Treatment Options

by S.P.
(Texas)

Treatment is essential to being able to live a productive, satisfying life for someone with bipolar disorder. The majority of bipolar people who are able to achieve relief from their symptoms follow a treatment regimen.

Because bipolar episodes are recurrent, treatment should include options for the acute crises episodes as well as long-term preventive care.

A comprehensive treatment plan should relieve current symptoms, prevent future episodes, and address any relationship or work-related problems caused by the illness. A plan combining psychotherapy with medication seems to be the best for meeting these goals for the majority of sufferers.

ACUTE PHASE:
During an acute phase the goal is to end the manic, depressive, hypomania, or mixed episode. There are four alternatives that may be used during an acute phase.
1. Medication
2. Electroconvulsive Therapy (ECT)
3. Hospitalization
4. Psychotherapy

MEDICATION
• Mood-stabilizing medications are the main choice during an acute phase. Drug choices include traditional mood stabilizers and atypical antipsychotics.
• Sedatives may be used for relief of anxiety and/or insomnia.
• Antidepressants combined with a mood stabilizer may be used for acute depression.

ELECTROCONVULSIVE THERAPY
• ECT is used for severe episodes of mania and depression. It can cause significant improvement.
• ECT is the choice for bipolar patients with a high risk of suicide or those suffering from delusions or hallucinations.
• ECT is an option for those who have medical issues that make medication therapy a negative choice.
Hospitalization
• When a bipolar sufferer becomes a danger to him/herself or to others, this option should be utilized.
• The patient can receive round the clock care until the episode is controlled or passes.
• The bipolar patient may want to prepare an advanced directive for hospital stays. This is a legal document that outlines the patient’s treatment preferences and who the patient would prefer to make healthcare decision when and if the patient is unable to do so.

PSYCHOTHERAPY
• May be of little benefit during acute phases.
• During normal or depressive phases, this therapy can be a tremendous benefit

MAINTENANCE/PREVENTATIVE PHASE:
In this phase of treatment, the focus is on maintaining a stable mood and preventing future episodes of mania or depression.
• Bipolar disorder is better controlled if the treatment is continuous rather than off-and-on. All mood changes should be reported immediately to the treating doctor.
• Doctor may be able to prevent a full-blown episode by adjusting medications.
Medication
• Most bipolar sufferers remain on mood stabilizing medications even when there are no symptoms and the mania and or depression is under control. When continued on a long-term basis, medications will reduce the frequency and severity of mood episodes and sometimes prevent them entirely.
• The medications used for bipolar disorder include mood stabilizers, antidepressants, and antipsychotic drugs. Since symptoms may change over time, medications may change also.

PSYCHOTHERAPY
Therapy is important for dealing with the disorder and the problems it has caused in the life of the patient. By working with a therapist, the patient can learn how to cope with difficult feelings, how to repair relationships, manage stress, and regulate one’s mood. There are several accepted therapies and a few alternative ones to be used in conjunction with the standard therapies.

EDUCATION
A thorough knowledge of bipolar disorder can help manage symptoms and prevent complications. The more one knows about the disorder, the more effective all will be at avoiding problems and dealing with setbacks.

SUPPORT
A solid support system can make a big difference in the bipolar patient’s outlook and motivation. By participating in a support system, one has the opportunity to share experiences and learn from others.

SUMMARY
The diagnosis of bipolar disorder can be immediately devastating, but also a relief to find out the reason for the patient’s behavior over a time. The important thing is to find medical help and to stay with the acute and maintenance programs. By doing this, the bipolar person can lead a happy, productive life with few or no recurrent episodes.