Mania can be depressing

Caution is a good prescription when using anti-depressants to treat bipolar disorder.

Although depression is one of the hallmark stages of this chronic mental illness, treating it with anti-depressants alone brings a risk of the patient switching from depression to mania.

A Swedish study published in 2014 in the American Journal of Psychiatry confirms this long-held observation.

Researchers from the Karolinska Institute in Stockholm performed a population-based study of more than 3,000 bipolar patients.

Results confirmed that those using just an anti-depressant were at increased risk for a manic switch compared to those using combined therapy of antidepressant and mood-stabilizing medication.

In this study, 34 per cent of people were treated with an anti-depressant alone and they had a two-fold increased risk for developing treatment-emergent mania.

Among those treated with both an anti-depressant and a mood stabilizer, no acute change in risk for mania occurred during the three months after starting the anti-depressant treatment and the risk actually decreased between three and nine months later.

This finding is reassuring because it confirms a treatment guideline we have been using for some time.

Most mental health professionals are careful not to prescribe an anti-depressant alone when dealing with bipolar disorder, however it does happen sometimes when a diagnosis is not yet made.

In the early days of bipolar disorder treatment, the individual may be thought to have unipolar major depression and be treated accordingly.

Bipolar disorder can be a difficult condition to treat even under ideal circumstances and it is best managed by a mental health professional with experience in its diagnosis and treatment.

Roughly three per cent of the population will experience bipolar disorder. It is a chronic, life-long mental illness that usually manifests itself in late adolescence or young adulthood.

People experiencing this condition will cycle between episodes of major depression as well as episodes of mania, which is an excessively heightened mood.

Although it may sound nice to be extra happy, mania is no picnic. People experiencing mania tend to be impulsive, reckless and irritable.

They lack insight into their behaviour and often say and do things they would never normally consider and which have a lasting harmful impact on their lives.

If a loved one’s behaviour is causing you to worry, encourage them to seek help as soon as possible.

As noted above, we do have treatment options available and this is a condition that can be managed effectively.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.