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Bipolar Disorder Treatment and Pharmacogenetic Testing

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Everyone experiences mood swings from time to time, but bipolar disorder takes those highs and lows to a more severe level. Approximately 4% of all U.S. adults will experience bipolar disorder, with women and men equally likely to be affected.

Whether a close friend is dealing with bipolar disorder or you’re struggling with it yourself, getting effective treatment can be crucial. Here’s what you need to know about bipolar disorder, including how pharmacogenetic testing (PGx) can be a helpful tool in your treatment.

What is Bipolar Disorder?

Bipolar disorder is a mental health disorder that causes someone to experience significant shifts in mood. This affects everything from their demeanor to their energy levels as well as their basic ability to function and make it through the day. An individual with bipolar disorder may experience manic, hypomanic, and/or depressive stages.

Dealing with changes in moods and emotions can seem confusing, and it may be difficult to recognize the signs of bipolar disorder.

What does a manic episode feel like?

Some common manic symptoms of bipolar disorder may include:

  • Feeling jumpy, wired, or irritable.
  • Needing less sleep than usual.
  • Having racing thoughts.
  • Talking louder, faster, or having pressured speech.
  • Having an inflated ego, for example thinking you can do things that normally you could not do.

What does a depressive episode feel like?

Some common depressive symptoms of bipolar disorder may include:

  • Feeling sluggish or restless.
  • Increased or decreased appetite.
  • Sleeping too much or having trouble falling asleep.
  • Difficulty focusing or making decisions.
  • Losing interest in things you ordinarily enjoy.
  • Having suicidal thoughts.

These mood swings don’t always happen consecutively. An individual may go through a manic episode, feeling heightened energy and self-confidence, only to fall into a depressive state a few days or weeks later. Alternatively, they may return to normal functioning for weeks or months before the next depressive or manic episode occurs.

Types of Bipolar Disorder

It is the intensity of manic episodes that helps us further categorize bipolar disorder. There are three main types:

  • Bipolar I is defined by manic episodes that last at least seven days, and typically lead to hospitalization. Bipolar I can also include depression lasting up to two weeks, or frequent switches between manic and depressive episodes.
  • Bipolar II is characterized by hypomania, or a milder manic episode. This is an elevated mood or state of mind that may cause high energy levels and make it more difficult to focus. Symptoms must be present for at least four days in order to be defined as hypomania. Bipolar II always involves depressive episodes as well, which mirror clinical depression. Usually depressive periods occur more often than hypomanic episodes.
  • Cyclothymic Disorder is characterized by mild hypomanic and depressive symptoms that occur over the course of two years but are not serious enough to be defined as episodes.

If you think you may have bipolar disorder, it’s important to speak to your healthcare clinician about your symptoms.

Bipolar Disorder Treatments

The first step to treating bipolar disorder is to make an appointment with your primary healthcare provider. They will likely start with a physical exam to rule out other causes of symptoms, then refer you to a specialist, such as a psychiatrist. From there, your treatment plan may include a combination of cognitive behavior therapy, lifestyle modifications, and medication.

There are several prescription medications used to treat bipolar disorder, such as mood stabilizers (like lithium), antipsychotics, and antidepressants, which may help stabilize your mood and may prevent the swing between manic and depressive episodes.

Possible Side Effects of Bipolar Medication

While medication may be an important and essential part of treating bipolar disorder, certain drugs may cause side effects. Potential side effects with medications used to treat bipolar disorder include:

  • Weight gain.
  • Increased blood pressure or blood sugars and altered cholesterol levels.
  • Feeling lethargic (sluggish) or sedated.
  • Akathisia, or feeling restless and unable to physically sit still.

Research published in the Journal of Affective Disorders states that these side effects may lead to non-adherence, or individuals not taking their medication as directed.

Can Bipolar Be Genetic?

There is no single bipolar gene that determines if an individual will be diagnosed with bipolar during their lifetime, but there is a hereditary component to the disorder. One review published in Neuroscience found that bipolar is one of the most heritable medical disorders.

Twin studies have corroborated this, estimating bipolar disorder to be 60-80% heritable. For example, having a parent who has bipolar can make you more genetically susceptible to having bipolar as well. Your risk increases if more than one immediate family member, say your other parent, has the condition too.

However, as with most mental health disorders, genetics is only part of the equation. Mental health is a combination of genetics, experiences, lifestyle choices, and your surrounding environment, both past and present.

Genetic Testing for Bipolar Medication

Your personal genetic profile can provide information on the likelihood of effectiveness and side effects with various medicines, as well as information on how your body processes medications. This does not have to be something you find out by trial and error. By being proactive and getting this information before starting a medication, your clinician can make more informed decisions when prescribing medication(s). This is done through genetic testing for medication response.

The Genomind Pharmacogenetic (PGx) test looks at 24 genes related to mental health treatment and can be used to help determine medication options to manage bipolar disorder. It provides guidance across 130 medications used to treat a multitude of neuropsychiatric disorders to help clinicians determine:

  • Which medications may be more or less likely to be effective.
  • Which medications may be more or less likely to show side effects.
  • How you metabolize medications for personalized dosing guidance.

The Genomind PGx test can be done at a clinician’s office—or from the comfort of your home. It requires a prescription, and Genomind can help connect you with a verified Genomind provider near you. Get started by filling out this form.

Is Your Bipolar Medication Working for You?

Bipolar disorder can be a difficult condition to manage, and difficulty in finding medication(s) that relieve symptoms and/or a stable treatment plan can be discouraging to both patients and providers.

Genetic assay testing provides insight into how your genes may play a part in your response or tolerability to different prescriptions. This pharmacogenomic testing gives your clinician information they can leverage to help you avoid trial and error and find appropriate treatment.

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