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BIPOLAR FACTS REASONS AND TREATMENT

A

ashir

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Joined
May 20, 2021
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1
Location
pakistan
Dear All members & friends,
Hope you all will be fine. I since 2017 am facing bipolar disorder . The reason as for as i know was work stress which i took by over burdening myself.
I lost my normal sleep, i started feeling fear, i started hesitating performing my daily works etc.
Till date i am using some kind of medicine . The last prescription was:
epival cr , co-depricap , clonazepam etc.
I felt tired to use such medicines very regular for couple of years. Last i limited myself to clonazepam only for sleep purpose.
overall i am ok, but in extra ordinary situations , i again starting loosing my normal sleep, feeling tired , lazy hopeless, continue thoughts .

Friends, who has if similar problems and if recovered , can you please help me what can i do to get rid of this.
Also the clonazepam is now short. What alternate is best to use . it is very important question please.
 
HLon99

HLon99

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Joined
Apr 15, 2020
Messages
922
Location
London, UK
Bipolar Disorder is a mental health condition charecterised by alternating episodes of low mood (depression) and high mood (mania). No one really knows what causes bipolar disorder. It is sometimes genetic, since bipolar does tend to run in the family. Persistant stress can also be a trigger for episodes. Regardless of the cause, it is nothing to be ashamed of - it is an illness like any other and can be treated. Many people with Bipolar Disorder go onto do incredibly well - hold down jobs and have families.

Symptoms of depression:
- Lack of motivation
- Difficulty thinking "Brain Fog"
- Oversleeping and overeating
- Feelings of guilt, worthlessness, loss of self-esteem
- Thoughts of harming yourself

Symtoms of mania:
- Inreased activity - Desire to keep oneself compulsively occupied
- Racing thoughts - "Flight of Ideas"; inability to concentrate
- Severe insomnia - Sleep typically reduced to 4-5 hours a night or less
- Impulsivity - Overspending, Reckless Driving, Hypersexuality
- Either elation or irritability - either feeling really good about yourself or feeling anger and rage

During periods of mania, you may experience symptoms of psychosis (loss of touch with reality), symptoms of which usually include Gradiose Delusions (feeling like you have special powers or are a really important person).

You may also experience:
Rapid Cycling - 4 or more episodes of depression and mania in one year, without breaks in between
Mixed States - Feeeling both manic and depressed at the same time

Treatment: Bipolar disorder is treated by medication; mood stabilisers and/or antipsychotics. Each mood stabiliser has a "polarity of effectiveness" - some treat mania, some treat depression, some treat both. Below I will list the common meds used, their usual brand names, and will mark them with either [M] for mania treatment, [D] for depression treatment or for both.

Mood Stabilisers: Lithium (Eskalith, Lithbiod, Priadel) , Sodium Valproate (Depakote, Epival) [M], Carbamazepine (Tegretol) , Lamotrigine (Lamictal) [D]

Antipsychotics: Quetiapine (Seroquel) , Olanzapine/Fluoxetine (Symbyax, Co-Depricap) , Aripiprazole (Abilify) [M], pure Olanzapine (Zyprexa) [M], Risperidone (Risperidal) [M]

Psychotherapy can also help with some of the anxiety/distress than one experiences as a result of living with the disorder. Lifestyle changes such as maintaining a regular sleep shedule, good diet and exercise are also beneficial.

Usual treatment plan in order of typical preferance in the UK:

1) Lithium - oldest and most reliable mood stabiliser, but is not suitable for everyone
Pros: best for long-term stabilisation, works for both mania and depression
Cons: Takes several (4-6 weeks to kick in), harsh side effects on the body (thyroid and kidney), Lithium levels require constant monitoring

2) Atypical Neuroleptics (Antipsychotics) - these work much quicker than Lithium (1-2 weeks), but some say that they are less effective in the long-run. Some work for both depression and mania, others work for mania only. They also provide protection against psychosis as well.

a) Quetiapine (Seroquel) or Olanzpaine/Fluoxetine combo (Symbyax, Co-Depricap)
Pros: treat both mania and sedation
Cons: Weight gain, sedation (feeling tired)

b) Aripiprazole (Abilify)
Pros: no weight gain, almost no sedation, very mild side effects overall
Cons: effective for mania only (no protection against depression), some people experience restlessness

c) Other antipsychotics e.g. Risperidone, pure Olanzapine, Amisulpride etc are used but less preferrable.

