Conditions & Diseases: Psychological

Bipolar Disorder

Bipolar Disorder Treatment

Bipolar disorder can be effectively treated and prevented. Even people that suffer from most severe forms of bipolar disorder can achieve substantial symptoms stabilization with proper treatment. Unfortunately, many of those that suffer from bipolar disorder do not perceive the manic episodes as needing treatment due to the good feeling they experience, therefore they refuse to be treated. Treatment is usually sought when the problems and painful consequences (such as job loss, excessive debt, losing a loved person, and drug or alcohol abuse) occur.

Bipolar disorder is a recurrent disorder that needs a long-term prevention type treatment that combines medication with psychotherapy. A better outcome is achieved when the treatment is continued rather than when it occurs off and on.

There are two main treatment approaches:

I. Medication:
The most effective medication used to treat bipolar disorder is known as mood stabilizers.

There are several options available for mood stabilization:

1. Mood-stabilizing medication, such as Lithium which is the first mood stabilizing medication approved by FDA to treat mania. This medication proves to be effective in controlling mania symptoms and preventing recurrence of manic and depressive episodes. Lithium is prescribed for children and adolescents that suffer from bipolar disorder.

2. Anticonvulsant medications: This category includes two medications: valproate (Depakote) and carbamazepine (Tegretol). These two drugs have mood stabilizing effects and have proven to be effective in treating difficult forms of bipolar episodes. Valproate and carbamazepine are prescribed for children and adolescents that suffer from bipolar depression. However, there is evidence that valproate may cause adverse hormone changes in teenage girls and polycystic ovary syndrome in women that have been treated with this drug before the age of 20. For a better outcome, anticonvulsant medication is administrated in combination with lithium.

There are several other new anticonvulsant medications, such as lamotrigine (Lamictal), gabapentin (Neurontin), and topiramate (Topamax), that can be prescribed for bipolar disorder patients. However, these new medication are being studied in clinical trails to determine their effectiveness in stabilizing mood swings.

3. Atypical antipsychotic medication: This category includes: clopazine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), quatrain (Seroquel), and ziprasidone (Geodon). However, this medication is still being studied in clinical trials to determine whether it is effective in treating bipolar disorder. There is evidence that clozapine is being helpful to stabilize mood swing in people that do not respond to lithium or anticonvulsant medication. Olanzapine also has proven its efficacy in controlling acute mania symptoms.

In some cases, other type of medication can be prescribe for a short period of time to control other symptoms associated with bipolar disorder. For example if insomnia becomes a problem, the psychiatrist might prescribe high-potency benzodiazepine medication (such as clonazepam - Klonopin^, or lorazepam - Ativan^®). This type of medication is highly addictive and is prescribed for a short period of time. To avoid the addictive effect, the specialist might prescribe a sedative (such as zoplidem - Ambien).

The medication prescribed to control and prevent mood swing can cause a series of side effects that include: dry mouth, weight gain, nausea, tremors, reduced sexual drive and performance, anxiety, hair loss, and movement problems.

II. Psychotherapy:
In addition to medication, psychotherapy is an effective treatment that provides support, education, guidance and help for those that suffer from bipolar disorder and their families. Usually, this type of treatment focuses on adjusting to life problems caused by the disorder, identifying the onset of both types of episodes (maniac and depressive), developing functional responses, and helping the person to accept, cope, and manage the disorder.

There are several approaches used to help people with bipolar disorder:

1. Cognitive behavioral therapy: This form of psychotherapy helps those that suffer from bipolar disorder to change their negative and dysfunctional thoughts and behaviors’ patterns associated with the disorder for a better symptoms management.

2. Psychoeducation: This is a form of therapy that focuses on teaching theose that suffer from bipolar disorder and their families to understand the disorder, the treatment approach, and to recognize the disorder symptoms and relapse signs.

3. Family therapy: This is a form of psychotherapy that focuses on the family as a unit where each member plays an significant role in the disorder. The purpose of the family therapy is to reduce the level of distress experienced by the family which affects the relationship between its members and can contribute to the sick person symptoms.

4. Interpersonal and social rhythm therapy: This is a form of psychotherapy specially developed to treat those that suffer from bipolar disorder. It is based on sleep deprivation and circadian rhythm disturbance caused by the disorder. It help the person who suffers from bipolar disorder to improve his or her interpersonal relationships and to regularize his or hers everyday routines. A regular daily activity routine, a regular eating routine, and a sleep schedule can help the person to prevent manic episodes.

Article by Alina Morrow,
MS Psychology
OmniMedicalSearch.com
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