Treatment of Bipolar Disorder

 

Important things to know before getting treatment for bipolar disorder include:

•        there are specially trained mental health professionals such as psychiatrists and psychologists who can help you with bipolar disorder

•        you need a thorough check from a health professional before treatment is prescribed

•        specially prescribed medication is the most effective way to treat and manage bipolar disorder

•        psychological and lifestyle therapies can be helpful additions to your treatment

•        treatment needs to be specially tailored to each person as everyone with bipolar disorder experiences it differently

•        it’s best to work in partnership with your psychiatrist, doctor and family. Clear understanding of the treatment goals will help you manage your condition and stay on track.

•        your treatment should also consider your lifestyle, employment, social support network, and any stressors which may be impacting your recovery

•        many people who have bipolar disorder have been able to seek help and live active, fulfilling lives.

Medication

Your doctor should undertake a thorough consultation before deciding which medication is a good option for you. A specialist in treating bipolar disorder, such as a psychiatrist, is often involved in prescribing treatment.

Taking medication for bipolar disorder must be supervised by a doctor. Your doctor should explain the reasons for choosing the medication they’ve prescribed.

Studies show that medications are the most effective in long-term treatment of bipolar disorder and decrease the risk of relapse.

Medication can also improve people’s adherence to prescribed treatment and reduce the number of hospital admissions.

Your doctor will also discuss the risks and benefits, side effects, and how regularly you need check-ups.

Your doctor can also advise what treatments can work together with the medication, such as psychotherapy, lifestyle changes (e.g. exercise), and other support options.

The three main types of medications that are used in the treatment of bipolar include mood stabilisers, antidepressants and antipsychotics. The type and combinations of medications is very specific and depends on your symptoms.

Mood stabilisers

Mood stabilisers that treat or prevent mania or hypomania. Some common examples include lithium carbonate and sodium valproate.

Antidepressants

Antidepressants treat depression. There are many different antidepressants. Examples include selective serotonin reuptake inhibitors (SSRIs) and dual action antidepressants. The use of antidepressants in bipolar depression is now considered safe for most people but should be closely supervised by a psychiatrist as for some people antidepressants may trigger manic episodes or rapid cycling.

Antipsychotics

Antipsychotics may be used if there are psychotic symptoms (i.e. hallucinations or delusions).

Some types of bipolar may need different medications and combinations such as:

•        rapid cycling bipolar (four or more episodes of highs and lows in 12 months)

•        bipolar disorder with mixed episodes (symptoms of highs and lows occurring simultaneously).

Sometimes medications may need adjusting or changing. Your doctor or mental health specialist must supervise this.

Don't try to self-medicate or change medications without your doctor's knowledge.

It's important to keep to the plan over the long-term, even when you’re feeling good.

Electroconvulsive therapy (ECT)

ECT plays an important role in treating both acute mania (and psychosis) and severe depression and (less frequently) mania that does not respond to medications.ECT may be used for depression when:

•        other treatments have proven to be ineffective

•        the patient is severely medically unwell as a consequence of their mental state.

How psychological therapies help with bipolar disorder

Recent studies recommend psychological therapies (or 'talking therapies') such as psychotherapy, cognitive behavioural therapy (CBT), or counselling as an additional treatment for bipolar disorder, alongside medication. There is evidence that these 'adjunctive therapies' can help reduce risk of relapse and improve quality of life through:

•        assisting acceptance of bipolar disorder

•        identifying early warning signs and intervening

•        minimising recurrences and hospitalisation

•        maintaining adherence to medication plans

•        decreasing depressive symptoms

•        improving knowledge and skills to manage bipolar disorder

•        helping cope with stressful events and family conflicts

•        assisting in maintaining regular sleep patterns and daily routines

•        improving family relationships, communication and reengaging at work

•        reducing drug and alcohol use.

These programs should be delivered by mental health professionals with training and experience in managing bipolar disorder.

Psychological therapies can also include education of patients and their families

Families and carers can learn about early warning signs and help their loved ones maintain a lifestyle, with plenty of sleep and exercise, while sticking to their treatment plan over the long term.