingandresearchingthemostcomplexneurologicaldisordersandadvancinginnovationsinneurology. ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. 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