Bipolar4LifeSupport

Picking up the pieces after a mood episode can be hard. The people you need most — especially your friends and family — may be angry with you or reluctant to help.

The best way to avoid these mood episodes is to get treatment for bipolar disorder. But unfortunately, periods of hypomania, mania, or depression aren’t completely preventable. Even people who always take their medication and are careful with their health can still have mood swings from time to time.

That’s why it’s important to catch changes in your mood, energy levels, and sleeping patterns before they develop into something serious.

Mood Swing Triggers in Bipolar Disorder

At first, mood swings may take you by surprise if you have bipolar disorder. But over time, you might start to see patterns or signs that you’re entering a period of mania or depression. Aside from a shift in your mood, look for changes in your:

• Sleep patterns
• Energy level
• Alcohol or drug use
• Sex drive
• Self-esteem
• Concentration

Mood episodes in bipolar disorder often occur spontaneously, for no particular reasons. Sometimes, however, you may discover particular “triggers” — situations or events that can provoke a period of mania or depression, such as sleep deprivation, changing seasons, or crossing multiple time zones when traveling. Some people find they’re more likely to become depressed or manic during stressful times at work or during holidays. Many people see seasonal patterns to their mood changes. Of course, not everyone can identify triggers. Also, some triggers can’t be anticipated or avoided, like a serious illness or a traumatic event.

One good way to see patterns or triggers in your bipolar disorder is to keep a journal. Make note of big events, stresses, your medication dosage, and the amount of sleep you’re getting. Over time, you might see some patterns emerge.

If you can recognize triggers for periods of mania or depression, you can prepare for times when you might be most vulnerable. Ask for more help from co-workers. Have your family and friends check in more often so you get extra support.

If you see the signs of potential trouble, get help. Don’t wait for the mood episode to pass on its own. With quick intervention, you might be able to stop a very minor mood swing from becoming a serious problem.

The Appeal of Mania in Bipolar Disorder

When people with bipolar disorder are depressed, they almost always know that something is wrong. Nobody likes feeling that way.

But it’s different for people who are hypomanic or manic. Often, they don’t think anything is wrong. Or if they notice a difference in their mood and personality, they think it’s an improvement.

Mania and hypomania can be seductive. You might feel more energized, creative, and interesting. You might be able to get extraordinary amounts of work done. So what’s the problem?

Manic phases often turn destructive. Some consequences of a manic episode can’t be undone. You can wipe out your savings account. You can have affairs that ruin your marriage. You can lose your job. Most dangerous of all, mania can make you do things that risk your life or the lives of others. And manias are often followed by depressive episodes. Effectively treating a mania or hypomania may help reduce the risk of developing a future depression.

Although hypomania or mania can feel good at the moment, in the long run, you’ll be happier, healthier, more productive, and more successful if you can maintain a stable mood.

Anyone who has experienced two or more episodes of bipolar disordergenerally is considered to have lifelong bipolar disorder, where the goal focuses not only on treating current symptoms but also preventing future episodes. That person should have maintenance therapy. Once your doctor has helped stabilize the moods of the acute phase of the disorder (either a manic or depressive episode), drug therapy is continued indefinitely — sometimes at lower doses.

It is important to remember this: Even if you have been without bipolar symptoms for several months, do not stop taking your medications. Your doctor may lower your doses, but discontinuation of medications will put you at risk for recurrence of bipolar symptoms.

Aripiprazole (Abilify), lamotrigine (Lamictal),  lithium ,  olanzapine(Zyprexa),  risperidone (Risperdal) Consta, and  quetiapine (Seroquel) or ziprasidone (Geodon), (either one in combination with lithium or valproate) are the only drugs that have been approved by the FDA specifically for maintenance therapy for bipolar disorder. These medications can differ in their ability to prevent manic versus depressive episodes, as well as in their side effects. However, many other drugs used to treat manic episodes are also used for maintenance treatment.