3) If you choose Lithium, Quetiapine or Olanzapine/Fluoxetine you will likely not need anything else (unless you're treatment resistant). But if you choose Aripiprazole or another antipsychotic, you will most likely need something else to prevent depression.

Lamotrigine (Lamictal) is an excellent mood stabiliser for depression.
Pros: extremely effective against depression, virutally no side effects (except mild headaches for first few weeks), decent protection against mixed and rapid cycling episodes
Cons: Takes longer to kick in (4-8 weeks), only works for depression not mania (will have to combine with Aripiprazole or other antipsychotic),

4) These medications can be used and do work very well for some people, but are less prefferable due to higher incidences of side effects. They are usually used if the meds listed above for you don't work for you.

a) Sodium Valproate (Epival, Depakote)
Pros: Good mania protection
Cons: Weight gain, sedation, emotional numbing and liver damage
b) Carbamazepine (Tegretol)
Pros: protection against mania and depression
Cons: Unrealiable - only really used if nothing else works, sedation, cognitive dulling and immune system problems

N.B. Benzodiazepines such as Clonazepam are occasionally gives to calm a person down quickly. However, they do not treat mania or depression; they mearly tranquilise you. They are also extremely addictive - avoid using them if you can.

I am currently on Aripiprazole 5 mg and Lamotrigine 200mg - I highly recommend this combination because it is very effective and has virtually no side effects.
They have worked brilliantly for me. However, I am currently considering switching to Quetiapine for a few reasons which I won't go into right now.

For basic cases, you will usually only need to use 1-2 meds, but for more complex/treatment resistant cases you may need more. You will likely have to go through a period of trial and error, before you find the meds which works for you and you can tolerate its side effects.

The most important thing is not the meds itself - its finding a good psychiatrist, who listens to you, informs you of you choices, works with you to find the most optimal regiment and ensures your long term wellbeing and functioning.

I hope this helps and I wish you the very best of luck with your recovery. If you have any questions, please do not hesitate to ask. Wishing you the best of luck and if you need more information feel free to ask. I will list a link from the Mayo Clinic explaining more about Bipolar Disorder and a document of the usual treatment plan used in the UK.


 
HLon99

HLon99

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Joined
Apr 15, 2020
Messages
922
Location
London, UK
P.S. Just to clarify; Those meds marked with [D] work for depression ONLY, those marked with [M] work for mania ONLY. Lithium, Quetiapine, Olanzapine/Fluoxetine and Carbamazepine work for both depression and mania (They are not marked with any sign). Where I said for pros of Quetiapine I said "works well for mania and sedation" I meant "Mania and depression" Sorry if this was unclear.
 
S

SFGuy

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Joined
Mar 28, 2021
Messages
250
Location
California
I'm sorry to hear that you are going through this, especially running out of medicine. My psychiatrist put me on a tranquilizer and a mood stabilizer first. The mood stabilizer (for me it is Valproate/Depakote) is the most important medicine I take and keeps me from having bad mood swings and mixed states (manic and depressed at the same time). I have a form of bipolar that does not go away between depressed and manic cycles, so I need medicine every day. I worked for more than a year with my psychiatrist to get a mix of drugs that makes me able to function fully, but her medicine made me dramatically better within 2 weeks of starting treatment. I hope you're able to find a specialist who can guide you to the best meds for you. HLon99's post above is also a helpful guide.
 
C

calliope21

Member
Joined
May 22, 2021
Messages
6
Location
Quebec
P.S. Just to clarify; Those meds marked with [D] work for depression ONLY, those marked with [M] work for mania ONLY. Lithium, Quetiapine, Olanzapine/Fluoxetine and Carbamazepine work for both depression and mania (They are not marked with any sign). Where I said for pros of Quetiapine I said "works well for mania and sedation" I meant "Mania and depression" Sorry if this was unclear.
I'm in a relationship with a man who is bipolar. I took him to the psychiatrist when he got totally out of control in a manic episode last winter. He was put on Seresta, because they considered he was on withdrawals. He had done meth at some point in the manic episode. The Seresta helped with the withdrawals and made him more calm. Now he is on Lactamil. My question is can the mania come back if he is only on Lactamil ?
 
