Maria's depression was difficult to treat. As you can recall, various medications had been tried to no avail. But after several months of treatment, Maria has eventually become stable on a combination of two antidepressants.
She's now able to do her usual activities and is motivated to go back to work — something she has struggled to do for a while. Despite her improvement, antidepressant side effects have emerged and are bothersome. Maria begins to consider discontinuing her medications prematurely.
Antidepressant side effects are real and negatively affect patient's compliance. Many patients like Maria consider stopping the medication even at the risk of relapse because of distressing side effects.
How do you deal with some of the common antidepressant side effects?
Insomnia
Some antidepressants e.g. SSRIs (serotonin-reuptake inhibitor) are highly stimulating that they cause insomnia when taken in the afternoon or at bedtime. Take this type of medication in the morning. Discuss with your physician the use of a sedating medication such as trazodone or sedative-hypnotic drug along with the antidepressant. If you want to take only one pill, talk to your doctor about switching to a sedating antidepressant such as mirtazapine.
Moreover, sleep hygiene should be practiced. Avoid naps and intake of caffeinated drinks such as coffee and soda in the afternoon and evening. Involve in regular exercise and physical activities during the day. Moreover, use the bedroom only for sleep and sex and not for recreational activities.
Weight gain
Regular exercise is weight gain's antidote. If no medical contraindication, you may consider jogging, walking, or swimming. To reduce some excess and unwanted fat, keep yourself busy with physical and recreational activities.
How about diet? Diet has always been a part of any weight control regimen. Monitor your carbohydrate intake. Ice cream, chocolates, and other high-caloric foods should be reduced. If none of the above works, talk to your doctor about switching pills.
Sexual dysfunction
Sexual dysfunction happens too often but is rarely asked or discussed in the clinic. Some physicians and patients feel embarrassed about this subject. When you have concerns, be open to your physician. Discuss the possibility of switching medication to an antidepressant (such as bupropion or mirtazapine) that doesn't significantly impair sexual functioning. Also, talk to your doctor about adding another drug such as bupropion, yohimbine, or even mirtazapine to counteract the sexual side effect.
How do you know if the sexual dysfunction is from the pill rather than from depression? If the dysfunction persists despite successful remission of depression, then you should consider other causes such as drug-induced dysfunction or other medical causes e.g. diabetes.
Dry mouth
Tricyclic antidepressants (TCA e.g. amitriptyline) are notorious for causing dry mouth. Why? These drugs have distressing anticholinergic side effects. Avoid this type of drugs. If TCA is still considered, talk about the use of desipramine or nortriptyline. Compared to other TCAs, these two drugs have less anticholinergic effects.
Moreover, try ice chips. Frequent sips of water should also help. To avoid dental cavities, try sugarless candy or sugar-free gum.
Constipation
Like dry mouth, constipation is usually caused by TCAs. To prevent it from happening, drink enough water and eat high fiber foods such as vegetables and fruits. Consider stool softeners if the above interventions fail. If possible, avoid TCAs.
Nausea and vomiting
Patience is the key in dealing with these side effects. Frequently, patients develop tolerance within two weeks. Take the medication with food. If ineffective, talk to your doctor about possibly reducing the dose of your medication or trying antacid or bismuth salicylate (Pepto-Bismol)
Memory lapses
If given permission by your doctor, try to reduce the dose. Also, discuss with your physician about switching antidepressant (especially if dose reduction doesn't alleviate your concern) and avoiding drugs with anticholinergic side effects.
Moreover, don't mix the antidepressant with alcohol. The alcohol-drug interaction can only worsen the memory and cognitive functioning. While on psychotropic drugs, be careful driving and using mechanized equipment.
Dizziness
While still in bed, sit up for 30 seconds, then stand up for another 30 seconds while holding a rail, a table, or a chair before walking. Take the medication at bedtime. Some people use support hose with success.
Agitation or anxiety
Some people benefit from a brief use of benzodiazepine such as lorazepam. Breathing exercises and progressive muscle relaxation should also help.
In general, some side effects such as gastrointestinal upset and insomnia may resolve in a few days. Patience is the key. However, be on guard. When they occur, address them promptly. I'm not however suggesting that you should be your own doctor.
Collaborating with your doctor is an effective way to cope with mental illness and medication problems. Treatment options such as the need to switch or reduce medications should be discussed in an open and accepting manner.
Copyright © 2003. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader's Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Through the CARE approach, Dr. Rayel helps individuals recognize the early signs of mental illness and provide early intervention. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores
For information about depression, visit http://yourdepressioninfo.com.
