A collection of the how-to article from Psychiatric Times
Making the Diagnosis
Mixed States. Anxious energy, restless drive, destructive impulsivity. Mixed states happen when mania and depression overlaps, but they look very different from mania and feel like a more intense depression.
The (other) Two Types of Bipolar. DSM focuses on bipolar I vs. II, but there’s another way to divide the illness that is just as informative about treatment.
Anxiety is common in bipolar disorder, but the word means many things, from phobia to distress. First, figure out what is causing the anxiety. Next, look for ways to treat it that don’t make the bipolar worse.
ADHD can occur with bipolar disorder, but the symptoms of bipolar can also be mistaken for ADHD. Here’s a brief overview of the differences, and an overview of the cognitive problems bipolar can cause. For more detail, the Carlat Report has a review of how to diagnose ADHD in bipolar disorder and how to treat it.
Borderline Personality Disorder. There’s a lot of debate about the overlap between borderline and bipolar disorders, but there’s a simple truth behind all that controversy. Bipolar and borderline have nothing in common, but cyclothymia and borderline have a lot in common. For further reading, this unique study paints a colorful portrait of the personal lives of people with bipolar.
Light and Darkness
Dark therapy for Springtime Mania.
Podcasts on light and darkness. From Finding Genius.
Light therapy. It treats bipolar depression as powerfully as a medication.
Pramipexole. Branded Mirapex, this treatment for restless leg syndrome has a largest effect size in bipolar depression – and the studies that tested it enrolled treatment-resistant cases.
Antidepressants. Who gets worse on them. Should you ever use them in bipolar (also as Podcast)? Bupropion is the most favorable – but it’s riddled with myths. Seven common mistakes with antidepressants.
Cognition. Treatments that sharpen the mind in bipolar disorder (it’s a 2017 article, but little has changed since then, except lurasidone/Latuda improved cognition in a randomized controlled trial of euthymic bipolar disorder, and we know a lot more about how cognition gets better when metabolic health improves.).
Cover image: Pablo Picasso, Harlequin and his Companion (Les deux saltimbanques), 1901