How Can Bipolar Disorder Be Treated?

Bipolar Disorder is a serious condition which has a debilitating effect on those that suffer from the illness.

In many cases, there is significant functional impairment involved. But, with the right treatment and support, the majority of people will see their symptoms be controlled more, and sometimes reduced.

In rare cases, a full recovery is possible. Though mainly, treatment is lifelong, but can greatly help a person.

What is Bipolar Disorder?

Bipolar Disorder (once known as Manic Depression) is a serious mental health condition characterised by intense mood swings. Someone with Bipolar Disorder will experience both highs – known as mania, and lows – known as depression. These periods will often last for weeks, and can cause significant distress. Sometimes, Bipolar Disorder can start as Depression, before exacerbating. The depressive periods of Bipolar feature long-term periods of low moods. During the manic phase, an individual will feel happy, energetic and ambitious – and often act recklessly, or exhibit signs of psychosis. There are different sub-types of Bipolar Disorder, based around the differing characteristics of each. Bipolar Disorder is normally a chronic condition. However, with treatment, the symptoms can be controlled far more, which should result in an improvement in quality of life.

Bipolar Disorder Treatment

Treatment for Bipolar Disorder tends to involve medication and some form of talking therapy.

In the absence of treatment, depressive episodes can last for several months, sometimes up to a year. Manic and hypomanic episodes can last several months too. Therefore, treatment is important – and helps to stabilise mood.

The exact treatment plan depends on the exact type of Bipolar Disorder that a person has. Treatment plans are concerned with the long-term management of Bipolar Disorder. Some of the possible treatments include:

Talking Therapy

Talking therapy is often used in the early stages of Bipolar Disorder, as an individual attempts to come to terms with their condition.

As the years go by, it is likely that the individual involved will have become more accustomed to living with their condition, meaning they may not need talking therapy.

There are many different types of therapy that can be used. Talking therapy can be particularly useful for helping an individual to recognise episode triggers, and to come up with healthy coping mechanisms. Some types used may include:

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

There are a range of other types of talking therapy, aside from the above.

Medication

Medication plays an important role in the treatment of Bipolar Disorder, and is the primary component of treatment. There are a range of medicines that can be used in treatment for Bipolar Disorder.

Mood stabilisers, such as Lithium Carbonate, are predominantly used. They need to be taken on a long-term basis, and also involve regular blood tests.

Some anticonvulsants (primarily used for epilepsy), also have mood-stabilising properties. These include Valproate, Lamotrigine and Carbamazepine. These are useful when someone can’t take Lithium. Sometimes, both Lithium and an anticonvulsant can be prescribed together.

In cases where mania is present, antipsychotics may also provide relief. Antipsychotics such as Quetiapine, Risperidone, or Olanzapine can be used.

Antidepressants shouldn’t be used as a standalone medication for any form of Bipolar Disorder. However, it appears that some antidepressants can help reduce the severity of depressive symptoms of those with Bipolar disorder, when used in conjunction with either a mood stabiliser or antipsychotic. More details are below:

Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Valproate is a well-known anticonvulsant which is often used as a stabiliser for people who cannot take Lithium Carbonate.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Valproate shouldn’t ever be prescribed to women who are at a childbearing age due to a high risk of physical and mental defects in an unborn child [1].

Other

In severe cases, electroconvulsive Therapy can be used. This can only ever be used in Bipolar Disorder when an individual has failed to respond adequately to a range of treatments, is experiencing a long and severe period of depression or mania, and is in a life-threatening situation.

Electroconvulsive Therapy (ECT): Electroconvulsive Therapy (commonly referred to as shock treatment) is a treatment that sees an electric current sent through the brain of an individual. The aim is to trigger an epileptic seizure, with the ultimate objective to relieve symptoms of a mental health problem. The human body is fully restrained during the procedure, which also involves a general anaesthetic. Electroconvulsive therapy is normally a last resort. Despite this, ECT actually has an impressive efficacy rate, with many people finding it helps immeasurably.

In the majority of cases of Bipolar Disorder, treatment can be conducted outside of the realms of a secure hospital. On occasion though, especially where cases of Bipolar involve psychosis, sometimes treatment will need to take place in a hospital.

This is especially relevant if an individual appears to be at risk of harming themselves or someone else. This doesn’t necessarily mean that an individual will need to remain overnight at the hospital.

There are also some alternative and complimentary treatments that offer a different approach to the above types of treatment.

Summary

Bipolar Disorder is a very difficult condition to live with. The understanding of the condition has improved immensely in recent years to the extent where there is no shortage of potential treatment options. However, there is no doubting the impairment the condition involves.

Hopefully, each individual can find a combination of treatment options that provide more control over their symptoms, and lead to a better quality of life.

See Also

1. Bipolar Disorder: Everything You Need To Know
2. What Are The Different Types of Bipolar Disorder?
3. What Are The Symptoms of Bipolar Disorder?
4. What Are The Causes of Bipolar Disorder?
5. How is Bipolar Disorder Diagnosed?
6. How Can Bipolar Disorder be Treated?
7. What is the Prognosis for Bipolar Disorder?
8. 10 Tips for Living With Bipolar Disorder