The Switch: Manic to Normal Mood


I have been thinking about what it is that we do in Psychiatry that is potentially helpful for people with bipolar and why that works. In many ways, the fulcrum of our work involves addressing the “switch process”. This refers to the way that moods can shift from manic to normal behavior, often quite suddenly.
A recent discovery has been that the switch process can be induced by some types of antidepressant medications.The serotonergic and noradrenergic diffuse modulatory systems have been shown the most correlation with speeding up the rate of the switch process in bipolar patients.  This is an example of why it is so dangerous to misdiagnose a patient with bipolar as a patient with depression. If put on depression medication, these patients will experience increased mood switching that will worsen their symptoms.
A way to keep track of your moods that I recommend to my patients is using a mood chart. Mood charts allow people to monitor how they are feeling throughout the day and identify factors that trigger changes in moods. By tracking the way we are feeling, we become more aware of the changing of moods. Tracking the changes in mood throughout the day can decrease the surprise and sudden element of mood switching for many bipolar patients. A patient named Bob B has recently been using mood charts and has experienced more  slowly shifting and stable changes in mood as a result.
By slowing down the mood changes, the symptoms of bipolar are more under the individuals control and make the symptoms feel more manageable.