Bipolar Disorder | Effective Short Term Treatment

Bipolar disorder or Bipolar depression affects the neurotransmitters of the brain (nerve cells that transmit signals), causing emotions and emotional responses to short circuit. This mental illness is able to lie dormant for a long time, even decades before striking the victim with sudden mania or a bout of extreme depression.

People who have bipolar disorder can be severely depressed and completely unable to find a way out of their sadness. Often such depression can lead to the patients attempting to hurt themselves and 15% will even commit suicide. If the illness is left untreated the depression will remain and become a danger to the victim and others. Symptoms of bipolar depression vary, but include:

  • Sleep disruption – insomnia or hypersomnia (sleeping too much).
  • Significant changes in body weight – increase or decrease.
  • Inability to feel pleasure or happiness.
  • Periodic loss of short-term memory.
  • Inability to focus and concentrate.
  • Feeling worthless and sad.
  • Withdrawing from others.
  • Loss of sex drive.
  • Feeling agitated.
  • Indecisiveness.
  • Feeling guilty.
  • Constipation
  • Headaches
  • Fatigue

In this state the symptoms of bipolar disorder are:

  • Delusional thoughts.
  • Hallucinations.
  • Catatonia

 

Bipolar Disorder: Treatment

Effective treatment is necessary for bipolar disorder but most sufferers believe they can control the problem. The episodic nature of the depression causes many of the patients to feel that they are able to cope until the next time their moods swing. As the maniac episode goes further, the condition of the patient deteriorates. The patient will be unable to concentrate, have problems controlling reactions and may become violent, with a tendency towards suicide or physical abuse to others. Treatments for bipolar depression include medications as well as psychosocial options which are used in tandem to control the illness and the behavior. The patient benefits from the suppressive nature of the drugs as well as the ‘talk therapy’ and ‘group therapy’ that is arranged by the psychiatrist handling the case. Any treatment changes are led by the doctor and always discussed with the patient before implementation.

Bipolar Disorder Treatment Includes :

  1. Medication
  2. Psychotherapy
  3. Long-term preventive (prophylactic) treatment

Dealing with Bipolar Depression Relapse

Bipolar disorder is a complex psychiatric disorder that affects the neurotransmitters in the brain, causing emotions to short circuit. Those affected by bipolar disorder become paralyzed in their state, unable to pull themselves out. Bipolar disorder is a highly recurrent illness, even when patients are receiving optimal, evidence-based treatment. Patients of bipolar disorder are usually on a cocktail of medications made up of mood stabilizers, antidepressants and antipsychotics. Before understanding how to deal with a bipolar disorder relapse, it is best to clarify what may cause a relapse.

The following behaviors can lead to depressive or manic relapse:

  • Stopping medication or reducing the dosage.
  • Under or over-medication.
  • Illicit drugs such as cocaine, alcohol, amphetamines or opiates.
  • Inconsistent sleep schedule.

It is believed that lower dosages of caffeine can work as an antidepressant but it can also be mania-inducing. If the patient is unable to manage the stress they can easily relapse when not medicated. The medication works to help the patient deal with stress, but if there is still a great deal of stress and no coping measures in place, relapse is likely.

Keeping Track

Treatment success is only seen over the long term. Relapse is fairly normal over the long term which is why psychiatrists work on psychotherapy measures in combination with the medication. It is important that the patient report mood changes immediately to make adjustments to the medicine before a relapse occurs. Medication adjustments are a normal part of long term maintenance treatment and should not be viewed as a failure of the treatment.

Long-term Use of Medicines for Bipolar Disorder

It can be difficult to follow long term treatments of any illness; such is the case with bipolar disorder treatments. While you may want to stop your treatment due to not having had a relapse in a long time or having negative side effects, you should know that stopping medication nearly guarantees a relapse within a matter of months, sometimes even weeks. You will even face an increased chance of suicide if you stop taking some medicines (like lithium) without tapering off under the care of a doctor.

