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It’s estimated that at least 4.4% of American adults are currently experiencing bipolar disorder. The number of individuals managing the mood disorder without a diagnosis is said to be even higher.
Bipolar disorder is arguably the most misunderstood mental health disorder when it comes to the public. Conversely, one of its most effective treatment methods, selective serotonin reuptake inhibitors or SSRIs, is said to come with its own set of issues — namely, antidepressant-induced mania.
Below, we’ll discuss what it means to be diagnosed with bipolar disorder, as well as the controversy surrounding the typical SSRI and mania.
Understanding Bipolar Disorder
No two individuals diagnosed with bipolar disorder will experience the exact same circumstances. This is because bipolar disorder — formerly known as manic depression — is characterized by extreme mood swings that can be broken down into emotional highs and emotional lows, all triggered by different events.
Bipolar I vs Bipolar II
The highs are commonly referred to as “mania” or “hypomania,” while the lows are simply referred to as “depression.” There are also several types of bipolar disorder, but the most common are bipolar I and bipolar II.
Bipolar I and II disorders involve periods of elevated feelings, which can include everything from euphoria to irritation. Both can affect an individual’s sleep patterns, regular activities, judgment, behaviors, thought patterns and, of course, energy levels.
Key Differences Between Bipolar I and Bipolar II
The primary difference between the two types of bipolar disorder is that:
- Bipolar I is considered to be more severe and longer lasting. It can also easily lead to episodes of psychosis due to long-lasting bouts of heightened mania.
- Bipolar II is much less severe, usually only lasting for a few days, and doesn’t tend to interfere with an individual’s daily life. However, it’s often more characterized by longer bouts of depression.
It’s important to understand that bipolar is not an umbrella term. Each type of bipolar disorder is considered a completely different diagnosis from its counterparts, and the symptoms of each will vary by the individual and as the mental health disorder unfolds over time.
How Is Bipolar Disorder Treated?
Both types of bipolar disorder are considered to be lifelong conditions. This means they both require ongoing regular treatment to help manage the symptoms.
Medications for Bipolar Disorder
That treatment typically involves one or more of the following medications:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Mood stabilizers
- Antipsychotics
- Antianxiety medications
Therapies for Managing Bipolar Disorder
In addition to medication, one or more forms of cognitive behavioral therapy are recommended. Depending on the severity of the case, this can include one or more of the following:
- Talk therapy
- Dialectical behavior therapy (DBT)
- Eye movement desensitization reprocessing (EMDR)
- Interpersonal and social rhythm therapy (IPSRT)
- Transcranial magnetic stimulation (TMS)
It can take a considerable amount of time to find the right combination of medications and therapies that work for each individual. However, there’s no guarantee which medication or combination of medications will work indefinitely.
The Controversy of SSRIs and Bipolar Disorder
Generally speaking, antidepressants are associated with a range of common side effects, including:
- Agitation
- Headaches
- Nausea
- Fatigue
- Decreased libido
It’s no secret that taking these medications can significantly alter the way an individual feels. One day, they may feel perfectly fine or “normal”; the next, they may feel unmotivated. Certain antidepressants have also been found to bring about both manic and hypomanic episodes.
Of course, it’s not that simple.
Antidepressant-Induced Mania in Bipolar Disorder
Generally speaking, all bipolar disorders essentially revolve around cyclic affective switching. This means that the individual in question will go through certain “mood episodes” during any given period of time, usually due to certain triggers. These triggers can easily range from poor sleep to a stressful situation or even hearing positive news.
Antidepressant-induced mania is not considered a part of the bipolar disorder switch process. Antidepressant treatment can, however, play a part in shifting a depressive episode via the common side effect of agitation, and some of the most common SSRIs associated with induced mania include:
- Zoloft
- Paxil
- Prozac
- Lexapro
- Celexa
It’s not yet fully known why antidepressant-induced mania occurs in some and not others, but we do know that this type of medication works by boosting nerve cell function in the brain. By doing so, it forces communication through the neurotransmitter serotonin.
Things to Consider When Deciding on Treatment for Bipolar Disorder
So, does SSRI-induced mania mean bipolar disorder confirmation? No. Can SSRI cause mania to materialize? Technically, yes.
If it all sounds complicated, that’s because it is. Many researchers argue that the general experience of antidepressant-induced mania can’t be properly classified under the existing diagnostic criteria for bipolar disorder or depression. They also argue that bipolar disorder should have its own subtype category within the list of diagnoses.
If you’ve been recently diagnosed with bipolar disorder or even depression, you may be struggling with the decision to start taking antidepressants due to their controversial effects. While it’s important to discuss your options and course of treatment with a trusted medical professional, here are a few things to consider to help you make the right decision:
- Mild to moderate depression and anxiety can worsen over time when left untreated. Additionally, bipolar disorder can become more severe if left untreated, causing you to become a danger to yourself or others.
- It can take time to find the right combination of medications and therapies, so you’ll need to be patient as well as honest with yourself and your doctor as you adjust.
- Take the time to learn about the typical side effects associated with each medication your doctor suggests. If you’re uncomfortable with taking certain medications, make it known and discuss alternative options with your doctor — they should be supportive rather than forceful when it comes to starting you on SSRIs or any other form of medication.
- Be prepared to make lifestyle changes in addition to taking medications. This means conscientiously eating healthier and getting enough exercise and time outdoors to help stabilize your mood and overall health.
- Understand that there’s no “cure” for bipolar disorder. Typical treatment is ongoing and may or may not require a change in dosage as your body gets used to the medication. Under no circumstances should you stop taking your medication, regardless of how “good” or “normal” you feel, without consulting your doctor.
Are You Ready to Start Treatment?
If you or someone you love is living with bipolar disorder, the best thing to do is seek treatment. As long as you’re under the right care and have the right support, you shouldn’t be afraid of antidepressant-induced mania.
To learn more about treatment options for bipolar disorder, including alternative treatments, call our knowledgeable staff at FHE Health. We’ll make sure you have all the information you need to move forward with your treatment and therapies.
