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Bipolar Depression Tough to Diagnose

Bipolar depression is often difficult to diagnose with some cases taking up to a decade of frustration before an accurate diagnosis is made. Without the correct diagnosis effective treatment cannot be accomplished. Research studies suggest that up to 50% of those with bipolar disorder are misdiagnosed with unipolar instead of bipolar depression.

Bipolar Depression is Different Kind of Depression

Bipolar depression is the depressive phase of a mental health disorder called bipolar disorder, referring to the lows or depressive phase of the disorder. Bipolar disorder is a chronic illness where extreme mood swings occur from mania, or “highs,” to depression, or “lows.” The treatment options are different for the different types of depression, with proper diagnosis a critical component for successful management.

Bipolar Depression Disrupting Phase

The depressive phase of bipolar disorder is often more debilitating and disruptive than the mania phase as it typically lasts longer and occurs more frequently. In a study published in the Archives of General Psychiatry, those with Bipolar I report depression 3 times as often as mania, and for those diagnosed with Bipolar II, the low phase occurs 40 times as often.

Depression Episodes Dominate Function

While many may feel the general instability of the disorder has the greatest impact on daily functioning, it is the depressive episodes that often disrupt one’s life. Depression dominates the functional ability to work, actively participate in family and social groups, and it contributes to a significant decrease in motivation, desire, self-worth, and self-esteem.

Symptoms of Bipolar Depression

You may experience some or all of the following symptoms. A comprehensive psychiatric evaluation is in order if you have any of the following symptoms and are having difficulty with daily functioning.

  • Feeling sad, worried, or empty inside
  • Having little to no energy as a common occurrence
  • Feeling like you do not enjoy anything
  • Sleeping too much or too little
  • Eating too much or too little
  • Difficulty with memory, focus, attention
  • Wanting to stay in bed
  • Difficulty with making decisions
  • Thoughts of suicide or death
  • Be full of energy but feel very sad
  • Feel “down” for at least 2 weeks at a time

Bipolar Depression Evaluation and Treatment

Stop the daily struggle and frustration. Correct treatment depends on an accurate diagnosis. Call Dr. Hege, Atlanta’s bipolar depression psychiatrist who has the experience and expertise you need for treatment.

Bipolar Premenstrual Mood Exacerbation Linked

After multiple research studies it has been determined that premenstrual mood exacerbation may be a clinical marker in predicting the display of severe bipolar symptoms in women of reproductive age. The American Journal of Psychiatry reports that women who have both bipolar disorder and experience premenstrual mood exacerbation, PME, tend to have a worse course of illness, a shorter time in which relapse occurs and increased severity of symptoms than women who do not report PME.

Mood Exacerbation

Women with premenstrual exacerbation and bipolar disorder typically had more severe depressive and mood elevation symptoms over the course of a year with women reporting a greater symptom burden.  Women with PME and a bipolar diagnosis also exhibited more depressive mood episodes overall than women without reported PME. Study data showed that although there were considerably more depressive mood episodes with PME, women did not exhibit more episodes of mania or hypomania when compared to those women who did not suffer from premenstrual exacerbation.

Bipolar Relapse Time

For women with bipolar disorder and PME the median time to relapse was 4.5 months compared to 8.5 months who were diagnosed with bipolar disorder but who did not suffer from PME. This is a significant finding that indicates mental health professionals working with women need to track their menstrual cycle as well as the appearance and severity of premenstrual exacerbation in order to provide optimum care and treatment before, during and after the menstrual cycle. PME points to a more severe course of bipolar disorder suggesting further evaluation and the need for an adjustable treatment plan.

Complications to Treatment Plan

The Department of Psychiatry at Brigham and Women’s Hospital report that hormonal changes associated with the menstrual cycle and menopause can complicate the treatment and course of disease. It is possible for hormonal changes to impact mood as well as impact the way mood stabilizing medications used in treatment of bipolar disease work.  Working with a psychiatrist who understands PME and its relationship with bipolar disorder is necessary for consistent treatment and management of the disorder. Call Dr. Darvin Hege for a confidential appointment today.

Bipolar vs Borderline Personality Disorder

While being diagnosed with the correct mental health disorder is critical for development of a treatment plan which includes medication, thousands of patients receive an incorrect plan, often continuing to struggle through life for years to come. The National Institute of Mental Health estimates that in the U.S. 1.6% of the population is diagnosed with BPD or Borderline Personality Disorder compared with 2.6% of the population that have bipolar disorder.

Is it Bipolar or BPD?

When comparing bipolar disorder, which may also be referred to as bipolar affective disorder, manic depressive disorder or manic depression — BPD or borderline personality disorder rivals the deterioration of psychiatric and physical health that is also present in those diagnosed with bipolar disorder. In addition, those with either bipolar or BPD present with co-occurring mental health illness symptoms that overlap each other make it difficult for even those with experience to ascertain which disorder (bipolar or BPD) is actually present.

