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Bipolar disorder - Treatment

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Treatment

Main article: Treatment of bipolar disorder

Currently, bipolar disorder cannot be cured, though psychiatrists and psychologists believe that it can be managed.

The emphasis of treatment is on effective management of the long-term course of the illness, which usually involves treatment of emergent symptoms. Treatment methods include pharmacological and psychotherapeutic techniques.

Treatment lag

The behavioral manifestations of bipolar disorder are often not understood by patients nor recognized by mental health professionals, so people may suffer unnecessarily for over 10 years in some cases before receiving proper treatment.[1]

That treatment lag is apparently not decreasing, even though there is now increased public awareness of the illness in popular magazines and health websites. Recent TV specials, for example the BBC's The Secret Life of the Manic Depressive[2], MTV's True Life: I'm Bipolar, talk shows, and public radio shows, and the greater willingness of public figures to discuss their own bipolar disorder, have focused on mental illnesses thereby further raising public awareness.

Despite this increased focus, individuals are still commonly misdiagnosed.[3]


Prognosis and long-term treatment

A good prognosis results from good treatment which, in turn, results from an accurate diagnosis. Because bipolar disorder continues to have a high rate of both under-diagnosis and misdiagnosis, it is often difficult for individuals with the illness to receive timely and competent treatment.

Main article: Bipolar disorder - Prognosis

Relapse

Even when on medication, some people may still experience weaker episodes, or have a complete manic or depressive episode. In fact, a recent study found bipolar disorder to be "characterized by a low rate of recovery, a high rate of recurrence, and poor interepisodic functioning." Worse, the study confirmed the seriousness of the disorder as "the standardized all-cause mortality ratio among patients with BD is increased approximately 2-fold." Bipolar disorder is currently regarded "as possibly the most costly category of mental disorders in the United States."[4]

The following behaviors can lead to depressive or manic relapse:

  • Discontinuing or lowering one's dose of medication, without consulting one's physician.
  • Being under- or over-medicated. Generally, taking a lower dosage of a mood stabilizer can lead to relapse into mania. Taking a lower dosage of an antidepressant, may cause the patient to relapse into depression, while higher doses can cause destabilization into mixed-states or mania.
  • Taking hard drugsrecreationally or not—such as cocaine, alcohol, amphetamines, or opiates. These can cause the condition to worsen.
  • An inconsistent sleep schedule can destabilize the illness. Too much sleep (possibly caused by medication) can lead to depression, while too little sleep can lead to mixed states or mania.
  • Caffeine can cause destabilization of mood toward irritability, dysphoria, and mania. Anecdotal evidence seems to suggest that lower dosages of caffeine can have effects ranging from anti-depressant to mania-inducing.
  • Inadequate stress management and poor lifestyle choices. If unmedicated, excessive stress can cause the individual to relapse. Medication raises the stress threshold somewhat, but too much stress still causes relapse.

Relapse can be managed by the sufferer with the help of a close friend, based on the occurrence of idiosyncratic prodromal events[5] That is, by noticing which moods, activities / behaviours or thinking process / thought content typically occur at the outset of their episodes. They can then take planned steps to slow or reverse the onset of illness, or take action to prevent the episode causing damage to important aspects of their life.[6]


Main article: Bipolar disorder - Medication


Assessment | Biopsychology | Comparative | Cognitive | Developmental | Language | Individual differences | Personality | Philosophy | Social |
Methods | Statistics | Clinical | Educational | Industrial | Professional items | World psychology |

Clinical: Approaches · Group therapy · Techniques · Types of problem · Areas of specialism · Taxonomies · Therapeutic issues · Modes of delivery · Model translation project · Personal experiences ·


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See also

Bipolar Disorder

References & Bibliography

  1. S. Nassir Ghaemi. Bipolar Disorder: How long does it usually take for someone to be diagnosed for bipolar disorder?. URL accessed on 2007-02-20.
  2. The Secret Life of the Manic Depressive. BBC. URL accessed on 2007-02-20.
  3. Roy H. Perlis. Misdiagnosis of Bipolar Disorder. URL accessed on 2007-02-20.
  4. Roger S. McIntyre, MD, Joanna K. Soczynska, and Jakub Konarski "Bipolar Disorder: Defining Remission and Selecting Treatment" Vol. XXIII, No. 11 (October 2006)
  5. Perry A, Tarrier N, Morriss R, McCarthy E, Limb K “Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment” BMJ 1999;318:149-153 (16 January)
  6. Kelly, M., Bipolar and the Art of Roller-coaster Riding, Two Trees Media 2000, 2005

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