Posted by: Ann | 2013-01-29

Bipolar and meds

My husband has been on depression meds for +-7 years (prescribed by a GP). Although he almost 70% of the time still withdraw from others and being moody and down. He went to a psychiatrist about 3 weeks ago for the first time. She changed his meds, but after 4 days changed it again to Seroquel XR and Epitec and then diagnosed him as bipolar type 2. I would like to know when I can expect the depression to elevate? And what exactly means bipolar type 2. We have small children, what are the chances that they will have depression and what can I do to prevent it with them?

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Our expert says:
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I'm sorry if the psychiatrist didn't explain the new diagnosis properly to your husband and yourself - that's part of the job which should never be neglected. On his next visit to the shrink, he should arrange for you to accompany him and insist on discussing all of these isues fully.
Briefly, Bipolar Disorder is a variety of depression, in which there are as the name implies, 2 "poles" to the mood disorder - one may swing into deep depression, or one's mood may swing upwards into hypomania in which one feels too energetic and cheerful. I can be obvious or can be difficult to diagnose accurately. It often does not respond well to treatment entirely with antidepressant meds, and response improves with the addition of mood stabilizing drugs ( like Epitec )
When one may reasonably expect to see noticeable improvement from new treatments varies among the drugs. For an antidepressant, one should hope to see improvement within around 2-3 weeks after starting the drug.
For a mood-stabilizer its harder to answer. As its purpose is to reduce the frequency and severity of mood swings, how it will show its benefits depends on how frequent and severe the usual mood swings are. Again, the prescribing shrink ought to have assessed this, based on a detailed knowledge of the history of the illness thus far.
Now, as regards the children. Depression isn't directly inherited in the sense of being inevitable if a parent has the disorder, but one can inherit, to a degree, a vulnerability to later develop a depression of some type, later in life, depending on the presence or absence o other relevant factors. If one parent has a properly diagnosed depression or bipolar disorder, there is a higher risk that a child may later develop the same disorder -but most of the children will NOT develop the disorder. If BOTH parents suffer from such a disorder, the risk of the child doing so will increase, but still, most of the children will not develop it.
Again, discussion with the diagnosing shrink, who should have assessed more of the relevant factors, will be most useful.
Its not clear, as much of the underlyhing process of depressive disporders and Bipolar Disorder are at a chemical level, whether there is anything useful you can specifically do to reduce these risks ; other than letting the child as they become an adult, know that this is possible, for them to maintain a degree of vigilance, so they can check with a shrink if they think they might be showing early signs of such a problem, because the earlier the treatment the better in terms of long-term control.

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