Bipolar and BPD Share Similar Symptoms

Science Daily reports that clinical comparisons and study have intimated that BPD is as disabling as bipolar disorders. Data from psychiatric patient samples show that BPD is seen as frequently as bipolar disorder and share many of the same overlapping issues. Both bipolar and BPD patients typically suffer from depression, anxiety disorders, substance abuse, eating disorders and suicidal behaviors.

Bipolar versus BPD

People with bipolar disorder may experience the same mood or phase of their cycle for weeks at a time while those with BPD find themselves dealing with intense bouts of anger, depression and anxiety that are relatively short in duration. Both disorders have similar symptoms such as extreme mood swings, displaying reckless behavior, and being impulsive. While a major defining factor of bipolar disorder involves extreme highs and lows in mood, those with BPD have significant difficulty regulating their emotions and thoughts, at times finding themselves at the extreme destructive ranges of mood.

Diagnosing Bipolar or BPD Correctly

The correct diagnosis is often confusing and tricky for mental health professionals with limited experience. While they may have similar and overlapping symptoms they are completely different disorders that require their own unique treatments and therapeutic plan. Having a correct diagnosis early allows for providing effective treatment more quickly. Misdiagnosis and delay of proper treatment brings with it a higher risk of complications, worsened symptoms, or even risk of suicide.

Dr. Hege, a highly respected psychiatrist in the Atlanta area has more than 25 years of experience providing correct diagnoses and successful treatment plans for those that have sought him out for the help they needed to get their lives back on track. If you too need help, call the office for an appointment.

Treatment for Bipolar and BDP

If Dr. Hege diagnoses bipolar disorder, he is very experienced in providing medication management. He usually also recommends a therapist for supporting and/or insight oriented psychotherapy to enhance the response to treatment. If he diagnoses borderline personality disorder, he refers patients for the most scientifically proven treatment, DBT. DBT is a structured treatment provided by a specially trained therapist. These therapists work in the same office in collaboration with a psychiatrist to provide the most effective, integrated treatments.

Untreated Bipolar Disorder Has Risky Consequences

The goals for treatment of diagnosed bipolar disorder include:

  • making the mood change episodes less frequent or less severe
  • helping patients function well in home, work and life situations
  • working to prevent self-injury or suicide.

Receiving proper bipolar disorder treatment from a qualified mental health professional allows for customization and modification of your treatment plan as changes occur over time.

Bipolar Disorder or Manic-Depressive Illness a Brain Disorder

The National Institute of Mental Health makes note that bipolar disorder, also known as manic-depressive illness, is a disorder of the brain where unusual shifts in mood, energy or activity levels occur that effect the ability to function in the day to day world. Behaviors and mood shifts seen with bipolar disorder are often severe, resulting in significant difficulty in maintaining a relationship, holding a job, succeeding in school, or in managing finances. Risk taking, drug or alcohol abuse, and thoughts of suicide are also seen, occurring at higher levels when bipolar disorder is left untreated — either through misdiagnosis or the patient’s own poor judgment and decision making.

Untreated Bipolar Manic Depression Episodes Last Longer

Studies conducted show a distinct difference in the length of bipolar mania and depressive episodes. Sharecare reports that untreated bipolar mania episodes can last for 3 to 6 months, while episodes of depression last for much longer periods of 6 to 12 months at a time. Effective treatment allows those with bipolar disorder to lead full productive lives with a better understanding of how to recognize and manage their behaviors or mood swings.

Consequences of Forgoing Bipolar Disorder Treatment

The National Alliance of Mental Health has reported that there are serious risks in deciding not to treat diagnosed bipolar disorder. Some of the consequences that can occur with untreated bipolar disorder include:

  • Having more severe episodes of mania and/or depression
  • Displaying risky behaviors, taking dangerous chances
  • Extreme changes in energy, activity level, sleep
  • Partaking in excessive drinking, drug abuse
  • Greater risk of suicidal ideation
  • Experience long lasting periods of unstable moods
  • Suffer from higher death rates from cancer, heart disease or stroke
  • Symptoms become more pronounced and debilitating
  • Increased involvement in illegal substances
  • Periods of irrational behaviors

About one-half of all people who have bipolar disorder or manic-depressive illness do not receive treatment. While bipolar disorder is a chronic lifelong condition, treatment is effective and frees those from harsh unrelenting episodes of mania and/or depression. Untreated bipolar disorder will display symptoms and behaviors that worsen, becoming more pronounced over time.

A Bipolar Disorder Psychiatrist in Atlanta is a Phone Call Away

Proper diagnosis and treatment is just a phone call away. If you suffer from recurring mood swings and episodes of mania or depression and find it increasingly difficult to manage your life, friends, family or work, call for a confidential appointment and expert diagnosis. Make the call that can change your life for the better.

Bipolar Medications Need Critical Adjustments Over Time

The National Association of Mental Illness reports that bipolar disorder can be successfully treated following an accurate diagnosis. While there is no cure for bipolar disorder, finding the correct medication regime is an essential part of treatment. The quantity and severity of bipolar episodes can be regulated via a medication maintenance program; however, the appearance of sporadic episodes of mania or depression require additional treatment, which can include medication adjustments and management.

