Bipolar-treatment-Are-bipolar-I-and-bipolar-II-treated-differently

Bipolar treatment: Are bipolar I and bipolar II treated differently?

From Daniel K. Hall-Flavin, M.D.

Bipolar treatment generally involves taking medications and going to mental health counseling (psychotherapy) — whether you have bipolar I or bipolar II. Both bipolar I and bipolar II disorders have several subtypes.

The types and doses of medications prescribed are based on your particular symptoms. Medications may include:

Mood stabilizers. Whether you have bipolar I or II, you'll typically need mood-stabilizing medication to control manic episodes. With bipolar I, unmanaged manic episodes can lead to irrational thinking, inappropriate decisions, and dangerous or out-of-control behaviour. A less severe type of mania (hypomania) occurs with bipolar II, but it can still cause problems. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
Antipsychotics. If symptoms of depression or mania persist in spite of treatment with other medications, adding an antipsychotic medication such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon) or asenapine (Saphris) may help. Your doctor may prescribe some of these medications alone or along with a mood stabilizer.
Antidepressants. For either type of bipolar disorder, a mood stabilizer or antipsychotic alone may be enough to control depression. If not, your doctor may add an antidepressant. Because an antidepressant can sometimes trigger a manic episode, it's usually prescribed along with a mood stabilizer or antipsychotic. Examples of antidepressants used for bipolar disorder include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and bupropion (Wellbutrin).

In addition to medication for bipolar disorder, other treatment approaches include:

Mental health counselling (psychotherapy). As a key part of treatment, your doctor may recommend individual, group or family counselling.
Substance abuse treatment. According to a national survey, about half of people with bipolar disease also abuse alcohol, significantly increasing the risk of life-threatening complications. If you have a problem with alcohol or other drugs, tell your doctor so this can be part of your treatment plan.
Hospital treatment. This can include an inpatient hospital stay or participation in an outpatient treatment program. Because bipolar I is generally more severe than bipolar II, the need for urgent outpatient treatment or hospitalization is more common with bipolar I.
Lifestyle changes. Successful management of your bipolar disorder includes living a healthier lifestyle, such as getting more sleep, eating healthier and getting more physical activity. If you need help in these areas, ask your doctor for advice.

You may need to try different medications or combinations of medications to determine what works best. So it's important to regularly meet with your doctor to see how well your treatment is working. If necessary, your doctor may make periodic adjustments to your medication to keep symptoms and side effects under control.

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Quotes

"The most important thing to have to deal with mental illness is to have at least one person who believes in you. I never had that until I met my therapist."

Anonymous

"I often have to step back and remind myself that I’m living with this condition and still experimenting with ways to manage and live with it."

Jessica Goldfinch

"My mind broke apart into a million pieces. I couldn't tell the difference between reality and fantasy."

Marcia

"In my early teens I began to really rebel – stealing, drinking, drugs etc. One minute I was completely hyped the next hating myself."

Jasmine

"Bipolar stories are invariably gut-wrenching litanies of loss and regret."

Sarah

"When I’m manic it feels like I just won money. It feels great. When I’m depressed, I feel like I have a draining flu that dwells in my emotions."

Candida Fink

"Manic-depression is a part of who I am, her voice is intertwined with my own; I have accepted that much."

Katherine Kizer

"My mind was a mess, a constant jumble of ideas which I couldn’t shut up."

Manoue

"I managed with some hard work and good support to get things under control, get a job and go back to college."

Anonymous

"It is sometimes very difficult to accept my husband’s emotions. Is he grumpy because he had not enough sleep or is he going down? What is normal?"

Est

"I feel useless. I used to be an active and happy person. But now all i do is want to sleep."

Noelle

"Because of bipolar disorder I have written more, drawn more, and simply made more. Because of it I care more."

Anonymous

"Normally I can get in trouble in autumn, but this year the trouble stays away and I still feel as normal as I did in the summer when the baby was born!"

Anonymous

"I can create amazing meals but wouldn't want to do it professionally, too much pressure, i get joy from taking my time, it's therapeutic too."

Fred

"I hate that feeling of "being well" I know it won't last."

Stan

"Sorry - sorry - sorry is a big part of my life, I say it every day and hate myself for what i have said or done to upset my family, friend or clients... I speak without thinking and still have not learned."

Deborah

"I think that self-harm and cyclothymia can be related. I mean, people who self-harm are usually depressed and may feel for some reason that they need to be punished."

Anonymous

"Escapism is important and nothing achieves such a medicinal self-forgetting than abandoning the self and imagining into the worlds and lives of imaginary others."

Robert

"You have to act as if you want to do daily activities. Doing daily activities give us a sense of mastery and that can help a lot with depression."

Marc

"I understand about being scared to take tablets - when they first gave them to me i was very nervous about taking them."

Samuel

"The 'real' you is a person with bipolar who is struggling but who is seeking help and support and that is something to be really proud of. None of us can say what we'd be like if we hadn't become ill - all we can do is work with what we have."

Elle

"I want people to know it gets better. Be honest with your doctors, reach out for friends and family, be your own advocate, fight for your wellness."

