Bipolar disorder is a mental health disorder associated with extreme mood swings that can significantly impact quality of life. It also has a high rate of treatment resistance to current therapies. In this article, we will examine the potential for low dose ketamine as an alternative means of treating refractory bipolar disorder. 

What is Bipolar Disorder?

Formerly known as “manic depression,” Bipolar Disorder is a category of mental health disorders associated with severe mood swings, or “highs” and “lows.” There are two subcategories of Bipolar:

Bipolar I

Bipolar I is characterized by extreme highs and lows, each with varying durations and functional impairment. The extreme highs are known as “manic” episodes. Mania can last more than one week and may require hospitalization, depending on the severity of impairment. People experiencing a manic episode may feel elated, energized, and full of plans and ideas. This can lead them to make poor or risky life choices that can affect their work and personal relationships. In some cases, patients may experience delusions or hallucinations that can further compromise their ability to function.

Bipolar I patients may also experience “hypomanic” episodes, which are shorter-lasting and may or may not cause functional impairment. Hypomanic individuals are bubbly, talkative, and may feel they do not need to eat or sleep. They are mostly able to keep up with personal and professional obligations, however, and they may or may not engage in especially risky behaviors.

Manic and hypomanic episodes are often followed by periods of intense and prolonged depression. 

Bipolar II

Bipolar II is similar to Bipolar I, but there are no episodes of full-blown mania in Bipolar II. Rather, patients experience alternating periods of hypomania and depression. The depressive phase tends to last much longer in Bipolar II patients, causing a significant reduction in quality of life. Poor sleep, poor appetite, loss of interest, and feelings of hopelessness also contribute to an increased risk for suicide. 

Why Ketamine May Help Treat Bipolar Disorder

Bipolar Disorder Patients are at Risk of Suicide

Of all mental health disorders, bipolar disorder has one of the highest lifetime risks of suicide. Ketamine has been approved for the treatment of acute suicidal ideation, which means it may be appropriate for bipolar patients. Effectively treating the more urgent symptoms of bipolar, such as thoughts of suicide, would be an important step in lifelong management of the disorder. 

Bipolar Disorder is Neuroprogressive

Like major depressive disorder, bipolar disorder is considered neuroprogressive. That is, it has a physical impact on the biochemical markers cerebral structures of the brain. This can be associated with reduced neurogenesis and neural plasticity. In other words, the brain is experiencing a kind of deterioration over time in patients with certain psychiatric disorders.

Ketamine has been shown to enhance structural plasticity within the brain, albeit transiently. The exact mechanism by which it achieves this is still being researched. One study theorizes that the short-term increase in neuronal plasticity is the result of a glutamate”burst,” which occurs in the frontal and hippocampal neurons as well as the mesencephalic DA neurons. 

The potential to stop and even reverse neuroprogression is, obviously, very exciting. And this is merely an incidental finding in patient and animal subjects being administered ketamine for other reasons. It will be interesting to see how studies progress in the use of ketamine in remediating damage to the brain’s structures caused by certain mental health disorders. 

Bipolar is Resistant to Treatment

Ketamine is also FDA-approved in the treatment of refractory depression. Depressive episodes are part and parcel of both types of Bipolar, and these episodes can be severe. The increased suicide risk of depressed bipolar patients warrants an effective treatment that also acts faster than traditional therapies, which can take weeks to show any appreciable effect. 

Low-dose ketamine can have a very rapid effect with rare physical dependence and relatively few unpleasant side effects. Repeated doses of ketamine at an appropriate interval may be beneficial not only in staving off suicidal thoughts, but also in treating Bipolar’s notoriously resistant depressive episodes. 

Ketamine Therapy in Destin, Florida

If you are experiencing symptoms of Bipolar Disorder or another mental health disorder, please contact the Crane Center. We understand how debilitating these disorders can be, and we will work with you to tailor a care plan that will get you feeling better. We offer a variety of traditional and alternative therapies, including intranasal and intramuscular ketamine for qualified patients. Go online or give our office a call today to get started.