What is Bipolar Disorder?

Bipolar disorder can cause fluctuations in mood from an extremely sad or hopeless state to an elevated, overexcited, or irritable mood. Bipolar disorder is caused by episodes of mania and major depression. 

  • Mania episodes can cause consistently elevated or irritable moods, along with increased activity or energy. These episodes can last at least one week and be present most of the day, nearly every day. 
  • Depression episodes can cause depressed mood and loss of interest in pleasurable life activities. These episodes can last for at least 2 weeks and be present almost every day. It is advised to see your doctor if you are experiencing any of these episodes to better diagnose your condition.

 

What are the symptoms of Bipolar Disorder?

The symptoms for specific episodes (mania and depression) are listed below:

Mania

  • Lots of energy, always moving
  • Acting like nothing’s wrong
  • Feeling overly happy or excited
  • Easily annoyed
  • Restlessness
  • Increased desire for sex 

Depression

  • Eating too much or too little  
  • Trouble sleeping or sleeping all the time  
  • Minimum to no interest in daily activities  
  • Lack of energy
  • Guilt, worthlessness, hopelessness, and regret  
  • Suicidal thoughts

Talk to your doctor if you experience such symptoms.

 

How can bipolar disorder be treated?

Treatment of bipolar disorder includes both medications and non-medication approaches. Some medications that work for both manic and depressive episodes are  lithium, carbamazepine, olanzapine, quetiapine, and cariprazine. Other medications target specific episodes of bipolar disorder. For example, aripiprazole and haloperidol work for manic episodes, while lamotrigine and lurasidone work for depressive episodes.

Non-medication options include psychoeducation, behavioral therapy, and exercise, etc. 

 

Medication options for bipolar disorder

There are several medications available for the treatment of bipolar disorder. Some medications that work both for manic and depressive episodes are second generation antipsychotics, mood stabilizers, and anticonvulsants. If taking daily oral medications is difficult, long-acting antipsychotics can be used to prevent future manic episodes, which are injected every few weeks or months at a provider’s office or pharmacy. There are several factors that can help your doctor decide which medication should be prescribed for you. Talk to your doctor to see what treatments would work best for you. 

 

Non-medication options for bipolar disorder 

Your doctor may recommend a non-medication approach along with the medications as they improve some symptoms. Psychoeducation helps you to understand the condition, stick to your treatment plan, and lead a more stable life. Psychoeducation also involves strategies such as regular sleep, balanced eating, and managing stress such as by listening to music or things that you like to do.

 

Behavioral therapy helps change unhealthy behaviors and develop healthier ways of thinking and acting. Exercise is not just good for physical health but can also help relieve some stress. Regular exercise has beneficial effects for patients with psychological diseases including schizophrenia and bipolar disorder.

 

How are first generation antipsychotics different from second generation antipsychotics?

First-generation antipsychotics block a brain chemical called dopamine. Too much dopamine can cause symptoms like delusions (believing things that aren’t real). Second-generation antipsychotics also block dopamine but also affect other chemicals in the brain, like serotonin, which can help with mood and other symptoms.

Side effects:

  • First-generation antipsychotics (such as haloperidol and chlorpromazine) can cause movement problems, like muscle stiffness, shaking, or restlessness. 
  • Second-generation antipsychotics (such as olanzapine and cariprazine) have a lower risk of movement problems, but they might cause weight gain, dizziness, or fatigue.

It is important to talk to your doctor to see what medication would work best for you.

 

Written by:

Shahroz Ul Haq

2025 PharmD Candidate

Philadelphia College of Pharmacy

 

References: 

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