Depression Treatment Care

Its Bi polar. Usually if someone has this it develops in late twenties. When they are taking medication they are fine and live normal lives, have steady jobs etc. Then something can trigger them to change when they go manic, basically when they are ok they accept that they have a problem and take the meds. When they go manic their brain begins to act to fast, they talk fast and go off doing weird stuff, sometimes causing trouble, sometimes start taking drink or drugs which make it worse. The whole character can totally change, they usually think they are normal during the manic stage and refuse to take the meds. The mind is racing and keeps going forcing the body to go without sleep, nutrition etc. Then they usually have a burnout or get sectioned for causing trouble, many go to jail because the condition is not understood. It’s a terrible illness, which really affects the family of the bi polar while they are in manic stage.

Manic depression = bipolar affective disorder
Here’s some info
Introduction
This leaflet is for anyone who wants to know more about Bipolar Affective Disorder. We hope it will be helpful for anyone who has bipolar affective disorder, as well as their friends and relatives.
This leaflet describes:
? the disorder itself;
? some of the problems it can create;
? ways of coping;
? some of the treatments available.
What is Bipolar Affective Disorder?
Bipolar disorder used to be called ‘manic depression’. As the name suggests, it is characterised by mood swings – or episodes – that are far beyond what most people experience in their lives. These are:
Low – feelings of intense depression and despair – ‘depressive’.
High – feelings of elation – ‘manic’.
Mixed – for example, depressed mood with the restlessness and
overactivity of a manic episode.
People usually experience both depressive and manic episodes, but some will have only manic episodes.
How common is bipolar disorder?
It affects about 1 in every 100 adults at some point in their life. It can start at any time during or after the teenage years, although it is unusual for it to start after the age of 40. Men and women are affected equally.
What types are there?
Bipolar I
There has been at least one high, or manic episode (see below), which has lasted for longer than one week. Some people will have only manic episodes, although most will also have depressive ones, whilst others will have more depressive episodes than manic ones.
Untreated manic episodes generally last three to six months, depressive episodes rather longer – six to 12 months without treatment.
Bipolar II
There has been more than one episode of major depression, but only mild manic episodes – these are referred to as ‘hypomania’.
Rapid cycling
There are more than 4 mood swings in a 12 month period. This affects around 1 in 10 people with Bipolar Disorder and can happen with both types I and II.
Cyclothymia
The mood swings are not as severe as those in full bipolar disorder, but may continue for longer. This can, sometimes, develop into full bipolar disorder.
What causes bipolar disorder?
We don’t have a complete answer to this, but:
? research suggests that it runs in families – it seems to have more to do with genes than with upbringing.
? there seems to be a physical problem with the brain systems which control our moods – this is why the symptoms of bipolar disorder can often be controlled with medication.
? episodes of illness can sometimes be brought on by stressful experiences or physical illness.
What does it feel like?
Depression
The feeling of depression is something we all experience from time to time. It can even help us to recognise and deal with problems in our lives.
But
for someone with clinical depression or bipolar disorder, their depressive feelings will be worse, they will go on for longer and they will make it harder to tackle the daily tasks and problems of living. Someone with this sort of depression is more likely to have the physical symptoms listed below. If you develop a depressive episode, you will have many of these symptoms:
Emotions
? feelings of unhappiness that don’t go away;
? losing interest in things;
? being unable to enjoy things;
? feeling restless and agitated;
? losing self-confidence;
? feeling useless, inadequate and hopeless;
? feeling more irritable than usual;
? thinking of suicide.
Thinking
? finding it hard to make even simple decisions;
? difficulty in concentrating.
Physical
? losing appetite and weight;
? difficulty in getting to sleep;
? waking earlier than usual;
? feeling utterly tired;
? constipation;
? going off sex.
Behaviour
? difficulty in starting or completing tasks;
? crying a lot – or feeling like you want to cry, but not being able to;
? avoiding contact with other people.
If you become depressed you will find that you aren’t able to do your job or your normal daily tasks properly. It will become harder and harder to think positively about things, and to see a hopeful future for yourself.
