How Does Medication Help Bipolar Disorder

Bipolar disorder affects about 2.8% of women, 2.9% of men, and 2.9% of adolescents per year in the United States. Approximately 4.4% of adults have had bipolar disorder at some point in their lives.

Because it manifests in different stages, types, and behaviors, bipolar disorder often goes undiagnosed or is misdiagnosed. The classic presentation is a dramatic swing from manic behavior to depressive feelings and behavior. However, you can have bipolar disorder even if you never have a severely manic or depressive episode. 

The mood and energy swings that accompany most cases of bipolar disorder can be highly destabilizing. You may find it difficult to carry out daily tasks or function at work or school. One day, you’re full of ideas and the energy to carry them out. Next, you have no interest at all.

At The Soho Center for Mental Health Counseling, our expert counselors offer an array of supportive therapies to help you manage bipolar disorder. However, we may also recommend medication to stabilize your disease.

How does medication help bipolar disorder? The following is a brief explanation of the benefits of finding the right medications for your individual case.

No magic pill

The first thing to know about treating bipolar disorder chemically is that there isn’t a single medication that can make your symptoms magically disappear. Finding the right combination of drugs may take some time, as your doctor must consider all of your unique symptoms and your unique biology. 

Medication also does not mean that you can skip therapy. The right medication augments therapy, but doesn’t replace it.

Usually, your doctor selects from a range of medications that help alleviate a complex cluster of symptoms, which may include: 

• Anticonvulsants
• Antipsychotics
• Antidepressants
• Mood stabilizers

Doctors use some medications to stabilize you during a manic or psychotic episode. Others are added or subtracted as needed. Your exact combination of medications may shift over time.

How mood stabilizers help bipolar disorder

Lithium (e.g., Eskalith®, Lithobid®, or Lithonate®) is the most widely studied drug to stabilize manic episodes. Lithium is a natural salt that has a long history of use in bipolar disorder and is usually safe, though your doctor may periodically measure levels in your blood to be sure you aren’t taking too much.

Mood stabilizers like lithium work by affecting the release and maintenance of neurotransmitters in your brain. By quieting down the activity, your symptoms eventually subside.

Within two weeks of starting lithium, manic symptoms tend to diminish or disappear. Your doctor may recommend continuing lithium for life. 

However, to stabilize you more quickly, they may also recommend other mood stabilizers and anticonvulsants, including:

• Valproic acid (Depakene®)
• Divalproex sodium (Depakote®)
• Carbamazepine (Tegretol®, Equetro®)
• Lamotrigine (Lamictal®)

Even if you don’t experience seizures as part of your bipolar symptoms, you could benefit from anticonvulsants. Originally, doctors prescribed these drugs to patients who didn’t respond to lithium. However, now they’re often included as mood stabilizers even for those who take lithium regularly.

Anticonvulsants calm down the hyperactivity in your brain that accompanies manic episodes. They may also help you sleep better, which, in turn, improves brain function. 

How antipsychotics help bipolar disorder

In addition to mood stabilizers, you may benefit from an antipsychotic (i.e., neuroleptic) medication. These drugs help dampen the effects of both manic and depressive episodes. Common choices include:

• Cariprazine (Vraylar®)
• Lurasidone (Latuda®)
• Olanzapine-fluoxetine combination (Symbyax®)
• Quetiapine (Seroquel®)

Antipsychotics are especially helpful for treatment-resistant bipolar disorder. You may also be able to use them as a long-term monotherapy if your bipolar disorder is relatively stable.

How antidepressants may help bipolar disorder

Antidepressants, when used in conjunction with mood stabilizers, may help ward off depressive episodes, which can occur after a manic high. However, they can’t be used as mono-treatment: An antidepressant alone, without a mood stabilizer, could set off a manic episode.

Find out how medication may augment your supportive therapies for bipolar disorder by calling us or scheduling an online appointment at our Greenwich Village, New York City office. You could also choose convenient, HIPAA-compliant teletherapy sessions.