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Bipolar Depression & Suicidality

Bipolar disorder is an illness that affects approximately 7 million individuals in the USA1. It can cause notable changes in a person’s mood, energy and ability to think clearly.

People with bipolar disorder experience high and low moods—known as mania (highs) and depression (lows). These common, severe mood changes are different and generally much more pronounced than the mood changes most experience. 

Bipolar depression (the depressive low mood phase) is a common symptom of this mental illness, and in about half of these individuals, bipolar depression is associated with suicidal ideation, these are thoughts of ending one’s life.

Emerging data indicates that suicidality in bipolar depression may be modulated by the brain’s NMDA receptor.

Learn about NMDA Receptors ➡️

Bipolar depression can sometimes lead to Acute Suicidal Ideation/Behavior (ASIB). This means they have strong suicidal thoughts, potentially also with a method in mind.

Patients with Bipolar Depression are 20-30x more likely to attempt suicide than the general population2. Over the course of 5 years, 1 in 5 patients suffering from Bipolar Depression will attempt suicide3.  Estimates indicate that 11-20% of those with Bipolar Disorder succumb to suicide4.


Currently, the only FDA approved treatment for patients with Bipolar Depression, associated with suicidal ideation is Electro-convulsive Therapy (ECT), also known as “electroshock therapy,” a procedure, done under general anesthesia, in which electric currents are passed through the brain, intentionally triggering a brief seizure.

While there are well-accepted drug therapies for the manic phase of bipolar disease, there is no approved medication for the treatment of Bipolar Depression when Suicidality is present. In fact, SSRI/SNRI-based antidepressants can increase the risk of suicide and bear an FDA-mandated warning label identifying that risk.

  1. National Institute  of Mental Health,
  2. Pompili, M. Gonda, X. Bipolar Disorders 2013; 15: 457-490
  3. Holma, K. Haukka J. Bipolar Disorders 2014; 16: 652-661
  4. Pallaskorpi, et al. Bipolar Disorders 2017; 19: 13-22
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