You may feel like bursting into tears for no reason. You may find it harder and harder to be with other people. In fact, they may notice that you are not yourself well before you have realised there is something wrong.
Mania
Mania is an exaggeration of feelings that we all experience from time to time. It is the opposite of depression – a feeling of well-being, energy and optimism. Surely this can’t be a problem? Well, actually it can.
These feelings can be so intense that you can lose contact with reality. When this happens, you may find yourself believing strange things about yourself, making bad judgements, and behaving in embarrassing, harmful – and sometimes even dangerous ways.
Like depression, it can make it difficult or impossible to deal with life in an effective way. A period of mania can, if untreated, destroy your relationships and work. When it isn’t so extreme, the word ‘hypomania’ is used to describe it. In an episode of mania, you may notice the following changes:
Emotional
? very happy and excited;
? irritated with other people who don’t share your optimistic outlook;
? you feel more important than usual.
Thinking
? full of new and exciting ideas;
? moving quickly from one idea to another;
? that you are hearing voices that other people can’t hear.
Physical
? full of energy;
? unable or unwilling to sleep;
? increased interest in sex.
Behaviour
? making plans that are grandiose and unrealistic;
? very active and moving very quickly;
? behaving in a bizarre way;
? speaking very quickly – if your mood is very high, it can be difficult for other people to understand what you are talking about;
? making odd decisions on the spur of the moment, sometimes with disastrous consequences;
? recklessly spending your money;
? becoming over-familiar or recklessly critical with other people;
? less inhibited in your general behaviour.
If you are in the middle of a manic episode for the first time you may not realise that there is anything wrong – it will be your friends, family or colleagues. You may feel quite insulted if someone tries to point this out – you may well feel better than you ever have done before. The problem with feeling like this is that it increasingly detaches you from day-to-day reality. And when you have recovered from one of these episodes, you will often regret the things that you said and did while you were high.
Psychotic Symptoms
If an episode of mania or depression becomes very severe, your experiences may become so intense that you – in effect – lose contact with reality. These are called psychotic symptoms. If you are in a manic episode, these will tend to be grandiose beliefs about yourself – that you are on an important mission or that you have special powers. If you are depressed – that you are uniquely guilty, that you are worse than anybody else or even that you don’t exist. As well as these unusual beliefs, you might experience hallucinations – when you hear, smell, feel or see something, but there isn’t anything (or anybody) there to account for it.
Between episodes
It used to be thought that, between episodes of depression and mania, people with bipolar disorder go back to normal. While this may be true for some, we now know that this is not the case for many people with bipolar disorder. They continue to experience low levels of depressive symptoms and mild problems in thinking even when they appear, to other people, to be ‘back to normal’.
Treatments
There are things you can do yourself to control mood swings so that they stop short of becoming full-blown episodes of mania or depression. These are mentioned below, but medication is still often needed to:
? keep your mood stable (prophylaxis);
? treat a manic or depressive episode.
Medication – Mood Stabilisers
There are several mood stabilisers, most of which are also effective in treating epilepsy. However, Lithium (a naturally occurring salt) was the first medication that was found to be helpful in stabilising moods.
Lithium
Lithium has been used as a mood stabiliser for 50 years – but how it works is still not clear. It can be used to treat both manic and depressive episodes. The main issue is getting the level of lithium in the body right – too low and it will not work, too high and it will become toxic.
Treatment with Lithium should be started by a psychiatrist. He or she will arrange for you to have blood tests in the weeks after you start Lithium, to make sure that you are getting an appropriate dose. Once the dose is stabilised, the prescribing and monitoring of lithium treatment can be taken over by your GP.
The amount of lithium in your blood is very sensitive to how much, or how little, water there is in your body. If you become dehydrated, the level of lithium in your blood will rise and you will be more likely to get side-effects, or even toxic effects. So, it’s very important to drink plenty of water – more in hot weather or if you are more active – and to use coffee and tea in moderation because they increase the amount of water you pass in your urine.