Amanda

"I am bipolar. My life is different. It has always been different to some extent. I am bipolar. My life is different. It has always been different to some extent."

Amy

"I quit taking the meds. A week later I saw the neurologist. The tests were inconclusive. From there I was sent to see yet another shrink. I was a mess."

Amy

"For the first time in my life I truly wanted to die. Other attempts had been cries for help."

Amy

"The thought of having a mental illness disturbed me deeply. I grieved. I cried."

Sheila

"I grew up in a family riveted with mental illness...I equated it with weakness. I grew up in a family riveted with mental illness...I equated it with weakness."

Sheila

"The doctors were telling me I, too, had a mental illness. I refused to believe it. I was too strong to succumb to such an illness."

Sheila

"Still, at the core of me, was the experience of being a survivor; I had always beaten the odds. But things did not get better; they got worse."

Sheila

"I'm still walking the fine line of good day-bad day but at least I'm walking, and knowing I'm not alone."

Kim B

"My teen years were a living hell and it felt as though they were wasted with doctors appointments, consuming dozens of medications, hospitalizations , and feelings of emptiness and worthlessness."

Anonymous

"Today, I haven’t done this well in a very long while or ever. I feel as though I can finally start to live and enjoy my life."

Anonymous

"I need to take time for myself to relax and unwind. It is really helpfull for me"

Jean

"Yes, I am a bipolar person, but I must remind sometimes that I am not my illness"

Kevin

"A big part of getting better is through acceptance and acceptance alone."

Anonymous

"It takes time and is hard, but stopping meds does NOT help. Eat healthfully and exercise vigorously when you have the energy. That has worked the best for me."

Alissa

"I do not know why, but I regulate my depression because of BD by touching water, at least, whenever going swimming is not possible. Splashing water over my face and head gives me an amazing awakening and a great sense of relief."

Phoebe

"I started to notice the symptoms when I was 5. I am 18 now and ready to graduate from High School to move onto college. My best advice is keep fighting; you are worth it."

Jessica

"If you are a patient of BD you should realize that you are given more energy and potential as compared to normal people and you should use that energy positively to live a very happy and successful life."

Anonymous

"Sometimes I feel in depression, but my friends and my family member's supports me to fight against my BD."

George

"I was diagnosed 5 years ago as being bipolar. I have never stopped taking my meds. I go to work every day. Never stop taking your meds. Always go for counseling, and get help whenever and wherever you can!"

Christine

More Send us your Quotes

Tips & Hints

Establish healthy routines
Doing exercise and establishing healthy routines can help you to relieve stress and level your moods. Try to sleep seven or eight hours...
Doing exercise and establishing healthy routines can help you to relieve stress and level your moods. Try to sleep seven or eight hours every night, as sleep deprivation can really interrupt regular mood patterns. Get some professional help if you are having problems getting to sleep.
More
Avoid alcohol and stimulants
Drinking alcohol can neutralize the beneficial effects of the medication you have been prescribed. Alcohol can also cause liver damage,...
Drinking alcohol can neutralize the beneficial effects of the medication you have been prescribed. Alcohol can also cause liver damage, seizures, unpredictable shifts in mood, and other health problems when it interacts with some medications. Stimulants such as caffeine and nicotine can tip your mood balance, especially if they cause you to lose sleep, so avoid taking that kind substances.
More
Be careful with the medication
People who suffer from bipolar disorders have to avoid taking medications that the doctor has not prescribed. Let your psychiatrist, nu...
People who suffer from bipolar disorders have to avoid taking medications that the doctor has not prescribed. Let your psychiatrist, nurse, or doctor know of any side affects you may have from the medication prescribed. If you have serious side effects your psychiatrist may want to change your medication or add something else to combat side effects.
More
Keep appointments with your therapist and psychiatrist
If you miss appointments, you tend to lose touch and can start to unwind. It is a good idea for your support team to know what is going...
If you miss appointments, you tend to lose touch and can start to unwind. It is a good idea for your support team to know what is going on with you, so that the right treatment plan is implemented. You may need a change of medicine or even be taken into hospital, so regular appointments to touch base are highly recommended. They can provide much more effective treatment if you make and keep regular appointments, consult them prior to making any medication or treatment changes, and are honest about what’s going on.
More
Master your triggers
This is extremely important. When you learn to identify your triggers you are able to manage your mood cycles when they begin, instead ...
This is extremely important. When you learn to identify your triggers you are able to manage your mood cycles when they begin, instead of after they have already started. Knowing what triggers your mood can be an effective tool towards a quicker successful recovery.
More

Make notes

Always take a notepad and pencil with you when you visit your doctor or therapist and write down all the advices and important informat...

List symptoms and side effects

List any symptoms and side effects that you have experienced since your last visit to your doctor or therapist. This will help the doct...

Stay positive

Remember: this will get better. Recovering from any addiction or self-destructive behaviour takes patience and persistence, but you can...

Take ownership of your illness

It’s not your fault you have bipolar disorder, but now that you have it, do your part to get help, lead a healthier lifestyle, and fo...

