Efficacy of Different Treatments for Bipolar Depression
April 3, 2020
Bipolar disorder is a mental health disorder and a form of depression previously classified as manic depression, which includes extreme emotional highs, known as mania, followed by very emotional lows, known as depression. 5.7 million American adults suffer from this debilitating disorder. Together, this causes an internal struggle and leads to mood swings and irrational behaviors, thoughts, and actions.
Depression in a person struggling from Bipolar Disorder is similar to the symptoms of major depressive disorder, characterized by sadness, hopelessness, and loss of interest in things. However, when a patient experiences mania, they can feel energetic, euphoric, and particularly irritable. These major mood swings can have adverse effects on judgement, energy, sleep, behavior, concentration. Typically, mood swings occur once or twice per year, but they can happen more often in a period known as rapid cycling. Bipolar disorder is a lifelong struggle, but there are ways to manage the mood swings and other behaviors and actions with a treatment plan. Here are some common antidepressants prescribed for Bipolar Disorder, as well as some non-pharmacological options that may be right for you.
Antidepressants to treat Bipolar Disorder
There are a variety of different antidepressants that can be prescribed by psychiatrists and doctors to attack Bipolar Disorder. These antidepressants all offer a host of side effects, and some are viewed as more effective than others.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are often the first line of defense in fighting depression, as they typically have less troublesome side effects in comparison with other antidepressants, and cause less problems at higher doses in patients than other types of antidepressants. Some side effects include nausea, vomiting, or diarrhea, headaches, drowsiness, dry mouth, insomnia, nervousness, dizziness, sexual problems (like reduced sexual drive), and can impact appetite leading to either weight gain or weight loss. SSRIs in trials were seen as significantly more effective than placebos, meaning they offer a high efficacy and could be highly effective in treating depression, particularly a more mild form of bipolar disorder (meaning the patient experiences less often or severe mood swings).
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs work by blocking the reuptake of critical neurotransmitters that affect mood and emotion, known as serotonin and norepinephrine. Side effects of SNRIs are similar to the side effects of SSRIs. SNRI side effects include dizziness, nausea, dry mouth, sweating, tiredness, insomnia, anxiety, constipation, trouble urinating, headaches, loss of appetite, and reduced sexual drive or trouble with arousal. Because SSRIs only block the reuptake of serotonin, and SNRIs block the reuptake of both serotonin and norepinephrine, some studies have shown that SNRIs may be more effective at reducing pain, and may be more effective at treating certain forms of depression, thus showing a high efficacy for treating bipolar disorder and depression more specifically.
Tricyclic Antidepressants (TCAs)
Tricyclic Antidepressants are a form of antidepressant that increases levels of norepinephrine and serotonin, and blocks another neurotransmitter, known as acetylcholine. Scientists believe that increasing these neurotransmitters and blocking acetlycholine’s reuptake can help restore balance to the neurotransmitters in the brain and thereby alleviate depression. TCAs cause sedation and can block the effects of histamine. Other side effects include blurred vision, dry mouth, constipation, weight gain or weight loss, low blood pressure upon standing, rashes, hives, and an increased heart rate. TCAs can also increase risk of seizure and may increase the risk of suicidal thoughts and actions. TCAs are seen as having less efficacy than SNRI or SSRIs but were still found to be more effective than the placebo.
Monoamine Oxidase Inhibitors (MAOIs)
Monoamine Oxidase Inhibitors were the very first class of antidepressants created. They are considered very effective, but they have been very much replaced by antidepressants that are seen as safer and with less side effects. An enzyme known as monoamine oxidase works to remove the neurotransmitters norepinephrine, serotonin, and dopamine from the brain. MAOIs block this enzyme from working and thereby prevent it from removing the mood-stabilizing transmitters. This allows these brain chemicals to work more effectively.