If this doesn’t work, or you find the side-effects unpleasant, there are other possibilities that you can discuss with your psychiatrist.
It can take three months or longer for Lithium to work properly so you may have to carry on taking the tablets, even if you continue to experience mood swings during this time.
Side-effects:
These can happen in the first few weeks after starting Lithium treatment. They can be irritating and unpleasant, but often disappear or get better with time.
Most common side-effects include:
? feeling thirsty;
? passing more urine than usual;
? weight gain.
Less common side effects (these can usually be improved by lowering the dose) are:
? blurred vision;
? slight muscle weakness;
? occasional diarrhoea;
? fine trembling of the hands;
? a feeling of being mildly ill.
If the level of Lithium in your blood is too high, you may experience:
? vomiting;
? staggering;
? slurred speech.
If this happens, contact your doctor urgently.
Blood Tests
At first you will need blood tests every few weeks to make sure that you have the right level of Lithium in your blood. You will need these tests for as long as you take Lithium, but less often after the first few months.
In some cases, long-term use of lithium can affect the kidneys or the thyroid gland. It’s wise to have blood tests every few months to make sure that they are working properly. If there is a problem, it may be necessary to stop Lithium and consider an alternative.
Taking care of yourself
? Eat a well-balanced diet.
? Drink regular amounts of unsweetened fluids. By doing this you can make sure you have a proper balance of salts in your body.
? Try to eat regularly – this will help maintain your fluid balance.
? Avoid taking in too much caffeine – in tea, coffee or cola. This makes you urinate more, and so can upset your Lithium levels.
Other Mood Stabilisers
? Lithium is probably the most effective. It reduces relapse by 30–40%.
? It is possible that Sodium Valproate, an anti-convulsant, is just as effective, but there is not yet enough evidence to be sure. It should not be prescribed to women of child bearing age.
? Carbamazepine is slightly less effective. It is not generally recommended but, if it has worked for you there is no reason to change it.
? There is now good evidence that atypical antipsychotic medications (such as Olanzapine) can act as mood stabilisers.
What is the best treatment for me?
This will need to be a joint decision between yourself and your psychiatrist.
? Lithium will usually be recommended for long-term treatment.
? Carbamazepine may be suggested if you have rapid and frequent mood swings.
? A combination of drugs is sometimes needed.
? Much depends on how well you get on with a particular medication. What suits one person may not suit another, but it makes sense to first try the medications for which there is best evidence.
What will happen without medication?
The more manic episodes you’ve had, the more likely you are to have another one.
Number of previous
manic episodes Chance of having another episode in the next year
Not taking Lithium Taking Lithium
1-2 10% (1 in 10) 6-7% (6-7 in 100)
3-4 20% (1 in 5) 12% (12 in 100)
5+ 40% (4 in 10) 26% (26 in 100)
The risk of getting further mood episodes does not get less as you get older. Even if you have been well for a long time, there is still the risk that you will have another episode.
When to start a mood stabiliser
This can play an important part in preventing future episodes – “prophylaxis”. After just one episode, it’s very difficult to predict how likely it you are to have another. However, it may be worth starting a mood stabiliser after just one episode, if that episode was very severe and disruptive.
If you have a second episode, you have an 80% chance of having further episodes – in this case, a mood stabiliser would usually be suggested.
For how long should a mood stabiliser be continued?
- For at least 2 years after an episode of bipolar disorder.
- For up to 5 years if there are risk factors, such as frequent previous relapses, psychotic episodes, alcohol or substance misuse, or continuing social stress.
More information about other mood stabilisers can be found in our companion leaflet “Treating mania and mood swings”.
Psychological Treatments
In between episodes of mania or depression, psychological treatment can be helpful. This should be around 16 one-hour sessions over a period of 6 to 9 months.
Psychological treatment should include:
? Psychoeducation – finding out more about bipolar disorder.
? Mood monitoring – to help you pick up when your mood is swinging too far.
? Mood strategies – to help you stop your mood swinging into a full-blown manic or depressive episodes.
? Help to develop general coping skills.
? Cognitive behavioural therapy (CBT ) for depression.
Pregnancy
You should discuss any pregnancy plans with your psychiatrist so you can arrange how you will manage your bipolar disorder during the pregnancy, and for the first few months after the baby arrives.