Discontinuing Medication

Discontinuing medication should always be done under the watchful eye of your psychiatrist. If you choose to stop taking medications, the risks are incredible that you will soon relapse. Sometimes the doctor will begin tapering medication after only one year if there has been only one episode of mania. Unfortunately, if you have a family history of bipolar disorder or severe episodes, you should consider very long-term maintenance treatment. Indefinite medication treatment is recommended in any patients who have had two or more episodes of either type.

You should really only discontinue a preventive/maintenance medication due to a medical condition or severe side effects. If you are a woman trying to conceive, you may want to consider reducing dosage or stopping medication but you should be aware that it can lead to a relapse.

Psychotherapy for Bipolar Disorder

Psychotherapy is a great addition to medication treatment and it can help prevent relapse. There are five major psychotherapy treatments for bipolar disorder along with medications. They are:

  • Prodrome Detection.
  • Psycho-education
  • Cognitive therapy
  • Interpersonal/Social Rhythm.
  • Family-focused therapy

By engaging in any one of these therapies, the patient and their family clearly understand the disorder and its impact on each individual affected. They also get a clearer picture of things which may act as triggers of relapse. Hence, they are then in a position to control these triggers and prevent these relapses.

Most cases of relapse occur because of inconsistency in the medication or therapy plan. People close to the patients must take it upon themselves to ensure that the medication plan is adhered to and that all therapy sessions are attended. After all, bipolar disorder is not dealt with alone on medication or therapy. It is a mixture of both things which, when done meticulously over a period of time, reduces the severity of the disorder and decreases the chances of relapse.

Without treatment or intervention during this extreme stage, the patient will die. Acute phase bipolar disorder treatment deals specifically with ending the current manic, hypo-manic or depressive state. The components of acute phase bipolar disorder treatment include medication, education, and psychotherapy. There are three important medications that are used to treat bipolar disorder symptoms: mood stabilizers, antidepressants, and antipsychotics.

Mood Stabilizers for Bipolar Depression

Mood stabilizers must have two main properties:

  1. Relieve acute mania or depression; prevent episodes from recurring.
  2. Not exacerbate symptoms or lead to an increase in cycling.

Antipsychotics for Bipolar Depression Treatment

Various drugs are used to treat different aspects of bipolar disorder. If the patient is having delusions or hallucinations from a severely manic episode, antipsychotic medications can be useful. Antipsychotics can be used for sedation sedatives early in treatment, insomnia, anxiety, and agitation. Newer antipsychotic medications are believed to work well as mood stabilizers.

Patients who have not had psychotic symptoms sometimes benefit from antipsychotic medications because they improve patient response to mood stabilizers. Some patients do not handle the typical mood stabilizers well or respond to them so antipsychotics may be used alone to stabilize their mood.

There are two types of antipsychotics: typical/conventional antipsychotics (older drugs) and atypical antipsychotics (newer drugs). Conventional antipsychotics come with the risk of tardive dyskinesia (TD) (a permanent movement disorder), muscle stiffness, restlessness, and tremors. Atypical antipsychotics come with a lower risk of TD (1% of patients) as well as other side effects. Since they are viewed as safer, atypical antipsychotics are the first line of defense against psychosis.

Side effects of Bipolar Disorder

Most people who have side effects from atypical antipsychotics suffer from drowsiness and weight gain. Clozapine is usually the primary medicine of this group because one of its side effects is a rare but serious blood disorder that requires regular blood tests.

Antidepressants for Bipolar Disorder Treatment

Antidepressants are combined with mood stabilizers to treat depression symptoms. Antidepressants must be used with a mood stabilizer to keep the patient from switching over to a manic episode. There are various antidepressants available and they have a wide range of side effects. Depression is often seen as something separate from mania so most of the research on antidepressant medications has been done on unipolar depression, without considering the effect it would have on a manic episode. Even with so little research on bipolar disorder and antidepressant medication, most research suggests that antidepressants are very effective in treating bipolar disorder when used with mood stabilizers.

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