HLon99

HLon99

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Joined
Apr 15, 2020
Messages
922
Location
London, UK
I'm in a relationship with a man who is bipolar. I took him to the psychiatrist when he got totally out of control in a manic episode last winter. He was put on Seresta, because they considered he was on withdrawals. He had done meth at some point in the manic episode. The Seresta helped with the withdrawals and made him more calm. Now he is on Lactamil. My question is can the mania come back if he is only on Lactamil ?
Lamictal is good at controlling depression, but there is a chance that the mania can come back. Speak to the pdoc about adding either Abilify or Lithium. Whatever he does make sure he stays away from the crank.
 
calypso

calypso

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Lamictal is good at controlling depression, but there is a chance that the mania can come back. Speak to the pdoc about adding either Abilify or Lithium. Whatever he does make sure he stays away from the crank.
Lamictal (lamotrigine) is a mood stabiliser not an anti depressant. For me it works very well and I love it. I never knew what balanced moods were before taking it.
 
C

calliope21

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Quebec
Lamictal (lamotrigine) is a mood stabiliser not an anti depressant. For me it works very well and I love it. I never knew what balanced moods were before taking it.
Thank you for sharing. In your experience it's been enough tobmanage depressionand mania ?
 
calypso

calypso

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Not on its own. I am on Aripiprazole for the psychosis that I experienced and Mirtazepine for the depression. Anti depressants on their own are dangerous for us as they can trigger mania
 
C

calliope21

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Thanks again.it's helping me understand the man i love
 
HLon99

HLon99

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Messages
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London, UK
Lamictal (lamotrigine) is a mood stabiliser not an anti depressant. For me it works very well and I love it. I never knew what balanced moods were before taking it.
I never said Lamictal is an antidepressant. Its a mood stabiliser. However, every mood stabiliser has a polarity of effectiveness; i.e. some work for depression but not mania (e.g. Lamictal), some work for mania but not depression (e.g.Valproate), some work for both mania and depression (e.g. Lithium, Quetiapine)
 
calypso

calypso

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Oh I see what you mean now. thank you
 
2

2Much2Feel

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US
Bipolar Disorder is a mental health condition charecterised by alternating episodes of low mood (depression) and high mood (mania). No one really knows what causes bipolar disorder. It is sometimes genetic, since bipolar does tend to run in the family. Persistant stress can also be a trigger for episodes. Regardless of the cause, it is nothing to be ashamed of - it is an illness like any other and can be treated. Many people with Bipolar Disorder go onto do incredibly well - hold down jobs and have families.

Symptoms of depression:
- Lack of motivation
- Difficulty thinking "Brain Fog"
- Oversleeping and overeating
- Feelings of guilt, worthlessness, loss of self-esteem
- Thoughts of harming yourself

Symtoms of mania:
- Inreased activity - Desire to keep oneself compulsively occupied
- Racing thoughts - "Flight of Ideas"; inability to concentrate
- Severe insomnia - Sleep typically reduced to 4-5 hours a night or less
- Impulsivity - Overspending, Reckless Driving, Hypersexuality
- Either elation or irritability - either feeling really good about yourself or feeling anger and rage

During periods of mania, you may experience symptoms of psychosis (loss of touch with reality), symptoms of which usually include Gradiose Delusions (feeling like you have special powers or are a really important person).
Damnit, HLon99, again I say you may want to rethink your major at university!! Printing this one out. THANK YOU.
You may also experience:
Rapid Cycling - 4 or more episodes of depression and mania in one year, without breaks in between
Mixed States - Feeeling both manic and depressed at the same time

Treatment: Bipolar disorder is treated by medication; mood stabilisers and/or antipsychotics. Each mood stabiliser has a "polarity of effectiveness" - some treat mania, some treat depression, some treat both. Below I will list the common meds used, their usual brand names, and will mark them with either [M] for mania treatment, [D] for depression treatment or for both.

Mood Stabilisers: Lithium (Eskalith, Lithbiod, Priadel) , Sodium Valproate (Depakote, Epival) [M], Carbamazepine (Tegretol) , Lamotrigine (Lamictal) [D]

Antipsychotics: Quetiapine (Seroquel) , Olanzapine/Fluoxetine (Symbyax, Co-Depricap) , Aripiprazole (Abilify) [M], pure Olanzapine (Zyprexa) [M], Risperidone (Risperidal) [M]

Psychotherapy can also help with some of the anxiety/distress than one experiences as a result of living with the disorder. Lifestyle changes such as maintaining a regular sleep shedule, good diet and exercise are also beneficial.

