Bipolar Disorder Treatment

Bipolar Disorder Treatment

Bipolar Disorder Treatment
The main treatment options for bipolar disorder include a combination of mood-stabilizing medication, psychotherapy and lifestyle changes to reduce stress and improve diet and exercise. Medications are used to stabilize your mood and to help moderate the depression and/or mania associated with bipolar disorder. While there is no cure for bipolar disorder, proper treatment can help even those with the most serious forms of the condition effectively control mood swings.

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    A , Psychology, answered
    It pays to be careful when you begin to explore alternative treatments. Just because a practice is "all-natural" doesn't mean it's the right treatment for bipolar disorder. For example, practices such as intense massage or stimulating yoga are something your partner should avoid when manic. Esoteric and unproven practices such as astrology or the Tarot can be very confusing for your partner, especially if psychotic symptoms are present. Your goal is to become an observant student of complementary treatments.

    Talk with complementary health care practitioners and ask them if they have experience treating bipolar disorder. It's also important that you understand that herbal treatments are not to be taken lightly. If you have questions about herbal treatments and their possible effects, seek the advice and counsel of a licensed naturopath. It's also essential that you make sure any herbs tried do not interact with your partner's medications. This is especially true concerning the popular herbal product Saint-John's-wort, as it has been found to have significant and, at times, dangerous drug-to-drug interactions. Before your partner tries anything new, it's always a good idea to talk with a pharmacist about drug interactions. Don't let these warnings discourage you; just be careful and thorough in what you try. Your goal is to explore what is available, maybe try it yourself, and then discuss the alternatives with your partner.
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    A , Social Work, answered
    To take your bipolar medications as prescribed and trust that they'll work, you must know the medications you're taking and their possible side effects so you can distinguish medication side effects from other medical problems you may have and from symptoms of the illness itself.

    In addition to asking your healthcare provider, you can do your own research on your medications. One good source of information is the online version of the Physicians' Desktop Reference (PDR) (also found in print at your local library). The PDR is based on information provided by the U.S. Food and Drug Administration (FDA). Simply typing in the name of your medication will get you other names, side effects, actions, indications, how the medicine is supplied, special warnings, and possible food and drug interactions. It's easier to search by brand name than the generic name of the medication. There's also a picture of the medication. For example, when searching for lithium, the PDR shows Eskalith (one of the trade names for this chemical) and lets us know that it's available in pill and capsule form.

    Another resource is the Consumer's Guide to Psychiatric Drugs (Preston, O'Neal, and Talaga 2009), or A Concise Guide to Medical Treatment for Bipolar Disorder in Adults and Adolescents (a Kindle eBook), which describes medical treatments for bipolar disorder in detail.
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    A Psychiatry, answered on behalf of
    Most physicians treating bipolar disorder agree that antidepressants tend to worsen the course of the illness over time and also have a strong tendency to induce manias or mixed states. Of course, there are exceptions to this general rule. To the extent that they induce severe mixed states, they can precipitate a suicide attempt. For this reason, we try to avoid antidepressants in people who have bipolar disorder, and when we have to use them, we try to make it a very short-term intervention. Additionally, in the largest long-term study every undertaken on bipolar disorder, called the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study, antidepressants just did not work.

    So how do we treat bipolar depression without using antidepressants? There are several "tricks of the trade" that can be helpful. The three most standard interventions utilize the following medications: Lamictal, Seroquel, or Abilify. Each of the options for treating bipolar depression is typically added into the existing mood stabilizer regimen, then adjusted to treat the depressive symptoms. In the case of Lamictal, one may then push the dose up to therapeutic levels, and try to then reduce or get off of some of the other mood stabilizers.

    Lamictal can be a remarkably effective drug both for treating the depressed phase of this illness as well as preventing cycles into mania. If one suffers frequently from the depressed phase and has not had an adequate Lamictal trial, this should really be considered.

    Seroquel and Abilify are "antipsychotic mood stabilizers." As it turns out, Abilify is a pretty good antidepressant in people with bipolar depression, and even in people with regular depression without any history of manias. One must monitor for akathisia when it is added for depression.
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    A Psychiatry, answered on behalf of
    Unless safety dictates otherwise, bipolar disorder medications should be introduced one at a time, adjusted carefully to optimize their effect, and given enough time to work prior to adding other medications. The reason for this is simple. If the physician is introducing multiple drugs quickly, he can't tell which of them is working or which of them is causing any specific side effect.
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    People with bipolar disorder can lead healthy and productive lives when the illness is effectively treated. Without treatment, however, the natural course of bipolar disorder tends to worsen. Over time a person may suffer more frequent (more rapid-cycling) and more severe manic and depressive episodes than those experienced when the illness first appeared. But in most cases, proper treatment can help reduce the frequency and severity of episodes and can help people with bipolar disorder maintain good quality of life.
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    A , Social Work, answered
    You'll need to know the scope of your insurance coverage so that you can take this into account when finding a healthcare provider for your bipolar disorder treatment and diagnosis. Read your benefits booklet and contact your health insurance company's customer service department or your human resources department at work to get answers to any questions you have. Learn whether your health insurance plan covers psychotherapy and psychoeducational groups, and find out the amounts of the deductible and co-payments for visits and medications. This will also help you plan financially for your treatment.
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    A , Neurology, answered
    How do I deal with bipolar disorder medication side effects?
    Some medications for bipolar disorder have side effects for some people, like sedation. In this video, psychiatrist Amanda Itzkoff, MD, discusses why its so important to communicate with your doctor about the side effects you are experiencing. 
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    A , Psychology, answered
    The goal of psychoeducation in the treatment of bipolar disorder is to educate people living with bipolar illness to become better at symptom management and increase awareness of the process of their own illness. There are also groups for loved ones who want to learn how to support family members or friends who have bipolar disorder. When conducted in groups, psychoeducation provides support through the sharing of experiences with people who are going through similar struggles. Most psychoeducation programs include information on treatment adherence, early identification of symptoms, and the development of daily routines. Research is still under way on the impact of psychoeducation on bipolar disorder symptoms.

    Support from family and friends is a crucial factor in recovery, and family psychoeducation groups are run by the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Disorder Alliance (DBSA), where families can learn about the disorder and find help to better support their loved ones' wellness.
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    A , Mental Health, answered
    Here are some tips on how to involve your partner in the treatment process for bipolar disorder:
    • Start the new plan yourself. As your partner sees you change and become more focused and stable, they will hopefully want the same for themselves.
    • Model your new behavior so your partner can follow you. Bipolar disorder takes a lot out of your partner. Sometimes it feels impossible for them to do anything that takes effort. They will appreciate the help.
    • Involve your family and friends and teach them the new techniques.
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    A , Social Work, answered
    Some people with bipolar disorder find that the number of pills they have to take and the importance of taking certain pills at certain times of day can be frustrating. It's easy to forget to take a dose, which may begin to trigger manic or depressive episodes. Daytime drowsiness is a major problem with many mood stabilizers and often interferes with compliance because it gets in the way of daily responsibilities, such as work, chores, child care, and so forth.

    If you find that you have trouble remembering to take your prescribed doses at certain times of day or that certain medications have negative effects at certain times of day (for example, you feel drowsy in the morning after taking lithium), speak to your provider about rearranging your medication schedule to better fit your lifestyle. You may be able to take different dosages at different times of day, change your medications to alleviate daytime drowsiness, or change medications altogether.
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