Depression in Bipolar Disorder: what You Can Do

Depression is part of the cycle of major highs and lows that come with bipolar disorder. It keeps you from feeling like yourself and can make it hard to do the things you need or want to do.

But the right treatment can make a big difference. There are many kinds of therapies for bipolar depression that work very well. What else helps? Keep track of your symptoms over time. That may help you know when a mood change is coming on so you can handle it early.

Symptoms

During the depression phase of bipolar disorder, you might:

• Feel sad, worried, or empty
• Have little to no energy
• Feel like you can’t enjoy anything
• Sleep too little or too much
• Have a hard time getting out of bed
• Eat too little or too much
• Have trouble focusing or remembering things
• Have a hard time making decisions
• Think about suicide or death

You could have all of these symptoms or some of them. Someone with bipolar disorder can sometimes feel very sad but also full of energy. The surest sign of a phase of depression is that you feel down for a long time -- usually at least 2 weeks. You might have these episodes rarely or several times a year.

What to Do When You’re Depressed

The most important step you can take is to start and stay on a bipolar treatment plan. Most include a mix of medicine and talk therapy.

Your doctor might prescribe a few different kinds of medication, including mood stabilizers, antidepressants, and antipsychotic drugs. Talk therapy can also help you control stress and recognize your symptoms sooner. Another type of therapy, called cognitive behavioral therapy, teaches you good ways to handle the negative thoughts that come with depression.

You can take other steps to fight depression, too:

• Don’t drink alcohol or use drugs. They can make your mood worse and keep your medications from working.
• Stick to a routine. Try to go to bed, wake up, exercise, and take your medicines at the same time every day.
• Don’t make major life changes while you’re depressed. Your doctor or therapist may be able to help you schedule absences from work if you need them.
• Ask a family member or friend for support. They can help you keep up with your appointments and medications.

If you are thinking about suicide or hurting yourself:

• Tell someone who can help you right now
• Call your mental health professional
• Call your doctor
• Call 911 or go to the emergency room
• Call theSAMHSA (Substance Abuse and Mental Health Services Administration hotline,SAMHSA’s National Helpline, 1-800-662-HELP (4357).

Recognize and Prevent Depression

The manic and depressive phases of bipolar disorder don’t necessarily follow a pattern. You can have a few bouts of depression before you have a manic phase.

But over time, you’ll notice things that cause changes in your mood and warning signs that depression could be setting in. When you catch those symptoms early, you can often avoid major depression.

Keep a mood chart to track how you feel, your treatments, sleep, and other activities. Take note of times when you feel stressed -- maybe when you’re with certain people or in a specific place. The first signs of depression could be that you feel tired and can’t sleep. Short periods of depression can be a sign that a severe phase is coming.

The people around you can help you recognize patterns, too. Ask your family and mental health professional to watch for changes in your behavior that signal an oncoming issue. They may be able to notice things that you don’t.

Even when you feel great, make sure to keep up with your treatment -- it can prevent a relapse of depression. Eat a healthy diet, exercise, and try new ways to ease stress and manage your moods: Join a support group, take up a hobby, or practice relaxation methods like meditation, yoga, or massage.

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