Friday, June 29, 2007
Thursday, June 28, 2007
The Healing Power of Celebrity? SurvivorList.net Offers a New Twist on Therapy for Manic Depression
June 9, 2004 -- As a newly diagnosed manic depressive, Lars Lohmiller felt a very strong sense of hopelessness. He was unsure if he would be able to live a normal life or be able to realize any of his childhood dreams. To his surprise, as he learned more about his condition, he discovered that manic depression is actually quite common. Here are just a few of the famous individuals who have beaten manic depression:
*Buzz Aldrin (astronaut)
*Ted Turner (media mogul)
*Drew Carey (comedian)
*Art Buchwald (writer)
*Beethoven (composer)
*Winston Churchill (politician)
*Cary Grant (actor)
*Marilyn Monroe (actress)
The complete list can be found at http://www.survivorlist.net/manic-depression/manic-depression-survivors.html
Searching for a way to beat the disease, Lars latched onto the obvious success of so many well-known manic depressives, and was profoundly affected by their efforts. Although scientific and medical treatments for depression are quite effective and should be pursued by individuals experiencing symptoms of depression, there is also an emotional component to the healing and treatment process. In particular, it is extremely important for depressed individuals to retain a sense of hope about the future. One way to give this feeling to sufferers of manic depression is by showing that other people with their condition were able to overcome their illness and achieve success.
Once his own manic depression was under control and being treated effectively, Lars decided to publish a list of famous manic depression sufferers on the Internet, and make the information available for free, so that other manic depressives seeking hope would be able to find it. The "Famous Manic Depression Survivors" list can be found at SurvivorList.net (http://www.survivorlist.net), along with pointers to some additional depression resources.
About SurvivorList.net
SurvivorList.net was founded to provide a comprehensive list of well-known manic depression sufferers as a free public service. SurvivorList.net is intended to provide inspiration and hope to anyone, anywhere who is experiencing pain or suffering as the result of depression. It is not meant as a substitute for medical advice from a trained physician or psychologist.
For information about depression, visit http://yourdepressioninfo.com.
*Buzz Aldrin (astronaut)
*Ted Turner (media mogul)
*Drew Carey (comedian)
*Art Buchwald (writer)
*Beethoven (composer)
*Winston Churchill (politician)
*Cary Grant (actor)
*Marilyn Monroe (actress)
The complete list can be found at http://www.survivorlist.net/manic-depression/manic-depression-survivors.html
Searching for a way to beat the disease, Lars latched onto the obvious success of so many well-known manic depressives, and was profoundly affected by their efforts. Although scientific and medical treatments for depression are quite effective and should be pursued by individuals experiencing symptoms of depression, there is also an emotional component to the healing and treatment process. In particular, it is extremely important for depressed individuals to retain a sense of hope about the future. One way to give this feeling to sufferers of manic depression is by showing that other people with their condition were able to overcome their illness and achieve success.
Once his own manic depression was under control and being treated effectively, Lars decided to publish a list of famous manic depression sufferers on the Internet, and make the information available for free, so that other manic depressives seeking hope would be able to find it. The "Famous Manic Depression Survivors" list can be found at SurvivorList.net (http://www.survivorlist.net), along with pointers to some additional depression resources.
About SurvivorList.net
SurvivorList.net was founded to provide a comprehensive list of well-known manic depression sufferers as a free public service. SurvivorList.net is intended to provide inspiration and hope to anyone, anywhere who is experiencing pain or suffering as the result of depression. It is not meant as a substitute for medical advice from a trained physician or psychologist.
For information about depression, visit http://yourdepressioninfo.com.
Wednesday, June 27, 2007
Depression: An Online Christian Answer Part I
Explains how specific symptoms of depression can be reduced through Bible based concepts and specific techniques. Offers a uniquely powerful solution in Christ.
According to the National Institute of Health clinical depression frequently includes: Sadness, anxiety, or "empty" feelings, Loss of interest or pleasure in activities that were once enjoyed, including sex, Feelings of hopelessness and pessimism, Feelings of helplessness, guilt, and worthlessness, Thoughts of death or suicide, or suicide attempts. Source: National Institute of Health Publication No. 97-4266 and 99-3561 as found online at the online "All About Depression" site. (http://www.allaboutdepression.com/)
The full list of depression symptoms includes several more physical aspects. This article, however, focuses on the thoughts and feelings aspects of depression.
