{"id":44,"date":"2014-11-07T09:02:35","date_gmt":"2014-11-07T09:02:35","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebmh\/?p=44"},"modified":"2015-10-09T09:12:40","modified_gmt":"2015-10-09T09:12:40","slug":"ebmhchat-treating-bipolar-depression-the-most-common-vexing-part-of-bipolar-disorder","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebmh\/2014\/11\/07\/ebmhchat-treating-bipolar-depression-the-most-common-vexing-part-of-bipolar-disorder\/","title":{"rendered":"#EBMHchat – Treating bipolar depression, the most common & vexing part of bipolar disorder"},"content":{"rendered":"

 <\/p>\n

Enjoyed our last two tweet chats? We did, so we’ve organised another!<\/p>\n

It will be on Wednesday\u00a019th\u00a0November at 3pm GMT<\/strong>, do join us, all are welcome.<\/p>\n

Follow us on @EBMentalHealth<\/a> and use #EBMHchat to join in.<\/strong><\/p>\n

Chat topic:<\/h2>\n

Treating bipolar depression, the \u00a0most common and vexing part of \u00a0bipolar disorder<\/strong>
\nInvited guest author: Professor\u00a0Trevor \u00a0Young, Department of Psychiatry, \u00a0University of Toronto<\/p>\n

\"B0008528<\/a><\/p>\n

Bipolar disorder is a potentially lifelong and disabling condition characterised by episodes of\u00a0mania \u00a0(abnormally elevated mood or irritability and related symptoms with severe functional\u00a0impairment or psychotic symptoms for 7 days or more) or hypomania (abnormally elevated mood\u00a0or irritability and related symptoms with decreased or increased function for 4 days or more) and\u00a0episodes of depressed mood. It is often comorbid with other disorders such as anxiety disorders,\u00a0substance misuse, personality disorders and attention deficit hyperactivity disorder (ADHD).\u00a0The peak age of onset is 15\u201319 years, and there is often a substantial delay between onset and\u00a0first contact with mental health services. The lifetime prevalence of bipolar I disorder (mania and\u00a0depression) is estimated at 1% of the adult population, and bipolar II disorder (hypomania and\u00a0depression) affects approximately 0.4% of adults. Bipolar disorder in children under 12 years is\u00a0very rare.<\/p>\n

Bipolar disorder is among the top causes of worldwide disability.\u00a0The depressive symptoms are now recognised to be the predominant cause of personal, social and functional impairment in the long term for most people with bipolar disorder.\u00a0Prior to 1999, the treatment of bipolar depression had been little studied and there was uncertainty about the treatment of this phase of the disorder.\u00a0In the past, bipolar depression was lumped in with unipolar depression, but a growing body of research suggests that there are significant differences between the two, especially when it comes to recommended treatments. Most people with bipolar depression are not helped by antidepressants. In fact, there is a risk that antidepressants can make bipolar disorder worse\u2014triggering mania or hypomania, causing rapid cycling between mood states, or interfering with other mood stabilizing drugs.<\/p>\n

Despite many similarities, certain symptoms are more common in bipolar depression than in unipolar\u00a0depression. For example, bipolar depression is more likely to involve irritability, guilt, unpredictable mood swings, and feelings of restlessness. People with bipolar depression also tend to move and speak slowly, sleep a lot, and gain weight. In addition, they are more likely to develop psychotic depression\u2014a condition in which they’ve lost contact with reality\u2014and to experience major disability in work and social functioning.<\/p>\n

Common symptoms of bipolar depression include:<\/p>\n\n\n\n
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    \n
  • Feeling hopeless, sad, or empty<\/li>\n
  • Irritability<\/li>\n
  • Inability to experience pleasure<\/li>\n
  • Fatigue or loss of energy<\/li>\n
  • Physical and mental sluggishness<\/li>\n<\/ul>\n<\/td>\n
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