Medications

Medications for bipolar disorder are mostly known as “mood stabilizers” and are typically prescribed by a Psychiatrist who is a Medical Doctor with expertise in the diagnosis and treatment of mental disorders.  There are several different types of mood stabilizers available.  Usually a person begins treatment taking a mood stabilizer which will be used for extended periods of time (usually for many years) and then other medications can be added if needed for break through mania or depression symptoms.  Work closely with your Psychiatrist and if a sudden change in mood occurs, report it immediately to prevent a full-blown episode by making adjustments to your medication management treatment plan.

Psychosocial Treatment

Psychosocial treatment can help in connection with medications for bipolar disorder.   It can provide education, support and guidance to people with bipolar disorder including their family members.  Psychotherapy, often referred to as “talk” therapy, can help with increased mood stability, fewer hospitalizations, and improve functioning in several areas including family, work and social interactions.  A licensed counselor or psychologist can provide these therapies and often works closely with a psychiatrist to help monitor patients progress.

The four most common types of psychosocial interventions that are used for bipolar disorder include cognitive behavioral therapy (CBT), family therapy, psychoeducation and interpersonal and social rhythm therapy.  Another treatment that can be used, if the combination of medication and psychosocial treatment prove ineffective or slow to work and where symptoms of psychosis or suicidality occur, is electroconvulsive therapy (ECT).  It is a highly effective treatment for severe depression, manic, and/or mixed episodes and the risks have been significantly reduced with the modern ECT techniques.

Support Groups  

Many people with bipolar disorder benefit from joining support groups.  There may be support groups offered in various different places in the community.  They are usually sponsored by the National Alliance for the Mentally Ill (NAMI), the National Depressive and Manic Depressive Association (NDMDA) and the National Mental Health Association (NMHA).  Families and friends may also attend these groups and get great benefit and support from these organizations.

Hospitalization

Sometimes a person with bipolar disorder may not realize they need help, especially if they are in the midst of a severe episode.  They may have to be strongly encouraged by family or friends to get an evaluation or treatment and may even have to be hospitalized against their wishes.  If this happens, usually the person is stabilized in the hospital for a few days or so and then referred for ongoing treatment in the community with a psychiatrist and mental health professionals.

These are the symptoms associated with Mania and Depression:

Mania

• Abnormal or excessive elation
• Unusual irritability (Hypomanic)
• Decreased need for sleep
• Grandiose notions
• Increased talking
• Racing thoughts
• Increased sexual desire (Hypersexual)
• Markedly increased energy
• Poor judgement
• Inappropriate social behavior

Depression

• Persistent sad, anxious, or empty mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex (Anhedonia)
• Decreased energy, fatigue, being “slowed down”
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight loss or overeating and weight gain
• Thoughts of death or suicide; suicide attempts
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Some types of depression run in families, suggesting that a biological vulnerability can be inherited.  This seems to be the case with bipolar disorder.  Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill.  However, the reverse is not true: not everyone with the genetic makeup that causes vulnerability to bipolar disorder will have the illness.  Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.

We will discuss treatment for bipolar disorder in a subsequent post.

Bipolar disorder is a very complex illness involving the brain chemicals that are out of balance.  It is not known what the specific cause of bipolar disorder is at this time, but it is known that genes play a role. 

Mood swings may have triggers associated with them, so it is important to know what triggers your symptoms such as health and lifestyle changes as well as other events. 

We will talk about the symptoms, triggers, treatments and risks connected to bipolar disorder in the next few posts.