While the symptoms can be very serious, occasionally contributing to suicide, there is hope and not just in a therapist's office. While good therapy from a skilled counselor or psychologist can have a great impact, not every one can afford it. Also, for people who believe in a Biblical worldview, it can be difficult to find a therapist who enhances rather than detracts from such faith. However, learning the truth about how God sees us and what He desires for us, can flood even the most isolated, empty, black lives with the brilliant vibrant life giving holy energy of God!
The Bible states "Then said Jesus... If ye continue in my word, then are ye my disciples indeed; And ye shall know the truth, and the truth shall make you free." John 8:31-32 KJV In the case of depression this truth can lift burdens so big that just crawling under them has become impossible!
Let's go through each symptom and see how God's truth can bring freedom to each one.
Negative and pessimistic thoughts are probably the most commonly recognized effect of depression. With those, life can seem nothing more than a tortuous threatening ordeal that must be endured, if possible. Failure isn't just an occasional disappointment; it becomes a basic expectation of everything in life. "I can never do anything right!" becomes the nearly constant slogan for our lives. Hopelessness becomes a way of life. There is no way out and going through simply means existing in our own private hell for an even longer eternity. And the "I'll never get anything good in life. It just can't happen to me." feeling becomes strong enough to make us forget the few good things that happen with us.
Underlying the constant negative pessimistic thoughts is a basic sense of hopelessness. This is most clearly seen in thoughts like these. "Things are bad and they are going to get worse. It is hopeless to try to change things, can't happen."
However, God offers us hope for a true solution to all problems forever. He offers us perfection for eternity with a taste of it right here and now!
Part of that hope springs from His deep desire for us to be happy. His first priority, of course, is our eternal salvation and life. With that, even if we have "hell on earth" we always have an eternity of the truest and fullest infinite happiness. However, God strongly desires joy, peace, prosperity and happiness for us right now. "For I know the thoughts that I think toward you, saith the LORD, thoughts of peace, and not of evil, to give you an expected end. Then shall ye call upon me, and ye shall go and pray unto me, and I will hearken unto you." Jeremiah 29:11,12 KJV Even though there are times the only way we can learn the lessons and be shaped for heaven is through pain, it lasts just long enough to accomplish what is needed. "For his anger endureth but a moment; in his favour is life: weeping may endure for a night, but joy cometh in the morning." Psalm 30:5 KJV
God, in the deepest part of His being, wants to make us happy, joyful, and vibrantly alive! After all that is the way He created us to live originally. It gives Him pleasure to see us joyful! It is only the results of our willful sin that have introduced fear, loneliness, despair, and an empty void of purposelessness.
God's desire for our happiness is incredible hope because he has the power, all the power that has ever existed or will exist, to make it happen! While the negative thoughts of depression are exaggerated beyond reality, there is definitely truth in the knowledge that we cannot do everything ourselves. We are just not smart enough, rich enough, strong enough or any other enough you can think of. On our own we are limited, and we often want and need what we can't get for ourselves. But choosing life in God blows all limits away. God's power is infinite and He longs to use it to benefit us, to give us a bright future and a joyous life. With God, we are not limited by our abilities, time, money or even death. "...verily I say unto you, If ye have faith as a grain of mustard seed, ye shall say unto this mountain, Remove hence to yonder place; and it shall remove; and nothing shall be impossible unto you. Howbeit this kind goeth not out but by prayer and fasting. Matthew 17:20-21 KJV A future far greater and more pleasing than we can imagine is guaranteed to us for eternity and available to us now if we will place God above ALL else. "Therefore take no thought, saying, What shall we eat? or, What shall we drink? or, Wherewithal shall we be clothed? (For after all these things do the Gentiles seek:) for your heavenly Father knoweth that ye have need of all these things. But seek ye first the kingdom of God, and his righteousness; and all these things shall be added unto you." Matthew 6:31-33 KJV But God wants to give us way more than we deserve, much more than just the minimum needed to survive, He wants to give us proportionate to HIS infinite universal wealth! "But my God shall supply all your need according to his riches in glory by Christ Jesus." Philippians 4:19 KJV
A sense of worthlessness , like their life is pointless, a valueless waste of space is also common. At other times we can simply feel worth less than just about everyone else, just never quite good enough but of still some small value.