Take your medications as prescribed

Most of the medications used to treat depression or mania need to be taken daily, not just when you think you feel depressed or manic o...

Don’t drink alcohol

Drinking alcohol can neutralize the beneficial effects of the medications and interact with some medications to cause liver damage, sei...

Sleep seven to eight hours per every night

Sleep deprivation can really throw your moods out of whack....

Steer clear of stimulants

Caffeine, nicotine, and other stimulants could tip your mood balance, especially if they cause you to lose sleep. Yep, those energy dri...

Establish healthy routines

You’ll be surprised at how much a daily routine can relieve stress and level your moods. Exercise can help, too....

Avoid triggers and stressors

Situations or people that get you hyped up, agitated, or upset can trigger mood episodes....

Team up with your doctor and therapist

They can provide much more effective treatment if you make and keep regular appointments, consult them prior to making any medication o...

Educate yourself

The more you and others around you learn about the disorder, the better equipped you’ll be to keep it under control....

Ask for help

Your friends, family members, and the people you work with probably want to help but don’t know what to do. Let them know what they c...

Working life

It's important to take things slowly and avoid stressful situations. If you already have a job, you might want to find out if you can r...

Day-to-day life

Routine is important, as well as good diet, enough sleep, exercise and enough vitamins, minerals and fatty acids....

Day centres

Day centres, day hospitals and drop-in centres can vary widely. Services may include therapy groups, counselling, information or advice...

Managing your own condition

Self-management involves finding out about bipolar disorder and developing the skills to recognise and control mood swings early, befor...

Turn to friends and family

Support for bipolar disorder starts at home. It’s important to have people you can count on to help you through rough times. Isolatio...

Join a bipolar disorder support group

Spending time with people who know what you’re going through and can honestly say they’ve “been there” can be very therapeutic....

Build new relationships

Isolation and loneliness make bipolar disorder worse. If you don’t have a support network you can count on, take steps to develop new...

Build new relationships

Isolation and loneliness make bipolar disorder worse. If you don’t have a support network you can count on, take steps to develop new...

Build structure into your life

Developing and sticking to a daily schedule can help stabilize the mood swings of bipolar disorder. Include set times for sleeping, eat...

Exercise regularly

Exercise has a beneficial impact on mood and may reduce the number of bipolar episodes you experience. Aerobic exercise is especially e...

Keep a strict sleep schedule

Getting too little sleep can trigger mania, so it’s important to get plenty of rest. For some people, losing even a few hours can cau...

Learn how to relax

Relaxation techniques such as deep breathing, meditation, yoga, and guided imagery can be very effective at reducing stress and keeping...

Make leisure time a priority

Do things for no other reason than that it feels good to do them. Go to a funny movie, take a walk on the beach, listen to music, read ...

Appeal to your senses

Stay calm and energized by appealing to the five senses: sight, sound, touch, smell, and taste. Listen to music that lifts your mood, p...

Eat a healthy diet

There is an undeniable link between food and mood. For optimal mood, eat plenty of fresh fruits, vegetables, and whole grains and limit...

Get your omega-3s

Omega-3 fatty acids may decrease mood swings in bipolar disorder. Omega-3 is available as a nutritional supplement. You can also increa...

Avoid the drugs

61% of people with bipolar go on to develop a substance abuse disorder. Where possible, stay away from anything with addictive potentia...

Beware side effects

educate yourself on the possible side effects of your medication. If these catch you unaware you may feel like the medication is actual...

Combat weight gain

A lot of bipolar medications, like lithium and antipsychotics, can cause metabolic syndrome or weight gain in patients. This might happ...

Don’t give up

medication giving you nasty side effects? Feel like you’re not making any progress? Instead of giving up, make sure you have an open ...

Perspective

Bipolar disorder goes through cyclical patterns. In the low times, try to remember that it will improve and this is only temporary....

Cravings

remember that these are natural but temporary. You can get through them and you can kick the habit. Ride out the wave rather than givin...

Hope

With good symptom management, it is possible to experience long periods of wellness. Believing that you can cope with your mood disorde...

Perspective

Depression and manic-depression often follow cyclical patterns. Although you may go through some painful times and it may be difficult ...

Personal Responsability

It’s up to you to take action to keep your moods stabilized. This includes asking for help from others when you need it, taking your ...

Self-advocacy

Become an effective advocate for yourself so you can get the services and treatment you need, and make the life you want for yourself....

Education

Learn all you can about your illness. This allows you to make informed decisions about all aspects of your life and treatment....

Support

Working toward wellness is up to you. However, support from others is essential to maintaining your stability and enhancing the quality...

Be Patient

Don’t expect an immediate and total cure. Have patience with the treatment process. It can take time to find the right program that w...

Communicate with your treatment provider

Keep the lines of communication open with your doctor or therapist. Your treatment program will change over time, so keep in close cont...

Be cautious when taking any medication

Certain prescription and over-the-counter medications can be problematic for people with bipolar disorder. Be especially careful with a...

More Tips & Hints