Q. Dear Anna,

When I encounter people who are unsure of whether they have bipolar or not, I often advise that they might try an anti depressant, and if they get manic symptoms then that would be a sign that they are. This is because of my personal experience with medications. How likely is it that someone with bipolar disorder would have manic symptoms if they took and anti-depressant?

A. Antidepressants can trigger a manic episode in some individuals with a predisposition to bipolar. Not everyone with bipolar will react to antidepressants in such a way, however, so it cannot be used as an indication of bipolar disorder. In fact, some studies have shown people with no history of bipolar develop manic symptoms after taking antidepressant medication.

In addition to this, manic episodes can be dangerous and there is evidence to support the belief that each episode worsens the course of the illness. For this reason it is never a good idea to suggest to anyone, especially someone suspected of having bipolar disorder, to take antidepressant medication without the knowledge and approval of a physician. A better course of action would be to suggest they see a mental health professional for an evaluation and treatment plan.

Anna