Co-Occuring Bipolar Disorder

Often a person will exhibit what could be symptoms of bi-polar disorder, however it is important to stabilize the client to see how much of this is attributed to addiction or alcoholism- both of which can cause bi-polar like symptoms. Often, a person with bi-polar disorder will self medicate to try to balance out the symptoms, not even knowing what is happening to them.

ONE80CENTER offers a comprehensive array of services to support our clients with co-occuring bipolar disorder.  Our services include:

• Providing contracted treatment services for bipolar symptoms that are present even when taking medication.
• Helping individuals who may be experiencing negative consequences from bipolarity and using drugs or alcohol, attempting to self medicate.
• Helping our clients and their loved ones recognize the early signs of a manic or depressive episode.
• Helping our clients create a healthy lifestyle with nutrition, exercise and a proper amount of sleep
• Providing medication management and encourage medication compliance.
• Providing help to family members and caregivers and helping connect them to local support services.

For further information on the causes, symptoms and medications please continue reading.

What causes bipolar disorder?

Bipolar disorder affects men and women equally. It usually appears between ages 15 – 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.

In most people with bipolar disorder, there is no clear cause for the manic or depressive episodes. The following may trigger a manic episode in people who are vulnerable to the illness including:

• Life changes such as childbirth
• Medications such as antidepressants or steroids
• Periods of sleeplessness
• Recreational drug use

What are the different types of bipolar disorder?

People with bipolar disorder type I have had at least one fully manic episode with periods of major depression. In the past, bipolar disorder type I was called manic depression.

People with bipolar disorder type II have never experienced full-fledged mania. Instead they experience periods of hypomania (elevated levels of energy and impulsiveness that are not as extreme as the symptoms of mania). These hypomanic periods alternate with episodes of depression.

A mild form of bipolar disorder called cyclothymia involves less severe mood swings with alternating periods of hypomania and mild depression.  People with bipolar disorder type II or cyclothymia may be misdiagnosed as having depression alone.

Treatment (Symptoms, Complications and Expectations)

Mood-stabilizing medication can help control the symptoms of bipolar disorder. However, patients often need help and support to take medicine properly and to ensure that any episodes of mania and depression are treated as early as possible.

Many people stop or improperly take medication, which may cause difficulty in personal and professional relationships, suicidal thoughts and behaviors.

Sometimes there is an overlap between the two phases. Manic and depressive symptoms may occur together or quickly one after the other in what is called a mixed state.

A diagnosis of bipolar disorder involves consideration of many factors. The health care provider may do some or all of the following:

• Ask about your family medical history, particularly whether anyone has or had bipolar disorder
• Ask about your recent mood swings and for how long you’ve experienced them
• Observe your behavior and mood
• Perform a thorough examination to identify or rule out physical causes for the symptoms
• Request laboratory tests to check for thyroid problems or drug levels
• Speak with your family members to discuss their observations about your behavior
• Take a medical history, including any medical problems you have and any medications you take
• Use of recreational drugs may be responsible for some symptoms, though this does not rule out bipolar affective disorder. Drug abuse may itself be a symptom of bipolar disorder.

Spells of depression or mania return in most patients, in spite of treatment.
The major goals of treatment are to:

• Avoid cycling from one phase to another
• Avoid the need for a hospital stay
• Help the patient function as best as possible between episodes
• Prevent self-destructive behavior, including suicide
• Reduce the severity and frequency of episodes

Drugs called mood stabilizers are considered to be the first-line treatment. The following are commonly used mood stabilizers: Carbamazepine, Lamotrigine,
Lithium, Valproate (valproic acid) and other antiseizure drugs may also be tried.

Antipsychotic drugs and anti-anxiety drugs (benzodiazepines), which can be used to stabilize mood.  Antidepressant medications can be added to mood-stabilizing drugs to treat depression.   People with bipolar disorder are more likely to have manic or hypomanic episodes if they are put on antidepressants.  Because of this, an antidepressant is only used in people who are also taking a mood stabilizer.

Electroconvulsive therapy (ECT) may be used to treat the manic or depressive phase of bipolar disorder that does not respond to medication.  ECT is a psychiatric treatment that uses an electrical current to cause a brief seizure of the central nervous system while the patient is under anesthesia.  ECT is the most effective treatment for depression that is not relieved with medications.

Transcranial magnetic stimulation (TMS) uses high frequency magnetic pulses that target affected areas of the brain. It is most often used as a second-line treatment after ECT.  Patients who are in the middle of manic or depressive episodes may need to stay in a hospital until their mood is stabilized and their behaviors are under control.  Doctors are still trying to decide the best way to treat bipolar disorder in children and adolescents. Parents should consider the potential risks and benefits of treatment for their children.