The true reality is that God values us above ALL else, even His life. He so passionately desires to live with us that one third of the God head died just to give us the option of choosing to live with Him. Without any assurance of our acceptance, because the choice is still ours, Christ endured torture, humiliation, and an agonizing death to have just the possibility of spending eternity with you and me. For the last 6000 years, God's time, attention, and infinitely loving efforts have been focused on us, His rebellious, selfish, self willed, distrusting, unfaithful, and unappreciative wayward children. It only makes sense that if any being, God or human, invested that much time, energy, heartache, and effort into you or me they have placed a huge value on us. In God's case, the very life of His own Son, for you… and me. For a more detailed explanation of our incredible God given value see: "Our Infinite Immortal Value" (http://home.earthlink.net/~srbaerg/Our%20Infinite%20Immortal%20Valuehtml.htm)
See "Depression: An Online Christian Answer Part II" for the role of Guilt, Forgiveness, and Loss of Interest in depression and a solution!
About the Author
Steven Baerg is 34 years old. He holds a bachelor's degree in Social Work and is currently pursuing a master's degree in preparation for working as a counselor. He is married to a wonderful and supportive wife and has a dog named Bailey. He relies on God's power and help for inspiration and maintaining a proper focus in life.
For information about depression, visit http://yourdepressioninfo.com.
According to the National Institute of Health clinical depression frequently includes: Sadness, anxiety, or "empty" feelings, Loss of interest or pleasure in activities that were once enjoyed, including sex, Feelings of hopelessness and pessimism, Feelings of helplessness, guilt, and worthlessness, Thoughts of death or suicide, or suicide attempts. Source: National Institute of Health Publication No. 97-4266 and 99-3561 as found online at the online "All About Depression" site. (http://www.allaboutdepression.com/)
The full list of depression symptoms includes several more physical aspects. This article, however, focuses on the thoughts and feelings aspects of depression.
While the symptoms can be very serious, occasionally contributing to suicide, there is hope and not just in a therapist's office. While good therapy from a skilled counselor or psychologist can have a great impact, not every one can afford it. Also, for people who believe in a Biblical worldview, it can be difficult to find a therapist who enhances rather than detracts from such faith. However, learning the truth about how God sees us and what He desires for us, can flood even the most isolated, empty, black lives with the brilliant vibrant life giving holy energy of God!
The Bible states "Then said Jesus... If ye continue in my word, then are ye my disciples indeed; And ye shall know the truth, and the truth shall make you free." John 8:31-32 KJV In the case of depression this truth can lift burdens so big that just crawling under them has become impossible!
Let's go through each symptom and see how God's truth can bring freedom to each one.
Negative and pessimistic thoughts are probably the most commonly recognized effect of depression. With those, life can seem nothing more than a tortuous threatening ordeal that must be endured, if possible. Failure isn't just an occasional disappointment; it becomes a basic expectation of everything in life. "I can never do anything right!" becomes the nearly constant slogan for our lives. Hopelessness becomes a way of life. There is no way out and going through simply means existing in our own private hell for an even longer eternity. And the "I'll never get anything good in life. It just can't happen to me." feeling becomes strong enough to make us forget the few good things that happen with us.
Underlying the constant negative pessimistic thoughts is a basic sense of hopelessness. This is most clearly seen in thoughts like these. "Things are bad and they are going to get worse. It is hopeless to try to change things, can't happen."
However, God offers us hope for a true solution to all problems forever. He offers us perfection for eternity with a taste of it right here and now!
Part of that hope springs from His deep desire for us to be happy. His first priority, of course, is our eternal salvation and life. With that, even if we have "hell on earth" we always have an eternity of the truest and fullest infinite happiness. However, God strongly desires joy, peace, prosperity and happiness for us right now. "For I know the thoughts that I think toward you, saith the LORD, thoughts of peace, and not of evil, to give you an expected end. Then shall ye call upon me, and ye shall go and pray unto me, and I will hearken unto you." Jeremiah 29:11,12 KJV Even though there are times the only way we can learn the lessons and be shaped for heaven is through pain, it lasts just long enough to accomplish what is needed. "For his anger endureth but a moment; in his favour is life: weeping may endure for a night, but joy cometh in the morning." Psalm 30:5 KJV
God, in the deepest part of His being, wants to make us happy, joyful, and vibrantly alive! After all that is the way He created us to live originally. It gives Him pleasure to see us joyful! It is only the results of our willful sin that have introduced fear, loneliness, despair, and an empty void of purposelessness.
