Before we discuss treating bipolar disorder we must initially define the disease and illustrate its general symptoms. Originally known as “manic depressive illness”, bipolar is defined by episodes of extremely excited/heightened mood, offset by periods of severe depression. The medical definition of the heightened disposition is either asmania or hypomania. The two definitions are diagnosed upon the severity of the disorder and if psychosis is present. As far as symptoms, the heightened mania is characterized by an irregular degree of happiness and/or energy. Poor or hair-trigger decisions are common in this state, without the thought of cost, and these combine to define the disorder. Quite often when the patient is in a manic stage of the disorder, the need for sleep is lessened or totally abandoned. The depressive cycle is often characterized by episodes of melancholy, absence of facial recognition and eye contact, as well as an unenthusiastic viewpoint on life in general. The risks of suicide and/or self-harm are great, and this is often dependent upon the age of the patient. Alcohol and/or drug abuse is common as an adjunct to bipolar disorder, as well as general anxiety disorder. Although bipolar disorder can be treated successfully it is also important to note that it is often a lifetime condition. Treatment should be consistent and should be sustained. As mentioned above, co-occurring disorders should be treated simultaneously, such as substance abuse; this often leads to dual diagnosis treatment which is common with the bipolar condition. In general, the most successful treatment of bipolar disorder is a combination of psychotherapy and medication. As far as medication goes, anti-depressants and mood stabilizers (which are the most common prescribed) have been extremely successful, as well as anti-psychotic medication in some cases. All of the medications have different degrees of stability as well as side effects, therefore it is imperative the patient remains in contact with the prescribing physician and communicate any changes in mood or side effects. Psychotherapy is a critical component in treating bipolar disorder, providing a degree of guidance and support in order to allow the patient an ability to define and control their mood swings. Cognitive behavioral therapy is extremely effective, allowing the patient to lessen or in some cases, eliminate negative thought and behavior. In addition, family therapy is extremely helpful, especially in educating the family to the signs of mood swings and how to effectively deal with changes, learn coping skills, as well as adherence to medication schedules. Psycho-education can provide the patient with the ability to recognize their own changes in mood and to seek out further treatment when required. In some cases – especially when dual diagnosis is diagnosed – a temporary stay at an inpatient program is often an excellent first step, providing stability and support removed from their routine life, and immediate education on managing the disorder and/or changes/modification of medication. 

 

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