How to Manage Bipolar Depressive Episodes

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People with bipolar disorder go through what’s known as episodes. These periods of both high and low feelings that come with their own respected set of symptoms [1].

People in a low period experience symptoms similar to standard depression. Feeling as though they aren’t themselves and having difficulty doing things they’d like.

Luckily, there are a number of different options available to help treat depressive episode – in the form of both professional and personal treatment.

This article seeks to teach you everything you need to know in order to manage a bipolar depressive episode. At the end, we invite you to ask further questions.

Symptoms of a Bipolar Depressive Episode

If you’re struggling with bipolar disorder and currently in the depressive stage, you can expect to feel the following symptoms [2]:

  • Difficulty focusing or retaining memory
  • Difficulty getting out of bed
  • Difficulty making decisions
  • Eating too much or too little
  • Feeling as though you don’t enjoy anything
  • Feelings of sadness, worry, and emptiness
  • Lack of energy
  • Lack of sleep or too much sleep
  • Suicidal thoughts

It should be noted, it’s unlikely you’ll feel every symptom on this list. Mental health tends to hit us on a personal level and, with that, your symptoms develop depending on who YOU are as a person. You may also find yourself with certain symptoms not mentioned here.

Furthermore, bipolar disorder can be a sporadic mental illness. For example, some people feel extremely sad, but retain a lot of energy. To top it off, some people with bipolar will rarely have depressive episodes while others will have them frequently.

If you aren’t sure whether or not you have bipolar, it’s important to consult a medical professional. If you’ve felt down for a long period of time – usually two weeks – then you’re most likely struggling with a mental health condition.

Initial Steps to Take

When you first recognize the signs of a depressive episode, it’s important to take steps of your own. Though you’ll still want to seek out professional treatment, your efforts to work against these episodes are essential to this treatment.

So, what are some important things to remember to offset depression? [3]

  • Avoid drugs and alcohol – Many people turn to drugs and alcohol as a way of self-medicating. However, numerous medical professionals agree these only worsen a person’s mood and can bring on problems that weren’t initially there [4].
  • Avoid major life changes – Sometimes life finds a way of playing itself out at the worst possible times. If you’re facing a depressive episode and have to make a major change (such as moving, getting a job, or falling in love), your mood will definitely play a role in how these situations play out. It’s important to wait and receive the proper treatment.
  • Develop a routine – One of the biggest difficulties people with depression face is having a structured routine. In turn, their life may end up feeling like a mess. It’s vital to get into the habit of waking up and going to bed at a specific time, exercising, eating well, and making sure you’re running on a regular schedule.
  • Seek out support – Don’t be afraid to reach out to family members or friends when you need someone to talk to. A support system can be key when overcoming depression and allow you to make sure you stick to a routine.

Handling Suicidal Thoughts

As mentioned, one of the most dangerous symptoms of depressive episodes is developing suicidal thoughts or thoughts of hurting yourself.

If you or someone you love is currently in this position, it’s vital to:

  • Call 911 or go to an emergency room.
  • Call your doctor.
  • Call your mental health professional.
  • Reach out to someone who can help you immediately.
  • Reach out to the National Suicide Prevention Lifeline at 1 (800) 273-8255

Professional Treatment

As you continue to take your initial steps towards treating depression, it’s just as important to receive professional treatment too.

In order to get a sense of how treatment works, we’ve provided a detailed step-by-step analysis of the entire process:

1. Diagnosis

There are many instances where people believe they’re suffering from one mental disorder when, in actuality, they’re suffering from another.

Therefore, a medical professional must evaluate you for two specific reasons:

  1. To determine what you’re suffering from.
  2. To determine the best course of treatment for you.

In order to gain a diagnosis, you’ll undergo the following [5]:

  1. Physical Exam – A mental health professional will require you to go to your physician for a physical exam and lab tests. The purpose of this is to develop an understanding of your current health, any medical problems you may be facing, and the specificities of your body (i.e. weight, height).
  2. Psychiatric Assessment – Once your physical exam is complete, medical professionals must now examine your psychology. You’ll be referred to a psychiatrist who will talk to you in order to learn more about your thoughts, feelings, and conduct patterns. If you’re uncomfortable with talking to someone about these issues, you may also complete a self-assessment or questionnaire. If you allow permission, your family and close friends might also be contacted.
  3. Mood Charting – Though it’s not always the case, some people are asked to keep a daily record of their moods, sleep patterns, and other important factors that could aid medical professionals with diagnosis and develop the right treatment plan for you.

Once you’ve completed these steps, your results will be compared to the criteria designed for bipolar published by the American Psychiatric Association. And a diagnosis will be developed.