God's desire for our happiness is incredible hope because he has the power, all the power that has ever existed or will exist, to make it happen! While the negative thoughts of depression are exaggerated beyond reality, there is definitely truth in the knowledge that we cannot do everything ourselves. We are just not smart enough, rich enough, strong enough or any other enough you can think of. On our own we are limited, and we often want and need what we can't get for ourselves. But choosing life in God blows all limits away. God's power is infinite and He longs to use it to benefit us, to give us a bright future and a joyous life. With God, we are not limited by our abilities, time, money or even death. "...verily I say unto you, If ye have faith as a grain of mustard seed, ye shall say unto this mountain, Remove hence to yonder place; and it shall remove; and nothing shall be impossible unto you. Howbeit this kind goeth not out but by prayer and fasting. Matthew 17:20-21 KJV A future far greater and more pleasing than we can imagine is guaranteed to us for eternity and available to us now if we will place God above ALL else. "Therefore take no thought, saying, What shall we eat? or, What shall we drink? or, Wherewithal shall we be clothed? (For after all these things do the Gentiles seek:) for your heavenly Father knoweth that ye have need of all these things. But seek ye first the kingdom of God, and his righteousness; and all these things shall be added unto you." Matthew 6:31-33 KJV But God wants to give us way more than we deserve, much more than just the minimum needed to survive, He wants to give us proportionate to HIS infinite universal wealth! "But my God shall supply all your need according to his riches in glory by Christ Jesus." Philippians 4:19 KJV
A sense of worthlessness , like their life is pointless, a valueless waste of space is also common. At other times we can simply feel worth less than just about everyone else, just never quite good enough but of still some small value.
The true reality is that God values us above ALL else, even His life. He so passionately desires to live with us that one third of the God head died just to give us the option of choosing to live with Him. Without any assurance of our acceptance, because the choice is still ours, Christ endured torture, humiliation, and an agonizing death to have just the possibility of spending eternity with you and me. For the last 6000 years, God's time, attention, and infinitely loving efforts have been focused on us, His rebellious, selfish, self willed, distrusting, unfaithful, and unappreciative wayward children. It only makes sense that if any being, God or human, invested that much time, energy, heartache, and effort into you or me they have placed a huge value on us. In God's case, the very life of His own Son, for you… and me. For a more detailed explanation of our incredible God given value see: "Our Infinite Immortal Value" (http://home.earthlink.net/~srbaerg/Our%20Infinite%20Immortal%20Valuehtml.htm)
See "Depression: An Online Christian Answer Part II" for the role of Guilt, Forgiveness, and Loss of Interest in depression and a solution!
About the Author
Steven Baerg is 34 years old. He holds a bachelor's degree in Social Work and is currently pursuing a master's degree in preparation for working as a counselor. He is married to a wonderful and supportive wife and has a dog named Bailey. He relies on God's power and help for inspiration and maintaining a proper focus in life.
For information about depression, visit http://yourdepressioninfo.com.
Tuesday, June 26, 2007
Major Depression and Manic-Depression — Any difference?
Countless number of patients and their family members have asked me about manic–depression and major depression. "Is there any difference?" "Are they one and the same?" "Is the treatment the same?" And so on. Each time I encounter a chorus of questions like these, I am enthused to provide answers.
You know why? Because the difference between these two disorders is enormous. The difference does not lie on clinical presentation alone. The treatment of these two disorders is significantly distinct.
Let me begin by describing major depression (officially called major depressive disorder). Major depression is a primary psychiatric disorder characterized by the presence of either a depressed mood or lack of interest to do usual activities occurring on a daily basis for at least two weeks. Just like other disorders, this illness has associated features such as impairment in energy, appetite, sleep, concentration, and desire to have sex.
In addition, patients afflicted with this disorder also suffer from feelings of hopelessness and worthlessness. Tearfulness or crying episodes and irritability are not uncommon. If left untreated, patients get worse. They become socially withdrawn and can't go to work. Moreover, about 15% of depressed patients become suicidal and occasionally, homicidal. Other patients develop psychosis—hearing voices (hallucinations) or having false beliefs (delusions) that people are out to get them.
What about manic-depression or bipolar disorder?
Manic-depression is a type of primary psychiatric disorder characterized by the presence of major depression (as described above) and episodes of mania that last for at least a week. When mania is present, patients show signs opposite of clinical depression. During the episode, patients show significant euphoria or extreme irritability. In addition, patients become talkative and loud.
Moreover, this type of patients doesn't need a lot of sleep. At night, they are very busy making phone calls, cleaning the house, and starting new projects. Despite apparent lack of sleep, they are still very energetic in the morning — ready to establish new business endeavors. Because they believe that they have special powers, they involve in unreasonable business deals and unrealistic personal projects.