These drugs include:

• Antipsychotic medication
• Antidepressants
• Carbamazepine (Tegretol)
• Valproate (Depakote)

A combination of these drugs may also be used.

Lamotrigine (Lamictal) for Bipolar Disorder

Lamictal is approved by the FDA for the maintenance treatment of adults with bipolar disorder. It has been found to help delay bouts of depression, mania, hypomania (a milder form of mania), and mixed episodes in those being treated with standard therapy. It is especially effective in the prevention of bipolar depression. It is the first FDA-approved therapy since lithium for maintenance in bipolar disorder.

Lamictal is considered a mood-stabilizing anticonvulsant and is most commonly prescribed to prevent or control seizures in the treatment of epilepsy. Recent studies have shown it may possess antidepressanteffects in bipolar disorder.

Lamictal Side Effects

Lamictal comes in several types of tablets, such as chewable or orally disintegrating. It adds to the effects of other central nervous systemsuppressants such as alcohol — and to those found in many antihistamines, cold medications, pain medications, and muscle relaxants. Check with your doctor before taking any of these.

Three out of every 1,000 people taking Lamictal will develop a rash. Sometimes the rash can prove serious or even fatal. If a rash develops, you should consult your doctor  immediately and the drug may need to be stopped promptly.

Common side effects of Lamictal include:

• Headache
• Dizziness
• Diarrhea
• Dream abnormalities
• Itching
• Vision difficulties

Medication errors have occurred in filling Lamictal prescriptions because other drugs have similar names, like  labetalol,  Lamisil, lamivudine, Lomotil, and Ludiomil. To avoid confusion, make sure the drug name is clearly written on your prescription.

Lithium for Bipolar Disorder

Lithium (brand names include Eskalith or Lithobid) is the most widely used and studied medication for treating bipolar disorder. It has been used for more than 50 years and helps reduce the severity and frequency of manic states. It may also help relieve bipolar depression.

People with bipolar disorder may take lifelong lithium as maintenance therapy to prevent relapses. When lithium treatment stops, relapses can occur within six months in 90% of patients. Moreover, subsequent lithium treatment may sometimes be less effective, particularly if lithium is stopped abruptly rather than gradually (meaning, over a period of 2 weeks or longer).

Studies show that lithium can significantly reduce the risk of suicideamong people with bipolar disorder. It also helps prevent future manic episodes.

Lithium is a simple salt that acts on a person’s central nervous system. Doctors don’t know exactly how lithium works to stabilize mood. However, it helps people with bipolar disorder have more control over their emotions and cope better with the problems of daily life.

When lithium is used as part of maintenance therapy for bipolar disorder, your doctor will want to take regular blood tests during your treatment because it can affect kidney and thyroid function. Blood tests will also help your doctor monitor the level of lithium in your blood. Your doctor also will probably suggest you drink two or three quarts of water or fluid a day during treatment and use a normal amount of salt in your food. Both salt and fluid can affect the levels of lithium in your blood, so its important to consume enough every day.

Lithium Side Effects

About 75% of people who take lithium for bipolar disorder have some side effects, although they may be minor. Sometimes side effects can be relieved by changing the dose of lithium. Never change your dose or drug schedule on your own. If you are having any problems, talk to your doctor about your options.

Common side effects of lithium include:

• Weight gain
• Impaired memory
• Poor concentration
• Confusion
• Mental slowness
• Hand tremor
• Sedation or lethargy
• Impaired coordination
• Nausea, vomiting, or diarrhea
• Hair loss
• Acne
• Excessive thirst and dry mouth
• Excessive urination
• Decreased thyroid function (which can be treated with thyroidhormone)

Particularly bothersome tremors can be treated with additional medication.

There are a few serious risks to consider. Lithium may weaken bones in children. The drug has also been linked to a specific birth defect in heartvalve formation occurring in 1 in 1000 to 1 in 2000 patients and should be administered with caution to pregnant women. Also, in a very few people, long-term lithium treatment can interfere with kidney function.