2. Medications

If you receive a bipolar disorder diagnosis, you’ll be suggested a select number of an assortment of medications. The most commonly prescribed medications for depressive episodes are as follows [6]:

  • Antipsychotics – Upon diagnosis, you most likely won’t immediately receive antipsychotics. These medications are primarily used when depressive and mania symptoms continue even when you use other medications. This medication includes olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), just to name a few.
  • Antidepressants – One of the most commonly prescribed medications for symptoms of depression are antidepressants. However, this medication might cause you to have further manic episodes. Therefore, medical professional often prescribes this along with a mood stabilizer or, in some cases, antipsychotics.
  • Antidepressant-antipsychotic – If struggle with extreme manic and depressive episodes, then you’ll most likely be prescribed an antidepressant-antipsychotic. The most common is known as Symbyax and it combines both fluoxetine (antidepressant) and olanzapine (antipsychotic).

It should be noted, if you’re suffering primarily from manic or hypomanic episodes, you’ll most likely be prescribed a mood stabilizer such as lithium (Lithobid) or valproic acid (Depakene).

Furthermore, it must be understood that some of these medications can be addictive if misused. If you do receive medication, it’s vital to only take as your medical professional directs you to. Improper use of these prescriptions can lead to further symptoms not initially felt.

3. Psychotherapies

The most important part of managing bipolar depressive episodes is finding yourself the right psychotherapy. These are “talk treatment” often done in individual, family, or group settings.

The most effective psychotherapies for bipolar disorder are [7]:

  • Cognitive Behavioral Therapy (CBT) – This form of therapy is designed to recognize unhealthy behavior and patterns in your emotions. By recognizing this, the goal is to give you the tools and advice necessary to develop healthier patterns. This is one of the most prominent therapies for bipolar disorder and can help you understand where your triggers are. It’ll also teach you how to manage stress and cope with depression.
  • Family Therapy – As mentioned above, having a support system can be key in helping you through depressive episodes. This therapy seeks to develop communication between you and your loved ones. In turn, they will be able to provide you with the right kind of support when necessary and help you stick to your treatment plan.
  • Interpersonal and Social Rhythm Therapy (IPSRT) – This form of therapy can be essential when it comes specifically to depressive episodes. It helps you develop a stabilized daily routine, such as sleeping, waking up, and when to eat. As you learn this routine and make it a habit, you will come to a point where this therapy isn’t necessary. However, in the beginning stages of treatment, it can be very effective.
  • Psychoeducation – By learning more about bipolar disorder, you’ll be better able to understand how you or your loved ones feel. Of course, psychoeducation isn’t very necessary with the advent of the internet. Yet, it can be a great tool in helping people stick with their treatment.

How to Recognize and Prevent Depressive Episodes

As discussed, bipolar disorder can be a very sporadic mental health condition. Much of the time, you manic and depressive episodes won’t follow a specific pattern.

Still, over time, you’ll start to recognize when your mood changes. With that, you’ll be able to pinpoint the warning signs of a depressive episode. By noticing and understanding these symptoms, there are things you can do to avoid depression.

For one, it may be essential to keep the mood chart mentioned above in diagnosis. By tracking every moment of your daily routine, you’ll be able to locate when you feel stressed – whether it be when your with a certain person or when you’re in a specific place.

You can also use the mood chart to recognize the early signs of a depressive episode. For example, you may feel tired more often as one of these episodes comes about. By writing this down, you’ll have the ability to be aware of future episodes.

Don’t be afraid to ask those around you to mention when they believe symptoms are appearing. Though they may not always notice them, it can help greatly if they do. By observing changes, your loved ones can provide both support and make sure you keep on track with your treatment.

Finally, there are a number of different habits you can continue to work on as you battle depressive episodes. These include having proper nutrition, exercising regularly, or experimenting with new ways to manage stress.

You may even benefit from doing communal activities, such as yoga or joining a support group.

Truly, it’s up to you to figure out how to beat a depressive episode. Though all the tips mentioned in this article can help you, your colors will prominently shine when you find the effort to battle depression.

Your Questions

Have any further questions concerning a bipolar depressive episode and what you can do to treat it?

We invite you to ask these in the comments below. If you have personal experience or knowledge on the topic, we’d also love to hear from you.

We try to reply to each legitimate comment in a prompt and personal manner.

Reference Sources

[1] NIMH: Bipolar Disorder

[2] MedlinePlus: Bipolar Disorder – Also called: Manic-depressive illness

[3] NIMH: Depression: What You Need to Know

[4] Addiction Science & Clinical Practice: Mood Disorders and Substance Use Disorder: A Complex Comorbidity

[5] Effective Health Care Program: Treatment for Bipolar Disorder

[6] HealthDirect: Bipolar disorder treatment

[7] HHS Public Access: Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence

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