Bipolar Medications Require Discovery Time for Optimal Dosage

Bipolar disorder is a complex illness that often requires patience by the patient. Determining the right bipolar medication(s) typically revolves around your psychiatrist making critical adjustments over time to achieve the desired effect. Mayo Clinic reports show some bipolar medications may take weeks to even months to take full effect; changes are often made one medication at a time to properly evaluate which one will not only work to relieve your symptoms, but which also has the least troubling side effects.

Common Medications for Bipolar Disorder

There are three main types of medications that are used to treat bipolar disorder. The National Institute of Mental Health defines these psychiatric medications as including mood stabilizers, antidepressants, and atypical antipsychotics. Examples of these three types of bipolar medications are:

  • Mood Stabilizers include the use of Lithium (Lithobid), and anticonvulsants such as valproic acid (Depakene, Stavzor), divalproex (Depakote), or lamotrigine (Lamictal). Lithium requires periodic blood tests. Common side effects include dry mouth, digestive issues, restlessness, weight gain, drowsiness, or dizziness. Medication may require periodic blood tests to determine medication blood levels and physiological effects on internal organs.
  • Antidepressants may be used by your psychiatrist depending on your symptoms. Some of these drugs include MAO inhibitors, tricyclics, or Symbyax. Common side effects with antidepressants include reduced sexual desire and response, weight gain, drowsiness, or increased appetite. Some of these bipolar medications require careful monitoring for potentially dangerous side effects.
  • Antipsychotics include aripiprazole (Abilify), olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel). Side effects may include weight gain, sleepiness, tremors, blurred vision and rapid heartbeat. Use of antipsychotics for bipolar disorder may also affect memory, attention, focus, as well as the possibility of causing involuntary facial or body movements.

Your bipolar disorder psychiatrist will determine which medications fit with your symptoms and lifestyle following a comprehensive evaluation. Adjustments and changes will be made over time to provide you with an optimal psychopharmacology regime that meets your unique needs. An experienced psychiatrist may also prescribe other medications such as anti-anxiety medications on a short term basis to address anxiety and poor sleeping patterns.

Atlanta Bipolar Disorder Psychiatrist

Dr. Hege, your bipolar disorder psychiatrist, can help turn your life around without years of suffering through misdiagnosis. Contact us today to request a consultation.

Bipolar Disorder Needs Close Monitoring of Medications for Success

The National Institute of Mental Health reports bipolar disorder, also commonly known as manic depression, is a serious mental health issue affecting approximately 5.7 million adults in America — with 89% of those diagnosed as severe.

Bipolar Disorder’s Four Types of Mood Swings

A comprehensive diagnosis of bipolar disorder involves more than the assessment of mood shifts and behaviors. A qualified expert in psychiatry looks beyond clinical observation, interview and professional evaluation. The four types of mood episodes are mania, hypomania, depression and mixed state; an experienced bipolar disorder psychiatrist will pinpoint the type of bipolar disorder cycle and degree of intensity that is causing the most life disruptions.

Bipolar Disorder Cycles Have Unique Symptoms

Each type of bipolar disorder mood shift presents with their own unique set of symptoms. An experienced bipolar disorder psychiatrist works with you to develop a treatment plan that works around you own unique mood shift cycles. While some cycles last for days, other cycles may last for months at a time. Each episode can intensify to where it interferes with the ability to function at home, work and in the community.

Bipolar Disorder Symptoms by Mood Disorder Type

The signs and symptoms of bipolar disorder vary from one person to the next along with cycle length and intensity.

  • Mania Phase: Symptoms include euphoria, heightened energy and well-being, creativity, sleeplessness, hyperactivity, grandiose ideas and beliefs. The mania cycle may lead to feelings of anger, irritability, aggressive or reckless behaviors, sexual promiscuity, wild gambling, instigating fights, or making foolish choices in life.
  • Hypomanic Episode: The bipolar disorder symptoms displayed here are typically a less severe form of mania. You feel good and accomplish many tasks, yet your family and friends still recognize definite mood swings. Without proper psychiatric evaluation and treatment, hypomania can progress into severe mania or depression.
  • Bipolar Depression: Antidepressants do not help bipolar depression and typically make it worse. Antidepressants can trigger rapid cycling between mood states, interfere with other medications, push you into a psychotic depression, or an intense manic state. Assessment by an expert in bipolar disorder psychiatry like Dr. Darvin Hege will ensure you receive the right diagnosis followed by the most therapeutic medication regime.
  • Mixed State: This type of bipolar disorder gives feelings of both mania and depression at the same time. In this equally tormented state are feelings of agitation, sadness, hopelessness and suicidal thoughts, while feeling highly energized at the same time. Hallucinations and delusions can also occur. A missed or incorrect diagnosis could label you with schizophrenia instead of having bipolar disorder.

Atlanta Bipolar Disorder Psychiatrist

Bipolar disorder is a complex chronic life-long condition that requires long-term treatment and development of a successful medication regime to prevent new episodes or reduce interfering symptoms. Stop the suffering and anguish – effective treatment exists.

Diagnosis of Atlanta bipolar disorder is often difficult and requires the skill of a seasoned expert such as Dr. Darvin Hege. Call the office to get the right help you need.