If you become pregnant, it’s usually best to discuss with your psychiatrist whether or not to stop Lithium. Although Lithium is actually safer in pregnancy than the other mood stabilisers, the risk to the baby needs to be weighed against the risk of relapse. The risk is greatest during the first three months of the pregnancy. Unless you are planning to breastfeed, Lithium is safe after the 26th week.
During pregnancy, everyone involved – the obstetrician, midwives, health visitors, the GP, the psychiatrist and community psychiatric nurse – need to communicate with each other.
It is advisable not to breast feed your baby if you need to take Lithium.
Treating an established manic or depressive episode
Depressive episodes
Antidepressant medication will usually need to be added to any mood stabiliser medication. The most commonly used antidepressants are the “SSRI” medications. These affect the action of a chemical in the brain called serotonin, and seem to be less likely than other kinds of antidepressant to push someone into a manic episode. The older “tricyclic” antidepressants should be avoided for this reason.
If you have had a recent manic episode or have a rapid-cycling disorder, an antidepressant is more likely to push you into a manic swing. It may be safer to increase the dose of the mood stabiliser without an antidepressant.
Antidepressants usually take between 2 and 6 weeks to work properly, but sleep and appetite often improve first.
Even when you are feeling better, it is important to carry on taking the tablets as your GP or psychiatrist advises. If you stop them too soon, it is more likely that you will become depressed again. If you stop them suddenly, you may have withdrawal symptoms.
Antidepressants should be continued for at least 8 weeks after there has been a major improvement in the depression, and then should be reduced slowly.
There is evidence that, if you have repeated depressive episodes, but have never switched to mania on antidepressants, you can continue on a combined mood stabiliser and antidepressant treatment to prevent further episodes. If you have had manic episodes, then it is not advisable to continue antidepressants long-term.
Mania and mixed depressive episodes
If an antidepressant is being taken, it should be stopped. The first line of treatment may be a mood stabiliser or antipsychotic medication, either alone or in combination. Antipsychotic medications are generally used in schizophrenia, but also help to reduce the overactivity, grandiosity, sleeplessness and agitation of a manic episode.
The older antipsychotics (e.g. Chlorpromazine, Haloperidol) have some unpleasant side-effects such as stiffness, shakiness, dizziness and dry mouth. However, some of the newer drugs (Risperidone, Olanzapine) can improve manic symptoms without many of the unpleasant side-effects of the older drugs.
Once the treatment has started the symptoms could improve within a few days, but may take several weeks for a full recovery. You should check with your GP if you wish to drive while still taking this sort of medication.
Stopping the mood swings – helping yourself
Self-Monitoring
Learn how to recognise the signs that your mood is swinging out of control, so you can get help early. By doing this, it may be possible to avoid both full blown episodes and hospital admissions. By keeping a mood diary, you may be better able to identify the things in you life that are helpful – and those that are not.
Knowledge
Find out as much as you can about your illness and how you can be helped. At the end of this leaflet, you will find some helpful sources of information.
Stress
If possible, avoid particularly stressful situations – these can trigger off a manic or depressive episode. It’s impossible to avoid all stresses, so it can be helpful to learn ways of handling it better. You can do relaxation training yourself with audio cassette tapes, join a relaxation group, or seek advice from a clinical psychologist.
Relationships
Episodes of depression or mania can cause great strain on friends and family – you may find that you have to rebuild some relationships after an episode. It’s helpful if you have at least one person that you can rely on and confide in. When you are well, try explaining the illness to people who are important to you. They need to understand what happens to you, and what to do.
Activities
It is vital to balance your life between work, leisure and relationships with your family and friends. You can bring on a manic episode if you get too busy when you feel well.
Make sure that you have enough time to relax and unwind. If you are unemployed, think about taking courses, or doing some volunteer work that has nothing to do with mental illness.
Exercise
Reasonably intense exercise for 20 minutes or so, three times a week, seems to have a positive effect on mood.
Fun
Make sure you regularly do things that you enjoy and that give your life meaning
Continue with medication
It may be tempting to stop taking your medication before your doctor recommends – unfortunately this will often lead to an early relapse. One way of feeling better about continuing with the treatment is to discuss this with your doctor and your family when you are well.
