Treatment for Bipolar Disorder, is there one that's accurate?
What is Bipolar Disorder?
“Bipolar Disorder is a heterogeneous group of conditions marked by the onset of mood episodes in adolescence and early adulthood and varying presentations, course, and response to treatment. It is commonly associated with co-existing alcohol and substance abuse, anxiety disorders, psychotic symptoms, and medical disorders. Although Bipolar I Disorder , with clear inter episode intervals, has been the center of classical descriptions of the condition, Bipolar II Disorder, mixed states and various types of accelerated cycling are being recognized as common.” (Vivek, et.al., 200).
Do you know the symptoms?
There are three spectrum of the bipolar disorder: Bipolar I, Bipolar II and Cyclothymic Bipolar. There are different criteria to diagnose each one of these. Criteria are as follows:
Bipolar I: "You've had at least one manic episode. The manic episode may be preceded by or followed by hypo manic or major depressive episodes. Mania symptoms cause significant impairment in your life and may require hospitalization or trigger a break from reality (psychosis)." ( Mayo Clinic Staff)
Bipolar II: " You've had at least one manic episode. The manic episode may be preceded by or followed by hypomanic or major depressive episodes. Mania symptoms cause significant impairment in your life and may require hospitalization or trigger a break from reality (psychosis)."
Cyclothymic disorder. "You've had at least two years — or one year in children and teenagers — of numerous periods of hypo mania symptoms (less severe than a hypo manic episode) and periods of depressive symptoms (less severe than a major depressive episode). During that time, symptoms occur at least half the time and never go away for more than two months. Symptoms cause significant distress in important areas of your life". (Mayo Clinic Staff)
You can get more information about Bipolar Disorder and how to get help at: http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/symptoms/con-20027544
Have you suffered from Bipolar Disorder?
Many studies point to Lithium as the best option for individuals that have been diagnosed with Bipolar Disorder. “There is considerable evidence that mood stabilizers may be sufficient in dealing with some psychotic symptoms and that adding benzodiazepines behavioral dyscontrol is managed” (Bowde et. Al., 1994).
When treating bipolar depression, lithium appears to have a limited effect on it. It has not been proven that lithium has any efficacy treating this symptom of the bipolar disorder. This is when monotherapy becomes difficult as we would have to treat bipolar depression with antidepressants in which case there would be a dilemma since antidepressants may exacerbate manic episodes. It has been proven that when we start with low dosages and slowly move into the dosage that we want to achieve lamotrigine is safe and efficacious in treating bipolar depression and it doesn’t induce mania or rapid cycling.
Lamotrigine would be the drug of choice when we want to treat rapid cycling. As it was stated before it controls both mania and rapid cycling along with bipolar depression. There has not been a similar prospective to this medication for this symptom.
For maintenance treatment and prophylaxis Lithium is the preferred drug (Coryell, 200) but individuals’ non compliance and limited efficacy in treating other symptoms has led to search for an alternative.
Check out Kim who has a little insight on what is like to live with this disorder and how does a person with Bipolar Disorder feels like everyday :)
You can live a normal life with Bipolar Disorder. The important things is that you need to pay attention to your symptoms and call your doctor if you feel any changes or any side effects from medication prescribed.
Bipolar Disorder is a complex mental illness. Within itself it has so many turnouts that we can not use a cutout pattern to treat every individual that presents with it. There have been many studies and done on medications and therapies to treat this complex disorder but not one suggests a specific treatment path. All we can do is pay attention to our clients and pinpoint where they are at on the bipolar spectrum so we can treat properly and suggest medication and therapy necessary.