Depression With Manic Episodes

Reviewed May 15, 2017

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Summary

  • How bipolar disorder differs
  • Treatment options for bipolar disorder vs. depression

Not all very bad depressions are the same. One kind is depression in someone who also has manic episodes. We say that someone is having a manic event when his mood gets too happy or angry or excited. It can create serious problems in getting along with others or doing the work that he should. This can happen once in a while or more often and it can last for a short time or a long time. Sometimes it seems like the mania can be blamed on an upsetting life event, and other times it is hard to figure out why the person got that way.

The illness runs in families somewhat and seems to be linked with chemical changes in the brain that cause major mood changes that go both up and down. Manic moods most often go along with other changes such as trouble sleeping, unsafe decision making, or spending too much money. During a manic event, someone can get into fights with others or cause lots of problems. Someone who gets both manic and depressive episodes is said to have “bipolar disorder” or “manic depressive disorder.”

How bipolar disorder differs

Although low spirits in someone who also gets manic episodes can look just like depression in other people, there are big differences. Some people with low spirits get better by talking to a therapist. They can also get better with the passage of time. People with bipolar disorder most often need medicine to help them get better. Some people do best with a mixture of medication and talk therapy.

Mood changes in people with bipolar disorder can get much better with treatment. But those mood problems sometimes come back at a later time. For some people, the mood changes come back often and unpredictably. Medications play a role in lowering the chance of the return of low mood or manic signs. Medications can lower the chance of thoughts of killing oneself for some people. It may be necessary to take drugs for bipolar disorder a long time, maybe for the person's whole life.

Treatment

Drugs for bipolar disorder are usually not the same as those given for normal depression. In fact, when the routine antidepressants are given to someone with bipolar disorder they can make the person feel worse. Antidepressants can set off a manic event or even milder signs of too much excitement in someone with bipolar disorder. When someone with it takes an antidepressant, they might start to get more angry or reckless.

For this reason, antidepressants taken alone can be an unsafe treatment for someone with bipolar disorder. Other drugs called mood stabilizers are used instead. Lithium, one that has been used for more than 50 years, is good for treating and preventing low spirits or mania. Some of the newer antipsychotic drugs like quetiapine (Seroquel®), olanzapine (Zyprexa®), aripiprazole (Abilify®), or risperidone (Risperdal®) can also be helpful. Some antiseizure drugs such as divalproex (Depakote®) can be helpful too.

Not everyone with bipolar disorder knows they have it, mostly if they have more often been depressed or not yet been manic. When a depressed person seems to be getting worse after taking antidepressant drugs, it is vital to consider that bipolar disorder may be the reason for not getting better. This is especially true when the person has relatives who have it.

By James M. Ellison, MD, MPH
Source: Connolly KR, Thase ME. The clinical management of bipolar disorder: a review of evidence-based guidelines. Prim Care Companion CNS Disord. 2011;13(4). pii: PCC.10r01097; Forester BP, Jordan B. Bipolar disorder in later life. In Ellison JM, Kyomen HH, Verma S. Mood Disorders in Later Life. Informa Healthcare, 2008, 65-90.
Reviewed by Mario Testani, MD, Physician Advisor, Beacon Health Options

Summary

  • How bipolar disorder differs
  • Treatment options for bipolar disorder vs. depression

Not all very bad depressions are the same. One kind is depression in someone who also has manic episodes. We say that someone is having a manic event when his mood gets too happy or angry or excited. It can create serious problems in getting along with others or doing the work that he should. This can happen once in a while or more often and it can last for a short time or a long time. Sometimes it seems like the mania can be blamed on an upsetting life event, and other times it is hard to figure out why the person got that way.

The illness runs in families somewhat and seems to be linked with chemical changes in the brain that cause major mood changes that go both up and down. Manic moods most often go along with other changes such as trouble sleeping, unsafe decision making, or spending too much money. During a manic event, someone can get into fights with others or cause lots of problems. Someone who gets both manic and depressive episodes is said to have “bipolar disorder” or “manic depressive disorder.”

How bipolar disorder differs

Although low spirits in someone who also gets manic episodes can look just like depression in other people, there are big differences. Some people with low spirits get better by talking to a therapist. They can also get better with the passage of time. People with bipolar disorder most often need medicine to help them get better. Some people do best with a mixture of medication and talk therapy.

Mood changes in people with bipolar disorder can get much better with treatment. But those mood problems sometimes come back at a later time. For some people, the mood changes come back often and unpredictably. Medications play a role in lowering the chance of the return of low mood or manic signs. Medications can lower the chance of thoughts of killing oneself for some people. It may be necessary to take drugs for bipolar disorder a long time, maybe for the person's whole life.

