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Bipolar depression: Treatment and symptoms

For some people, bipolar disorder can cause episodes of depression. People can manage bipolar-related depression using medications, therapies, and other treatments.


By Aaron Kandola, Medical News Today

Bipolar disorder is a mental health condition that involves shifts in mood, energy levels, and activity levels.

Depending on the type of bipolar a person has, they may experience episodes of depression that interfere with their completion of daily tasks.

These symptoms of depression are similar to those of other depression-related mood disorders, such as major depressive disorder. However, people with bipolar disorder may also experience episodes of mania or hypomania.

Bipolar disorder is a lifelong condition, but people can manage the symptoms of depression and mania and prevent complications with treatment.

This article will discuss the symptoms of and treatments for bipolar depression.



Treatment

Bipolar disorder is a lifelong condition. Treatments aim to stabilize a person's mood and help them manage other symptoms.

In some cases, a person's mood changes can be severe.

Mental health professionals adapt treatments to the individual to help reduce their impact on daily life and mental well-being.

Treatment for bipolar disorder typically involves a combination of medication and therapy.



Medication

There are several types of medication for people with bipolar disorder. The type will depend on the type and severity of symptoms.

Some of the most common types of medication for treating bipolar disorder are:
  • mood stabilizers, such as lithium
  • antipsychotics, such as olanzapine
  • antidepressants, such as fluoxetine
These medications can have side effects, some of which can become serious. For example, using antipsychotic medication for a long time can cause weight gain, changes in cholesterol levels, and heart problems.



Therapy

Mental health professionals often recommend psychotherapy alongside medication to treat bipolar disorder. Psychotherapy is also known as talk therapy.

Psychotherapy has a range of benefits in addition to treating symptoms, such as providing support and education about living with bipolar disorder.

Types of psychotherapy include:

Read now

What should you know about bipolar disorder

This article provides an overview of bipolar disorder, including the types, causes, symptoms, and treatments.

Other treatments

Combinations of medication and therapy are effective for many people. If a person finds that their medications are not having the desired effect, a mental health professional may recommend alternative options.

For example, electroconvulsive therapy (ECT) uses electrical pulses to induce a seizure, which has an impact on symptoms through pathways as yet unknown. ECT can be effective for people with severe, treatment-resistant bipolar disorder.

The National Institute of Mental Health (NIMH) say that modern ECT methods hold promise for treating mental health conditions. However, ECT methods may cause the following side effects:
  • headaches
  • stomach aches
  • muscle aches
  • memory problems
Research is currently underway to develop new treatment approaches relating to brain stimulation, lifestyle modification, and new drugs as treatments for bipolar disorder.

Bipolar disorder can also lead to a range of physical health complications over time, such as cardiovascular disease.

Healthcare professionals will determine the best course of action to prevent or treat these complications on a case-by-case basis.



Symptoms

The symptoms of bipolar disorder differ depending on the type. Within these types, people may experience a different frequency and severity of manic and depressive episodes.

Bipolar I disorder is characterized by manic episodes that last for at least 7 days, or less if the symptoms are so severe that the person requires hospitalization. People may also experience depressive episodes that typically last 2 weeks, though people with bipolar I may never experience a major depressive episode.

People with bipolar II disorder tend to experience hypomanic episodes that are preceded or followed by a major depressive episode.

During episodes of depression, symptoms can include:
  • low mood
  • feelings of helplessness and worthlessness
  • irritability
  • lack of energy
  • difficulty concentrating
  • loss of interest in daily life
  • delusions
  • lack of appetite
  • difficulty sleeping
  • suicidal thoughts
During episodes of mania, symptoms can include:
  • emotional highs, or being very happy
  • hyperactivity
  • talking very quickly, with rapid changes in topic
  • rapid thoughts
  • feelings of self-importance
  • engaging in spontaneous, risky behaviors
  • irritability
  • delusions
  • difficulty sleeping
The frequency of these episodes varies. Someone may experience rapid-cycle episodes or extended periods of depression, or mania.

People can also experience symptoms of depression during a manic episode, which mental health professionals may call mixed symptoms.

In the long-term, people with bipolar disorder can experience serious physical health issues, including the following:
  • obesity
  • diabetes
  • metabolic disorders
  • cardiovascular disorders
  • sexual dysfunction
  • stroke
These complications can become severe. In fact, one study estimates that the average life expectancy of people with bipolar disorder is around 12–13 years lower than it is for people without the condition.

However, effective treatment will reduce the risk of a person developing health complications related to bipolar disorder.



Diagnosis

A person's doctor may refer them to a mental health professional, who can then assess a person for bipolar disorder.

The mental health professional will ask questions about the person's symptoms as well as broader questions about life events and general well-being.

They will ask about family history, focusing on whether other family members have had a history of mental health conditions.

Diagnosing bipolar disorder can be challenging for several reasons. Its symptoms overlap with those of other conditions, such as depression or psychosis. Plus, some people may begin with a major depressive episode, without manic or hypomanic symptoms.

Otherwise, people with bipolar disorder may also have other mental health problems, such as anxiety disorders, which can also make diagnosis more complex.



When to see a doctor

Mental health issues affect everyone differently. If a person suspects that they or a loved one may have bipolar disorder, they can talk to a healthcare professional for more information.

It is worth visiting a doctor for any persistent symptoms relating to mood or anxiety, or other symptoms of a mental health condition.

Mental health conditions are less visible than some physical health disorders, but it is just as important to look after mental health.

Talk to a doctor if the current bipolar treatment is causing side effects. The NIMH advise that people should avoid stopping medication abruptly, as this can worsen symptoms and cause withdrawal effects.

Always consult a doctor before making any changes in medication.



Causes

It is currently unclear what causes bipolar disorder.

The cause is likely to be a combination of biological and environmental factors that lead to the development of bipolar disorder. Risk factors for bipolar disorder include:
  • a family history of mental illness
  • genetics
  • brain structure and function



Summary

Bipolar disorder can cause episodes of depression.

With the help of a mental health professional, people can manage the symptoms of bipolar depression to stabilize their mood and prevent future health complications.
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