A challenge in the acute treatment of a depressive episode in patients with bipolar disorder is differentiating the symptoms from major depressive disorder; key to this differentiation is the presence of a prior (hypo)manic episode.1 The standard approach to treatment is with mood stabilizing medications, antipsychotics, and psychotherapy – although any therapy should be tailored to the individual, taking into account a patient’s symptoms, their response to any previous medications, and a patient’s preferences for therapy.1
References:
1. Nierenberg AA, Agustini B, Köhler-Forsberg O, et al. Diagnosis and treatment of bipolar disorder: a review. JAMA 2023; 330 (14): 1370–1380.
2. Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord 2018; 20 (2): 97–170.
3. Grunze H, Vieta E, Goodwin GM, et al.; WFSBP Task Force on Treatment Guidelines for Bipolar Disorders. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. World J Biol Psychiatry 2013; 14 (3): 154–219.
4. Goodwin GM, Haddad PM, Ferrier IN, et al. Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2016; 30 (6): 495–553.