Mood Stabilizers for Depression: What to Know

Since people with bipolar disorder move from episodes of depression to mania and back again, treatment often includes medications known as mood stabilizers. These prescription drugs can help reduce the severity of emotional swings and, in many cases, prevent or limit the onset of manic and depressive episodes.

But what is a mood stabilizer, exactly, and how can it help with depression?

Read on to learn all about mood stabilizers, their side effects, and how these drugs can help treat depression, bipolar disorder, and certain other mood disorders.

Having bipolar disorder means going through periods of mania (feeling “up” and either very happy or easily irritated) and bouts of depression (feeling “down” and lethargic).

According to the World Health Organization (WHO), roughly one out of every 150 adults around the world has bipolar disorder.

It’s a condition that’s either chronic or episodic:

• Chronic bipolar disorder means having persistent mood swings or constantly recurring mood swings

• Episodic bipolar disorder means mood swings occur at regular intervals or randomly and without warning.

You’ve probably heard about these medications, but you may still wonder, What do mood stabilizers do?

A mood stabilizer is a drug that works on receptors or ion channels in the brain. Some of them also help regulate the release of a specific kind of growth hormone that keeps brain cells healthy. It influences the production and activity of certain neurotransmitters like serotonin and dopamine as well as influencing the firing of neurons, their growth, and their vitality. Neurotransmitters are chemical messengers that carry signals from one neuron (brain cell) to another.

Mood stabilizers work on the brain circuits  involved in mood and emotional regulation.

Mood-stabilizing drugs are typically taken daily and are usually prescribed for life. Besides helping to even out dramatic mood swings, mood stabilizers can often help those with bipolar disorder improve their sleep and avoid reckless or unhealthy behaviors.

Healthcare providers may prescribe mood stabilizers for depression and anxiety. Mood-stabilizing drugs for depression are usually only prescribed if other more established depression treatments — such as psychotherapy (talk therapy) — and antidepressants haven’t been effective.

Research suggests that some folks may benefit from taking both antidepressants (either SSRIs or SNRIs) and mood stabilizers. However, this type of medication regimen would need to be carefully supervised by a healthcare professional.

An antidepressant alone may not be enough to manage the condition. Why not? Antidepressants taken without a mood stabilizer can sometimes trigger manic episodes in bipolar patients, only heightening the severity or intensity of a manic period for someone already struggling with bipolar depression.

Mood stabilizers are sometimes prescribed for borderline personality disorder and schizoaffective disorder too.

The best mood stabilizer medication list includes several types of drugs, but the three most common mood stabilizers are:

• Lithium

• Anticonvulsants

• Antipsychotics

Here’s what to know about these mood-stabilizing drugs.

Lithium

Up first on the mood stabilizers list is lithium. This has been the primary treatment for bipolar disorder for more than 70 years.

Lithium is known for its ability to regulate mood and how it helps reduce suicide risk among individuals with bipolar disorder (hypomania with depressive episodes).

Lithium is generally well-tolerated, though side effects of lithium can happen, such as:

• Weight gain

• Excessive thirst

• Increased urination

• Mild trembling in the hands

Other less common side effects of lithium mood stabilizers include nausea, drowsiness, and cognitive difficulties.

It’s also worth noting that as you get older, your body has a harder time excreting medications, such as lithium and other mood stabilizers. High levels of lithium carbonate or lithium citrate in the bloodstream can be dangerous and are more common if you’re dehydrated.

Since lithium remains in the body longer than many other drugs, your provider may have to adjust the dosage to avoid dangerously high levels of lithium in your bloodstream. Long-term use of lithium might call for regular monitoring of kidney and thyroid function.

Anticonvulsants

Anticonvulsant medications are prescribed to prevent seizures for those with epilepsy, as well as bipolar disorder.

A commonly prescribed option is valproate sodium (Depakote^®), a type of valproic acid. Then there’s carbamazepine (Tegretol XR^®, Carbatrol^®), quetiapine (Seroquel^®), carbamazepine (Tegretol^®), and lamotrigine (Lamictal^®).

What is the best mood stabilizer for anxiety? Interestingly, it might be lamotrigine.

Anticonvulsant side effects can include:

• Fatigue

• Muscle weakness

• Dry mouth

• Nausea

These types of side effects are often temporary with anticonvulsants, but some may linger. Their frequency and severity, as well as your ability to tolerate the side effects, might factor into whether you try different medications.

Antipsychotics

Antipsychotics were originally prescribed to patients with schizophrenia, as their main effect is helping people distinguish between what’s real and unreal. But some antipsychotic medications are also helpful for those with bipolar disorder and depression.

This type of mood stabilizer is often given to help people who are already experiencing a severe manic or depressive episode.

In recent decades, researchers have developed certain antipsychotic medications that are especially effective in treating mania (olanzapine and risperidone) and depression (lurasidone, cariprazine, and lumateperone).

The antipsychotics aripiprazole, olanzapine, and risperidone can be helpful in preventing recurrent episodes of mania and symptoms of depression in people with bipolar disorder.

Some antipsychotics can cause twitching or other muscle movement problems, along with heart rhythm changes.

If you’ve been diagnosed with bipolar disorder or another mood disorder, such as depression, understand that medications may be only part of your overall treatment plan.

Treatment of bipolar disorder, depressive disorders, and other mental health conditions often includes talk therapy. Speaking with a therapist can help you identify unhealthy or unhelpful thoughts, feelings, and behaviors, and then develop strategies to help manage or overcome them.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is often used in bipolar disorder treatment. It’s based on the idea that feelings and behaviors follow thoughts. So, by changing how you think about a particular situation or problem, you may soon feel better and engage in healthier and more positive behaviors.

Even if talk therapy is going well, bipolar disorder almost always requires the use of mood stabilizers to help control this chronic and challenging condition.

What works for one person with bipolar disorder or depression may not work for you. These are very individualized mental health conditions.

Here’s what to remember about mood stabilizers for depression and anxiety disorders:

• Your healthcare provider can guide your decision. Go over a mood stabilizer medication list with your provider and talk about the risks and benefits of each drug.

• It might take some trial and error. The National Institute of Mental Health (NIMH) notes that some people may need to try more than one medication and try different dosages to find the treatment that’s safest and most effective in managing their condition.

• Side effects and withdrawal can happen. Mood stabilizers aren’t addictive in that they don’t create a sensation you crave physically or psychologically. But they can produce withdrawal symptoms if stopped abruptly and without the advice of a healthcare professional.

• Talk therapy and lifestyle changes may help. Your provider might also recommend psychotherapy and lifestyle adjustments like exercising, eating healthier, a regular sleep schedule, and drinking less. These things can help you get the most out of mood stabilizer medication and maintain more consistent moods.

Psychological health is crucial to overall well-being. Explore mental health resources, treatment options, and medications on our telehealth platform.

You can start with our free online assessment, and we’ll connect you with a licensed healthcare professional who can determine if prescription antidepressants are right for you.