Bipolar Disorder Treatment Options
Recognizing that the way you feel (the way your moods fluctuate between emotional lows and manic highs) is a symptom of a treatable mental illness is the single biggest obstacle to a better life for most bipolar patients.
Once accurately diagnosed, bipolar disorder can be effectively managed through a combination of medication and psychotherapy.
There are many effective treatments for the disorder, but each person responds differently to varying treatment options, and it can take some trial and error experimentation to develop an effective and well tolerated treatment plan.
Bipolar disorder is generally treated over a lifetime, even during periods of maintenance (or remission). Treatment during these maintenance phases can prolong asymptomatic periods and can reduce the severity of mania or depressions that do occur.
Treatments can vary, depending on the stage of the illness.
- During acute (symptomatic) phases, treatment is aimed at shortening the episode and reducing the severity of symptoms.
- During maintenance phases, treatment is targeted at preventing new episodes of mania or depression.
Bipolar Disorder Medication
Medication is an essential part of any bipolar treatment plan. Different medications often used in the treatment of bipolar disorder include:
- Mood Stabilizers – These medications balance out emotional states, curbing the highs and reducing the lows. Mood stabilizers have been used effectively in the treatment of the disorder for decades, and are still often used during a first attempt at treatment. Lithium is a very widely used type of mood stabilizer. People who find mood stabilizers effective will generally take them for a lifetime.
- Anticonvulsants – Certain anticonvulsant (anti seizure) medications induce mood stabilization and can be helpful within a bipolar treatment plan. Examples include valproic acid and carbamazepine.
- Atypical Antipsychotic Medications – These medications were developed originally to treat psychosis disorders, such as schizophrenia. They have been found to have mood stabilizing properties and are sometimes used as an alternative to conventional mood stabilizers or anticonvulsants, such as lithium or valproic acid. These medications are often combined with benzodiazepines to help with sleep. Some suggest that these newer and more expensive medications may offer greater symptoms relief than traditional mood stabilizers. They are also associated with increased side effects.
There are a great many choices, which can lengthen the process of finding a “perfect fit” but this variety of choice increases the likelihood of finding a medication that works well for you, and that produces side effects that you can live with.
Most bipolar medications induce significant side effects, and since you will likely use these medications for life, this is a serious matter. One of the most typical side effects is weight gain. Doctors find that one of the biggest challenges with bipolar treatment is maintaining patient compliance, especially during periods of hypomania, a time of high feelings and altered judgment! This is one of the reasons why medication alone is rarely an effective solution to the problems facing a bipolar patient. Education, therapy and family therapy are all useful in helping patients improve medication treatment compliance.
*Antidepressants – antidepressants are not commonly used to treat bipolar disorder, as there is significant risk of their inducing mania and exacerbating the problem. Unfortunately, many people eventually diagnosed with bipolar were first diagnosed with depression and given anti-depressants.
Patients that do not understand their complicated disorder and its implications will very likely fail to engage fully in treatments, especially during phases of altered judgment.
It is very helpful for a person with bipolar and her entire family get deeply educated about the signs, symptoms, treatments and consequences of the disease. Having an educated and supportive family can be especially helpful in diagnosing initial phases of mania.
Regular sessions with a therapist can help a lot, especially during the initial phase of treatment. You need to learn to live and thrive while receiving bipolar treatments, dealing with side effects and in many cases; you will need to make substantial lifestyle changes.
Therapists work with you to help you develop a true acceptance and understanding of your disease, and help you to internalize the lifestyle changes that are needed for symptoms remission. Having professional guidance during the acceptance phase and while striving to make enduring changes in lifestyle leads to better long term patient outcomes.
Some of the commonly offered forms of therapy include:
- Family therapy
- Cognitive behavioral therapy
- Group therapy
Getting Benefit from Psychotherapy
Psychotherapy and psycho education are 2 of the 3 cornerstones of a successful lifelong management of bipolar disorder. There is value in any form of psychotherapeutic participation, but for best effects, patients need to take some ownership over the process and participate actively in their own treatment.
Ways to maximize the benefits of psychotherapy include:
- Attend appointments regularly and as scheduled
- Continue regular psychotherapy during maintenance phases
- Make a meaningful effort to complete take home assignments honestly and fully – this greatly extends the healing power of a weekly therapeutic session
- Talk honestly with your therapist about the way you are feeling and about any concerns you have about the psychotherapy
- Remember to be patient – psychotherapy works well and is an essential part of a comprehensive treatment plan, but no therapy for bipolar works overnight. Make sure to give any form of psychotherapy a few months of evaluation before discontinuing, it can take a couple of months or longer to feel the benefits.
Electroconvulsive Therapy (ECT)
Electroconvulsive Therapy (ECT) is never offered as an initial treatment for the disorder, but is sometimes recommended should other methods of treatment fail, or when a patient is in a severe acute depression and a danger to him or herself or to others.
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