Anatom3D
ENCZDE
Download

Bipolar disorder

Morbus affectivus bipolaris · Bipolární afektivní porucha

What it is

Swings between mania and depression, with normal periods between.

Symptoms & signs

  • Elevated mood
  • reduced sleep need
  • grandiosity
  • risk-taking
  • racing speech
  • then crushing depression

🚩 Get help if…

  • call 112 / 911 now Thoughts or plans of suicide
  • call 112 / 911 now Mania with risky acts, no sleep for days or losing touch with reality
  • see a doctor soon Tremor, vomiting or confusion while on lithium
  • see a doctor soon Early signs of a new mood swing: less sleep, racing thoughts

Where it strikes

Medical treatment

  • Lithium — the only mood stabiliser shown to cut suicide, at the price of thyroid and kidney monitoring trials support
  • Valproate and lamotrigine — valproate causes birth defects in about 1 in 10 exposed pregnancies mixed evidence
  • Quetiapine, aripiprazole — effective, with weight gain and metabolic cost mixed evidence
  • Psychoeducation trials support
  • ECT in severe or drug-resistant episodes trials support

Natural & lifestyle

  • Rigid sleep and routine (social rhythm therapy)
  • no stimulants or sleep loss
  • mood charting
  • family education

Emerging & experimental

  • Interpersonal and social rhythm therapy protocols
  • ketamine caution studies
  • N-acetylcysteine adjunct

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Omega-3 — small benefit for the depressive phase mixed evidence
  • Shop-bought lithium orotate — low doses, unmonitored; not a substitute for prescribed lithium anecdotal / traditional
  • St John's wort — can trigger mania; avoid anecdotal / traditional

ICD codes