However, MAOIs have major side effects. Taking an MAOI means you must practice diet restrictions, because MAOIs can cause dangerously high blood pressure levels when taken with certain foods and medications. Major foods that must be avoided include cheeses, pickles, and wines, and a patient on MAOIs may need to stop taking pain medications, decongestants, and herbal supplements. Other side effects of MAOIs include dry mouth, nausea, diarrhea, constipation, headaches, drowsiness, insomnia, dizziness. More serious side effects include involuntary muscle jerks, reduced sexual drive, weight gain, difficulty urinating, muscle cramps, and paresthesia. MAOIs can also majorly increase risks of suicidal thoughts and actions.
Non-Pharmacological Treatments for Bipolar Disorder
There are many non-pharmacological treatments that can be utilized to treat bipolar disorder. These treatments work without side effects and without a need for a shift in diet or alternate medications.
Given that bipolar disorder can be triggered for either highs and lows by major life events, such as a move, loss of a job, family conflicts, ends of relationships, deaths, trauma, etc., it can be important for a patient to have a safe space to talk out their bipolar disorder. Cognitive Behavioral Therapy teaches a person suffering from bipolar disorder to identify their negative assumptions and negative patterns in their thinking (i.e. what may trigger the highs and lows), and challenge themselves to adapt their negative situations into a positive light. They also must monitor their levels of activity and social interaction to ensure they are engaging in positive atmospheres when depressed, and are not trying to do too much when manic.
Family Focused Therapy, another form for treating Bipolar Disorder, operates by bringing the patient in to see a therapist along with their parents, spouse, or other family member. In this environment, they learn about the symptoms of bipolar disorder, how a person may cycle over time, how to recognize warning signs, and how to stop major mood swings. They also work on communication and problem-solving skills, as communication is key with any mental health disorder. Research has found that family focused therapy can help drastically reduce mood swings and improve a patient’s day-to-day function.
Interpersonal and Social-Rhythm Therapy operates by having the patient suffering from bipolar disorder track their bedtime, wake time, and activity for each day, and how changes in these routines can affect a patient’s mood. The psychologist can then coach the patient through how to regulate their daily routines and sleep-wake cycles in order to regulate and stabilize mood cycles, and also monitor any triggers that cause manic highs and depressed lows in order to identify ways to reverse this.
My Transformations has perfected a rapidly growing new field for treating a variety of mental health disorders known as Transcranial Magnetic Therapy. This treatment has been adapted to fit the varying degrees of bipolar disorder, and may be effective in treating by using Rapid Transcranial Magnetic Therapy, or rTMS, may be a key to changing the lives of patients suffering from bipolar disorder, even without the use of mood-altering substances. TMS targets specific areas of the brain associated with the issues that doctors wish to treat (frontal lobe to treat depression), and place magnetic coils on the brain to stimulate neural pathways and, with enough sessions, rewire the targeted area of the brain, providing long-lasting relief from symptoms of depression and mania, and helping to slow or even negate mood swings.
TMS was approved in 2008 by the FDA as an incredible new treatment for Major Depressive Disorder, and quickly adapted to treat other disorders. TMS therapy is non-invasive and non-pharmacological, thereby providing an alternative for the many antidepressants discussed for treating bipolar disorder that come with many side effects. Typically, the order of treatment for bipolar disorder goes psychotherapy, followed by medication, but TMS can help naturally and eliminate the need for antidepressants entirely.
TMS is similar to electroconvulsive therapy (ECT) in that it stimulates the brain and can help to relieve symptoms of depression, but differs in the fact that TMS is much safer. TMS does not require anesthesia, and since it is non-invasive, there is no need to change diet or alter other medications in order to treat. TMS therapy may also be used in conjunction with antidepressants, if that treatment plan is right for you.
Now that you understand the variety of options for treating Bipolar Disorder, it may be time to talk to your doctor or psychiatrist about what treatment plan would be best for you. As the field of TMS Therapy rapidly grows, people are quickly turning towards My Transformations as a jumpstart for treating their Bipolar Disorder without the use of medicines with varying side effects and low efficacy rates. Schedule a consultation today and see what life-changing steps you can take to decrease your mood swings or highs and lows as a result of your Bipolar Disorder.