Recognizing hypomania as a disordered mood state in bipolar II disorder is very important. However, in practice it can go below the radar causing the diagnosis of bipolar II disorder to be missed. One reason is that patients will remember their depressions very clearly as the pain of them is not easily forgotten. However, may […]
We have talked about hypomania and mania but I haven’t said much about depression. It is very common in bipolar disorder and often follows right on from a period of mania or hypomania. It is as though the patient crash lands into depression. The higher you were the worse is the fall into depression. Bipolar […]
Bipolar disorder is a common mood disorder which is characterized by extremes of mood from depression to mania. It effects about 3% of the population and in its more severe form is equally common in men and women. It is distinct from major depression. The latter is characterized by bouts of severe depression. In contrast […]
Now that we know something about the illness and how it presents let’s move on to treatment. The treatment of bipolar I and II disorders are essentially the same. The goal of treatment in both disorders is to stabilize mood, treat hypomania or mania, treat depression and for the long run prevent relapses back into […]
Back to hypomania. It is quite unfortunate that many patients with bipolar disorder wait for many years fruitlessly seeing psychiatrists until the correct diagnosis is made. According to data collected by the Depression and Bipolar Support Alliance (DBSA) (www.dbsalliance.org)about 60% of patients ultimately diagnosed with bipolar disorder had the illness for at least 5 years […]
We have talked about hypomania and mania but I haven’t said anything yet about depression. It is very common in bipolar disorder and often follows right on from a period of mania or hypomania. It is as though the patient crash lands into depression. The higher you were the worse is the fall into depression. […]
Bipolar disorder is a common mood disorder which is characterized by extremes of mood from depression to mania. It effects about 3% of the population overall and in its more severe form (Bipolar I disorder) is equally common in men and women (BP -I occurs in 1% of the population). It is distinct from major […]
This is an unusual antidepressant with distinct advantages and disadvantages. By virtue of effects on complex regulating receptors on serotonin and norepinephrine receptors on their respective neurons it has effects similar to SNRI antidepressants (Effexor, Cymbalta and Fetzima). In addition Remeron (mirtazapine) due to effects on other receptors can be very sedative so it can […]
Beyond SSRI and SNRI antidepressants are two other very interesting medications for depression, Wellbutrin (bupropion) and Remeron (mirtazapine). Wellbutrin is called an NDRI antidepressant (= a Norepinephrine and Dopamine Reuptake Inhibitor). Notice right away is does not have effects on serotonin which confers both an advantage and disadvantage for Wellbutrin. The disadvantage is that without […]
The acronym SNRI stands for serotonin and norepinephrine reuptake inhibition. In this sense they are broader acting in the brain that the SSRIs but confusingly this has not translated in practice to they being more effective that the SSRIs. Generally speaking, unless there is a specific reason, it is better to start with an SSRI […]