Treatment

Drugs for bipolar disorder are usually not the same as those given for normal depression. In fact, when the routine antidepressants are given to someone with bipolar disorder they can make the person feel worse. Antidepressants can set off a manic event or even milder signs of too much excitement in someone with bipolar disorder. When someone with it takes an antidepressant, they might start to get more angry or reckless.

For this reason, antidepressants taken alone can be an unsafe treatment for someone with bipolar disorder. Other drugs called mood stabilizers are used instead. Lithium, one that has been used for more than 50 years, is good for treating and preventing low spirits or mania. Some of the newer antipsychotic drugs like quetiapine (Seroquel®), olanzapine (Zyprexa®), aripiprazole (Abilify®), or risperidone (Risperdal®) can also be helpful. Some antiseizure drugs such as divalproex (Depakote®) can be helpful too.

Not everyone with bipolar disorder knows they have it, mostly if they have more often been depressed or not yet been manic. When a depressed person seems to be getting worse after taking antidepressant drugs, it is vital to consider that bipolar disorder may be the reason for not getting better. This is especially true when the person has relatives who have it.

By James M. Ellison, MD, MPH
Source: Connolly KR, Thase ME. The clinical management of bipolar disorder: a review of evidence-based guidelines. Prim Care Companion CNS Disord. 2011;13(4). pii: PCC.10r01097; Forester BP, Jordan B. Bipolar disorder in later life. In Ellison JM, Kyomen HH, Verma S. Mood Disorders in Later Life. Informa Healthcare, 2008, 65-90.
Reviewed by Mario Testani, MD, Physician Advisor, Beacon Health Options

Summary

  • How bipolar disorder differs
  • Treatment options for bipolar disorder vs. depression

Not all very bad depressions are the same. One kind is depression in someone who also has manic episodes. We say that someone is having a manic event when his mood gets too happy or angry or excited. It can create serious problems in getting along with others or doing the work that he should. This can happen once in a while or more often and it can last for a short time or a long time. Sometimes it seems like the mania can be blamed on an upsetting life event, and other times it is hard to figure out why the person got that way.

The illness runs in families somewhat and seems to be linked with chemical changes in the brain that cause major mood changes that go both up and down. Manic moods most often go along with other changes such as trouble sleeping, unsafe decision making, or spending too much money. During a manic event, someone can get into fights with others or cause lots of problems. Someone who gets both manic and depressive episodes is said to have “bipolar disorder” or “manic depressive disorder.”

How bipolar disorder differs

Although low spirits in someone who also gets manic episodes can look just like depression in other people, there are big differences. Some people with low spirits get better by talking to a therapist. They can also get better with the passage of time. People with bipolar disorder most often need medicine to help them get better. Some people do best with a mixture of medication and talk therapy.

Mood changes in people with bipolar disorder can get much better with treatment. But those mood problems sometimes come back at a later time. For some people, the mood changes come back often and unpredictably. Medications play a role in lowering the chance of the return of low mood or manic signs. Medications can lower the chance of thoughts of killing oneself for some people. It may be necessary to take drugs for bipolar disorder a long time, maybe for the person's whole life.

Treatment

Drugs for bipolar disorder are usually not the same as those given for normal depression. In fact, when the routine antidepressants are given to someone with bipolar disorder they can make the person feel worse. Antidepressants can set off a manic event or even milder signs of too much excitement in someone with bipolar disorder. When someone with it takes an antidepressant, they might start to get more angry or reckless.

For this reason, antidepressants taken alone can be an unsafe treatment for someone with bipolar disorder. Other drugs called mood stabilizers are used instead. Lithium, one that has been used for more than 50 years, is good for treating and preventing low spirits or mania. Some of the newer antipsychotic drugs like quetiapine (Seroquel®), olanzapine (Zyprexa®), aripiprazole (Abilify®), or risperidone (Risperdal®) can also be helpful. Some antiseizure drugs such as divalproex (Depakote®) can be helpful too.

Not everyone with bipolar disorder knows they have it, mostly if they have more often been depressed or not yet been manic. When a depressed person seems to be getting worse after taking antidepressant drugs, it is vital to consider that bipolar disorder may be the reason for not getting better. This is especially true when the person has relatives who have it.

By James M. Ellison, MD, MPH
Source: Connolly KR, Thase ME. The clinical management of bipolar disorder: a review of evidence-based guidelines. Prim Care Companion CNS Disord. 2011;13(4). pii: PCC.10r01097; Forester BP, Jordan B. Bipolar disorder in later life. In Ellison JM, Kyomen HH, Verma S. Mood Disorders in Later Life. Informa Healthcare, 2008, 65-90.
Reviewed by Mario Testani, MD, Physician Advisor, Beacon Health Options

The information provided on the Achieve Solutions site, including, but not limited to, articles, quizzes, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©2017 Beacon Health Options, Inc.

 

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