12.01.23
Everything You Ever Wanted to Know About Mood Stabilizers
No emotionless zombies here.
You know that mental health medications can help you manage the symptoms that make it hard to live your life. And if you’re dealing with a condition that impacts your mood in a big way (or know someone who does), you might’ve heard about meds called mood stabilizers.
For some, these can be game-changing. Take Brandon, 30, who has bipolar I. He previously told Wondermind that mood stabilizers help with the “impending sense of doom” he often experienced in the morning. Therapist Amanda Eldabh, LCSW, who has bipolar II, told Wondermind in that same story that her mood stabilizer (along with an antidepressant) is totally life-saving.
But how does someone get prescribed mood stabilizers, and how do they know which one works for them? Truth is, your primary care provider or psychiatrist will ultimately be the one to help you figure out what prescription makes the most sense for your situation. In the meantime, here are the need-to-know basics about these mental health meds.
What are mood stabilizers, and how do they work?
Mood stabilizers basically do what the name implies: stabilize your mood. For people with bipolar disorders and schizoaffective disorder, or mental health conditions that cause dramatic mood swings, these meds keep those high highs (mania and hypomania) and low lows (depression) in check, says psychiatrist Samantha Saltz, MD. Mood stabilizers can treat other conditions that impact your mood too, like depression and generalized anxiety disorder, if other meds aren’t doing the job on their own, according to psychiatrist and psychotherapist Patrice Mann, MD, MPH.
And there isn’t just one kind of mood stabilizer out there. Docs can prescribe one of the three main types depending on your age, symptoms, how your brain has responded to other meds, and whether you’re pregnant (or want to be soon), explains Dr. Saltz. For some, that means taking lithium, antipsychotics (like aripiprazole and quetiapine), or antiseizure or anticonvulsant medications (like valproic acid and lamotrigine), explains Dr. Mann.
Each of these work in a different way. Lithium is an OG mood stabilizer first used to treat mania in the 1940s, according to the American Psychological Association (APA). Though it’s not totally clear how it works, it might have to do with something called cellular signaling, per the APA.
Antipsychotics can double as mood stabilizers too (even if you don’t have psychosis) by stifling extra dopamine in the brain, Dr. Mann explains. Antiseizure meds are another type of mood stabilizer that "decrease hyperactivity in certain brain areas," she adds.
Sometimes, doctors prescribe more than one type of mood stabilizer, Dr. Mann says. It really just depends on how you respond to the first prescription you try and if you’re still having symptoms, she explains.
Science aside, a lot of people (maybe you!) often think mood stabilizers work by turning people into emotionless zombies—which isn’t the case, says psychiatrist Aarti Jerath, MD.
Cat, 31, thought that starting mood stabilizers would make her a “boring potato”...literally. “I thought creativity, bubbliness, and friendliness came hand in hand with what I now know can be hypomania,” she previously told Wondermind. But she’s still able to tap into all of those parts of her personality. The meds just turn down the volume on her hypomania and depression symptoms.
Obviously, if you’re used to having certain highs and lows, it’ll feel different and maybe even uncomfortable to live without those extremes, says Dr. Mann. That said, if you feel like something is really off, like you’re more apathetic than ever, you can talk to your doc about changing up your medication, she notes.
What are the side effects of mood stabilizers?
Like any medication, this type of pharmaceutical can, unfortunately, have drawbacks. For example, some antipsychotics can come with metabolic side effects like increases in blood sugar, weight, and cholesterol, says Dr. Mann. Antiseizure meds can make you tired and upset your stomach, while lithium is associated with shakiness and thyroid issues, notes Dr. Saltz. Certain antiseizure meds aren’t suggested during pregnancy since they can lead to birth defects, she says. Lithium has also been linked to risks during pregnancy, but recent research suggests that risk may be low and is something each person should discuss with their doctor. That sounds like a lot, but it really varies from person to person and your doctor can keep a close eye on your blood work, weight, and blood pressure to make sure everything’s OK, says Dr. Mann.
You might also be able to manage mood stabilizer side effects by being strategic about when you take it. “I have felt incredibly stable on this medication over the years, especially if I can time it right with food and taking them before bed,” says one 35-year-old woman who wanted to stay anonymous.
It’s also possible that you might not have any side effects, notes Dr. Jerath, who says she’s had patients on mood stabilizers like lithium, lamotrigine, and aripiprazole without any reactions.
How long can you take mood stabilizers?
Some people stay on mood stabilizers for the long haul, says Dr. Saltz. And while others come off of them after several months or years, ultimately it depends on their diagnosis. For example, people with bipolar disorder are often on mood stabilizers for their whole lives, and someone with depression who’s using a mood stabilizer in addition to an antidepressant might get off of the mood stabilizer once their symptoms improve, says Dr. Jerath.
Regardless of how long you take them, you might not be on the same exact mood stabilizer forever. For instance, if you need to be hospitalized for a manic episode, your doctors might put you on a higher dose or a different type for a couple of months to see how it impacts your mood, says Dr. Mann.
Depending on the medication and your symptoms, you may need to take them for weeks or months to see the full effects, so try to level set your expectations before you get discouraged, says Dr. Mann.
The bottom line: Mood stabilizers are a solid way to manage any mental health condition that causes extreme highs and lows. With the help of a doctor, you can find the one that makes the most sense for you and start feeling better soon.
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
