Suggest Treatment For Anxiety And Depression

Posted on Sat, 6 Sep 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 6 Sep 2014 Answered on

Mon, 6 Oct 2014 Last reviewed on

Question : Hi. I'm having a manic episode and took the mania assessment on this site. I have not been diagnosed with bipolar disease, but I recognize the mania. I am in poor physical and mental condition. I've been through a lot, spent three days in a psychiatric institution. Now, I am on good meds and have good support. However, I am coming down from the mania, and I am scared that I will fall backwards as far as anxiety, suicidal ideation, and depression. So, I need some advice to help me through this. I'm scared.

Answered by Dr. Jonas Sundarakumar (54 minutes later)

Brief Answer:
You need to report these symptoms to your doctor.

Detailed Answer:
Hello and thanks for your query.

I understand your worries about your mental health issues. From your description of your current situation, there are two issues that are concerning:

1) If you've recognized a manic episode, then there is a possibility that this could get severe and you could even develop psychotic symptoms.

2) Even if the current manic episode resolves without getting worse, there is still a possibility that you could develop a depressive episode in the future.

Therefore, it is very important that you report these symptoms to your doctor, so that appropriate treatment can be started promptly. If a diagnosis of mania is confirmed, then you need to be started on a mood stabilizer medication in order to prevent future episodes of mania or depression.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jonas Sundarakumar (13 hours later)

I am currently on the mood stabilizer, Lamictal. I have not been diagnosed with bipolar disorder. I'm not sure why I become manic. Hope you can advise on this. I have insomnia and racing thoughts. Thanks for your help.

Answered by Dr. Jonas Sundarakumar (22 hours later)

Brief Answer:
Clarified...

Detailed Answer:
Hi,

Mania can occur anytime and with anyone. Even in persons diagnosed to have another psychiatric disorder, for example psychosis, manic episodes can still be superimposed.

Lamictal is a relatively less powerful mood stabilizer compared to its counterparts and is usually not used as a first line medication when there are significant manic symptoms. in your case, where you are having a manic episode, Lithium or Divalproate sodium would be better choices. Also, in many instances antipsychotic medication like Olanzapine may also be used to quickly control the manic symptoms. so, I would advise you to report your manic symptoms to your doctor and get your medication altered accordingly.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Shanthi.E