Usual treatment plan in order of typical preferance in the UK:

1) Lithium - oldest and most reliable mood stabiliser, but is not suitable for everyone
Pros: best for long-term stabilisation, works for both mania and depression
Cons: Takes several (4-6 weeks to kick in), harsh side effects on the body (thyroid and kidney), Lithium levels require constant monitoring

2) Atypical Neuroleptics (Antipsychotics) - these work much quicker than Lithium (1-2 weeks), but some say that they are less effective in the long-run. Some work for both depression and mania, others work for mania only. They also provide protection against psychosis as well.

a) Quetiapine (Seroquel) or Olanzpaine/Fluoxetine combo (Symbyax, Co-Depricap)
Pros: treat both mania and sedation
Cons: Weight gain, sedation (feeling tired)

b) Aripiprazole (Abilify)
Pros: no weight gain, almost no sedation, very mild side effects overall
Cons: effective for mania only (no protection against depression), some people experience restlessness

c) Other antipsychotics e.g. Risperidone, pure Olanzapine, Amisulpride etc are used but less preferrable.

3) If you choose Lithium, Quetiapine or Olanzapine/Fluoxetine you will likely not need anything else (unless you're treatment resistant). But if you choose Aripiprazole or another antipsychotic, you will most likely need something else to prevent depression.

Lamotrigine (Lamictal) is an excellent mood stabiliser for depression.
Pros: extremely effective against depression, virutally no side effects (except mild headaches for first few weeks), decent protection against mixed and rapid cycling episodes
Cons: Takes longer to kick in (4-8 weeks), only works for depression not mania (will have to combine with Aripiprazole or other antipsychotic),

4) These medications can be used and do work very well for some people, but are less prefferable due to higher incidences of side effects. They are usually used if the meds listed above for you don't work for you.

a) Sodium Valproate (Epival, Depakote)
Pros: Good mania protection
Cons: Weight gain, sedation, emotional numbing and liver damage
b) Carbamazepine (Tegretol)
Pros: protection against mania and depression
Cons: Unrealiable - only really used if nothing else works, sedation, cognitive dulling and immune system problems

N.B. Benzodiazepines such as Clonazepam are occasionally gives to calm a person down quickly. However, they do not treat mania or depression; they mearly tranquilise you. They are also extremely addictive - avoid using them if you can.

I am currently on Aripiprazole 5 mg and Lamotrigine 200mg - I highly recommend this combination because it is very effective and has virtually no side effects.
They have worked brilliantly for me. However, I am currently considering switching to Quetiapine for a few reasons which I won't go into right now.

For basic cases, you will usually only need to use 1-2 meds, but for more complex/treatment resistant cases you may need more. You will likely have to go through a period of trial and error, before you find the meds which works for you and you can tolerate its side effects.

The most important thing is not the meds itself - its finding a good psychiatrist, who listens to you, informs you of you choices, works with you to find the most optimal regiment and ensures your long term wellbeing and functioning.

I hope this helps and I wish you the very best of luck with your recovery. If you have any questions, please do not hesitate to ask. Wishing you the best of luck and if you need more information feel free to ask. I will list a link from the Mayo Clinic explaining more about Bipolar Disorder and a document of the usual treatment plan used in the UK.


 
R

rosaconespinas

Member
Joined
May 28, 2021
Messages
5
Location
miami
Bipolar Disorder is a mental health condition charecterised by alternating episodes of low mood (depression) and high mood (mania). No one really knows what causes bipolar disorder. It is sometimes genetic, since bipolar does tend to run in the family. Persistant stress can also be a trigger for episodes. Regardless of the cause, it is nothing to be ashamed of - it is an illness like any other and can be treated. Many people with Bipolar Disorder go onto do incredibly well - hold down jobs and have families.

Symptoms of depression:
- Lack of motivation
- Difficulty thinking "Brain Fog"
- Oversleeping and overeating
- Feelings of guilt, worthlessness, loss of self-esteem
- Thoughts of harming yourself

Symtoms of mania:
- Inreased activity - Desire to keep oneself compulsively occupied
- Racing thoughts - "Flight of Ideas"; inability to concentrate
- Severe insomnia - Sleep typically reduced to 4-5 hours a night or less
- Impulsivity - Overspending, Reckless Driving, Hypersexuality
- Either elation or irritability - either feeling really good about yourself or feeling anger and rage

During periods of mania, you may experience symptoms of psychosis (loss of touch with reality), symptoms of which usually include Gradiose Delusions (feeling like you have special powers or are a really important person).