Have your say in how you are treated
If you have been admitted to hospital for bipolar disorder, you may want to develop an ‘advance directive’ with your doctor and family. This will say how you want to be treated if you become ill again.
What can I expect from my GP? (England & Wales only)
GPs are now expected to make sure that, if you have bipolar disorder and are taking Lithium, you have:
? a health check every year;
? your Lithium levels checked every 3-6 months;
? a blood test for thyroid and kidney function at least every 15 months;
? yearly checks of your blood pressure.
Advice for family and friends
Episodes of mania or depression can be very distressing for family and friends. A manic episode can exhaust all those who are close to the person. Depression can leave family and friends feeling completely powerless to help.
1. Dealing with a mood episode
Depression
It can be difficult to know what to say to someone who is very depressed. They seem to interpret everything in such a negative way. It can be very difficult to know what they want – and they may not know themselves. They may be very withdrawn and irritable, but at the same time unable to do without your help and support. They may be very worried, but unwilling or unable to accept advice. Try to be as patient and understanding as possible. If they talk of harming or killing themselves, this should be taken seriously and professional help should be obtained.
Mania
At the start of a manic mood swing, the person will appear to be happy, energetic and outward-going, the ‘life and soul of the party’. They will relish being the centre of attention, and will enjoy social occasions, such as parties or heated discussions. However, these will tend to make them more excited, so their mood will go even higher. So, it is a good idea to steer them away from these situations while you try to persuade them to seek help. They will benefit from information about the illness, advice about how to help, and practical support.
2. Helping your loved ones stay well
Being practical is very important – and much appreciated. Make sure that your relative or friend is able to look after themselves properly. If you find that they are:
? seriously neglecting themselves by not eating or drinking;
? behaving in a way that places them, or others, at risk;
then seek medical help immediately.
In between mood episodes, find out more about bipolar disorder. It may be helpful to accompany your friend or loved one to appointments with the doctor or psychiatrist.
3. Staying well yourself
It is important that you give yourself space and time to recharge your batteries. Make sure that you are able to spend some time on your own, or with trusted friends, who will give you the support you need. If your relative or friend has to go into hospital, make sure that you share the visiting with someone else. You will be better able to support your friend or relative if you yourself have had some time to rest.
4. Dealing with an emergency
If a manic swing has become severe, the person may become hostile, suspicious and verbally or physically explosive. If a depressive swing is severe, a person may start to think of suicide. Don’t argue with them, but get professional help immediately.
Keep a contact telephone number and the name of a trusted professional handy for any such emergency. There may be times when a short admission to hospital is necessary.
Looking after children
When unwell, a parent with bipolar disorder may not be able to properly look after their children. Their partner, or another family member, will need to make sure that the children are looked after during these times. It’s helpful to make plans for coping when the parent with bipolar disorder is well.
When a parent can’t look after their child as they usually do, the child will often feel anxious and confused. If they cannot express their distress in words, toddlers can become difficult or clingy, and older children will show it in other ways.
A child will find it helpful if the adults around them are sensitive, understanding, and can respond to difficulties in a calm, consistent and supportive way. Adults will need to help them understand why their parent’s behaviour has changed. They will feel better if their daily routine can be kept going as normally as possible. Their questions should be answered calmly, factually and in language they can understand.
Explaining bipolar disorder to children
Older children may worry that they have caused the illness – they may feel it is their fault. They need reassurance that they are not to blame, but also to be shown what they can do to help. When an older child takes responsibility for caring for a sick parent they will need special understanding and practical support.
More information about helping children cope with a sick parent is provided in the factsheet ‘Parental mental illness – the problems for a child’.