They also become hypersexual — wanting to have sex several times a day. One–night stands can happen resulting in marital conflict. Like depressed patients, manic patients develop delusions (false beliefs). I know a manic patient who thinks that he is the "Chosen One." Another patient claims that the President of USA and the Prime Minister of Canada ask for her advice.
So the big difference between the two is the presence of mania. This manic episode has treatment implications. In fact the treatment of these disorders is completely different. While major depression needs antidepressant, manic-depression requires a mood stabilizer such as lithium and valproic acid. Recently, new antipsychotics, for example risperidone, olanzapine, and quetiapine, have been shown to be effective for acute mania.
In general, giving an antidepressant to manic–depressed patients can make their condition worse because this medication can precipitate a switch to manic episode. Although there are some exceptions to the rule (extreme depression, lack of response to mood stabilizers, among others), it is preferable to avoid antidepressants among bipolar patients.
When considering the use of antidepressant in a depressed bipolar patient, clinicians should combine the medication with a mood stabilizer and should use an antidepressant (e.g. bupropion) that has a low tendency to cause a switch to mania.
Copyright©2004. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader's Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.
For information about depression, visit http://yourdepressioninfo.com.
You know why? Because the difference between these two disorders is enormous. The difference does not lie on clinical presentation alone. The treatment of these two disorders is significantly distinct.
Let me begin by describing major depression (officially called major depressive disorder). Major depression is a primary psychiatric disorder characterized by the presence of either a depressed mood or lack of interest to do usual activities occurring on a daily basis for at least two weeks. Just like other disorders, this illness has associated features such as impairment in energy, appetite, sleep, concentration, and desire to have sex.
In addition, patients afflicted with this disorder also suffer from feelings of hopelessness and worthlessness. Tearfulness or crying episodes and irritability are not uncommon. If left untreated, patients get worse. They become socially withdrawn and can't go to work. Moreover, about 15% of depressed patients become suicidal and occasionally, homicidal. Other patients develop psychosis—hearing voices (hallucinations) or having false beliefs (delusions) that people are out to get them.
What about manic-depression or bipolar disorder?
Manic-depression is a type of primary psychiatric disorder characterized by the presence of major depression (as described above) and episodes of mania that last for at least a week. When mania is present, patients show signs opposite of clinical depression. During the episode, patients show significant euphoria or extreme irritability. In addition, patients become talkative and loud.
Moreover, this type of patients doesn't need a lot of sleep. At night, they are very busy making phone calls, cleaning the house, and starting new projects. Despite apparent lack of sleep, they are still very energetic in the morning — ready to establish new business endeavors. Because they believe that they have special powers, they involve in unreasonable business deals and unrealistic personal projects.
They also become hypersexual — wanting to have sex several times a day. One–night stands can happen resulting in marital conflict. Like depressed patients, manic patients develop delusions (false beliefs). I know a manic patient who thinks that he is the "Chosen One." Another patient claims that the President of USA and the Prime Minister of Canada ask for her advice.
So the big difference between the two is the presence of mania. This manic episode has treatment implications. In fact the treatment of these disorders is completely different. While major depression needs antidepressant, manic-depression requires a mood stabilizer such as lithium and valproic acid. Recently, new antipsychotics, for example risperidone, olanzapine, and quetiapine, have been shown to be effective for acute mania.
In general, giving an antidepressant to manic–depressed patients can make their condition worse because this medication can precipitate a switch to manic episode. Although there are some exceptions to the rule (extreme depression, lack of response to mood stabilizers, among others), it is preferable to avoid antidepressants among bipolar patients.
When considering the use of antidepressant in a depressed bipolar patient, clinicians should combine the medication with a mood stabilizer and should use an antidepressant (e.g. bupropion) that has a low tendency to cause a switch to mania.
Copyright©2004. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader's Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.
For information about depression, visit http://yourdepressioninfo.com.
Monday, June 25, 2007
Are you depressed?
Are you depressed? I have been for many years.
Find out what the signs and symptoms of different types of depression are.
Explore methods of coping with and curing depression.
Most of all, DO SOMETHING. It doesn't matter much what it is, but you can't just sit around and expect to get better.
For information about depression, visit http://yourdepressioninfo.com/
Find out what the signs and symptoms of different types of depression are.
Explore methods of coping with and curing depression.
Most of all, DO SOMETHING. It doesn't matter much what it is, but you can't just sit around and expect to get better.
For information about depression, visit http://yourdepressioninfo.com/
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