You may also experience:
Rapid Cycling - 4 or more episodes of depression and mania in one year, without breaks in between
Mixed States - Feeeling both manic and depressed at the same time

Treatment: Bipolar disorder is treated by medication; mood stabilisers and/or antipsychotics. Each mood stabiliser has a "polarity of effectiveness" - some treat mania, some treat depression, some treat both. Below I will list the common meds used, their usual brand names, and will mark them with either [M] for mania treatment, [D] for depression treatment or for both.

Mood Stabilisers: Lithium (Eskalith, Lithbiod, Priadel) , Sodium Valproate (Depakote, Epival) [M], Carbamazepine (Tegretol) , Lamotrigine (Lamictal) [D]

Antipsychotics: Quetiapine (Seroquel) , Olanzapine/Fluoxetine (Symbyax, Co-Depricap) , Aripiprazole (Abilify) [M], pure Olanzapine (Zyprexa) [M], Risperidone (Risperidal) [M]

Psychotherapy can also help with some of the anxiety/distress than one experiences as a result of living with the disorder. Lifestyle changes such as maintaining a regular sleep shedule, good diet and exercise are also beneficial.

Usual treatment plan in order of typical preferance in the UK:

1) Lithium - oldest and most reliable mood stabiliser, but is not suitable for everyone
Pros: best for long-term stabilisation, works for both mania and depression
Cons: Takes several (4-6 weeks to kick in), harsh side effects on the body (thyroid and kidney), Lithium levels require constant monitoring

2) Atypical Neuroleptics (Antipsychotics) - these work much quicker than Lithium (1-2 weeks), but some say that they are less effective in the long-run. Some work for both depression and mania, others work for mania only. They also provide protection against psychosis as well.

a) Quetiapine (Seroquel) or Olanzpaine/Fluoxetine combo (Symbyax, Co-Depricap)
Pros: treat both mania and sedation
Cons: Weight gain, sedation (feeling tired)

b) Aripiprazole (Abilify)
Pros: no weight gain, almost no sedation, very mild side effects overall
Cons: effective for mania only (no protection against depression), some people experience restlessness

c) Other antipsychotics e.g. Risperidone, pure Olanzapine, Amisulpride etc are used but less preferrable.

3) If you choose Lithium, Quetiapine or Olanzapine/Fluoxetine you will likely not need anything else (unless you're treatment resistant). But if you choose Aripiprazole or another antipsychotic, you will most likely need something else to prevent depression.

Lamotrigine (Lamictal) is an excellent mood stabiliser for depression.
Pros: extremely effective against depression, virutally no side effects (except mild headaches for first few weeks), decent protection against mixed and rapid cycling episodes
Cons: Takes longer to kick in (4-8 weeks), only works for depression not mania (will have to combine with Aripiprazole or other antipsychotic),

4) These medications can be used and do work very well for some people, but are less prefferable due to higher incidences of side effects. They are usually used if the meds listed above for you don't work for you.

a) Sodium Valproate (Epival, Depakote)
Pros: Good mania protection
Cons: Weight gain, sedation, emotional numbing and liver damage
b) Carbamazepine (Tegretol)
Pros: protection against mania and depression
Cons: Unrealiable - only really used if nothing else works, sedation, cognitive dulling and immune system problems

N.B. Benzodiazepines such as Clonazepam are occasionally gives to calm a person down quickly. However, they do not treat mania or depression; they mearly tranquilise you. They are also extremely addictive - avoid using them if you can.

I am currently on Aripiprazole 5 mg and Lamotrigine 200mg - I highly recommend this combination because it is very effective and has virtually no side effects.
They have worked brilliantly for me. However, I am currently considering switching to Quetiapine for a few reasons which I won't go into right now.

For basic cases, you will usually only need to use 1-2 meds, but for more complex/treatment resistant cases you may need more. You will likely have to go through a period of trial and error, before you find the meds which works for you and you can tolerate its side effects.

The most important thing is not the meds itself - its finding a good psychiatrist, who listens to you, informs you of you choices, works with you to find the most optimal regiment and ensures your long term wellbeing and functioning.

I hope this helps and I wish you the very best of luck with your recovery. If you have any questions, please do not hesitate to ask. Wishing you the best of luck and if you need more information feel free to ask. I will list a link from the Mayo Clinic explaining more about Bipolar Disorder and a document of the usual treatment plan used in the UK.


Hi, do you know a good psychiatrist that you can recommended, please
 
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