I think so, not really sure though.

It is actually called bi-polar disorder and is much, much more than highs and lows of mood. It can involve hearing command hallucinations, feeling paranoid and highly frightened, being so low you cannot eat, move, think and just want to die or being so high you feel invincable and put yourself at huge risk, such as trying to fly off a multi storey car park. It has become trendy for celebs to jump on the “bi-polar band wagon” often as a way of trying to hide or legitimise bad behaviour.
The high and lows come in phases of weeks or months and are not minute to minute changes which are merely normal mood swings.
Bi-polar should only be diagnosed by a Psychiatrist and it is much more than feeling ok one minute and a bit fed up the next so please, don’t trivialise it.

Manic depression normally takes place as changes in mood that last several weeks, sometimes months.
Minute to minute changes can be a symptom of manic depression (bipolar disorder) but are also associated with schizophrenia.

As others have said, some bipolar go up for weeks/months then down for that long as well. Mania (the up) is usually characterized by some kind of psychosis (delusions, paranoia, hallucinations, etc.) Depression can get as bad as suicide. Hence bipolar disease is one of the most dangerous of mental illnesses. It can lead to your death.
Some bipolars do indeed cycle from up to down several times a day. They are called rapid cyclers. I am one of these and have suffered the illness for many years.
It is a treatable illness. If you suspect you have it please get help. Good Luck

Manic depression is a very debilitating illness that affects every aspect of your life. Literally the “manic” relates to the way the depression appears to not be under any regulated pattern of occurance.
As you described the sequence of moods can rapidly swing from overpowering high positivity and over exuberance to an overpowering feeling & sense of dismay & negativity.
Both these moods make the person feel ” out of control ” and can consequently lead onto severe mental instability.
The good news is that through cognitive therapy and behavioural treatment ( in conjunction with medication to help control the hormonal inbalances associated with manic depression) the prognosis is that people who have “md” can learn to live with their illness and work strategies out that can help them overcome any issues.
ps. remember that many people go through quite turbulent mental times in their life associated with many external factors, divorce, bereavement etc that can create feelings of powerless concerning their emotions & moods , so try and seek help either in person or by phone as talking about problems really can help.

Based on your reports you are not bi-polar or have manic depression.
A depressed or manic episode lasts longer and is probably more severe. There is such thing as being a rapid cycler with bipolar, but I think you may not have any mental illness or might have some type of depression.
Feeling better momentarily is a part of depression in a way as this is fleeting and will actually result in you being more depressed and you know this is how it goes. Ultimately the episode of feeling better can be an unrealistic one that is really a part of the depression and is not based on realistic events or thoughts.
Beware of amateur psychologists on this site who will tell you to go on bipolar meds or antidepressants. You don’t need these and don’t want to be taking these considering the side effects to your health.
The only thing realistic is that your mood will change and be down and up. This is normal and natural even with int he same day or hour. Lets not pathologize being human.

you need to see a doctor that can prescribe some meds to help
and get some therapy to find out the reason you are so low
going up and down with moods is a sign of bi polar depressionhttp://www2.oprah.com/health/coping/depr…
try this test http://www.stresscenter.com/selftestv1/t…
bipolar depressionhttp://www.psychologyinfo.com/depression…

Manic depression, otherwise known as bipolar disorder is a mood disorder classified by cycles between highs (manic phases) and lows (depressive phases). Characteristics of a manic phases include sleeplessness, excessive spending, a feeling of elation, potential hallucinations, rapid speech, etc. whereas during the depressive phase, the person is well, depressed. The cycles do not change from minute to minute, but by days or weeks.

Well manic depression is a type of mood disorder that is now classified as bipolar disorder.
It’s actually pretty difficult to diagnose unless you see an actual professional.
By being bipolar, you cycle through different stages. The first is the depressive stage where you’re extremely sad or angry. You feel majorly down and you feel like your life is worthless and stuff. The second is the manic stage which can range from sever suspicion or euphoria (feeling really happy or elated).
I have a friend with bipolar and I’ll tell you what she usually is like. One day she’ll be very very upset, she won’t leave her room and no matter what you do or say, she won’t come out and she will cry herself to sleep (if she can sleep). The next morning she’ll be angry and she’ll snap at everyone and you just want to get out of her way. Later on that evening she’ll be extremely happy. She’ll look like she’s on drugs on something. She’ll be really bouncy and she’ll talk really fast.
If you think you have it, you should go see a doctor right away but you should know that it’s not just mood swings, it is severe mood swings that can interrupt your life.http://www.healthyplace.com/Communities/… <- this is a small test so you can check to see if you’re in the ballpark, but go see a psychologist anyways if your symptoms are really extreme and the test turns out negative. You may have something else.

It’s now called “Bi-Polar” and it does have to do with having extreme highs and extreme lows, but it isn’t “one minute” at a time.
You should talk to a professional to find out what’s going on, and what can be done about it.
Uh, this question appropriately goes in the Psychology category, which is where it is.

As I know it, it is you’re up for a few months and you’re down the next few months.

Uh no ,it sounds to me like perhaps you might be Bi-polar see a doctor for diagnosis if your so worried about it. The word Manic means much of or crazy for, and depression well we all know what that means.