Overview of Treatment Options

If you have Bipolar Disorder, you are probably already taking some kind of medication.  But there are many other treatment options available to help you cope with the disease, as well.  Medication is the first course for treatment and management of this confounding illness and should be the primary means of treating it.  The other options should be used in conjunction with your medication and never as a substitute for it.

 

In my experiences with this disease, I have met many others with it and I do not believe any of them have been successfully aided without medication and strict supervision of their medication and treatment by a doctor or psychiatrist.  Please be aware that this blog is merely a source of information, and should NEVER be viewed as a substitute for supervised doctoral care.  You cannot treat this illness on your own and you should not try to.  You need a doctor to oversee your treatments and to prescribe the care that is appropriate for your needs and situation.

With that said, here is the first of a few posts regarding some treatment options that are available to you.
 

Treatment may include several options.  In the initial phases of treatment, it is usually necessary to balance your moods right away through medication.  This provides some immediate relief and your condition will improve over the course of a few weeks as the medications stabilize in your system.  

 

Maintenance treatment will be necessary for continued symptom relief.  You will work closely with your doctor through these early aspects of treatment to find the best combination of medications for you.  It is important that some type of maintenance medication is taken, even when you feel better.  The point of the medication is to make you feel better, after all.  Keep in mind that there is no cure for bipolar disorder and without this maintenance treatment, symptoms will eventually, and inevitably, return.
 

 

Early in your treatment program, and later on, as well, hospitalization may be necessary.  This is especially important if you are behaving dangerously, feeling suicidal, or are becoming detached from reality.  This aspect of treatment can help keep you calm and safe while stabilizing your moods, whether you are manic or suffering from depression.

 

Day treatment programs are also available to you.  These programs provide the support and counseling you need while you learn to manage and cope with the symptoms of your illness.  Day programs also allow you to have focused treatment while staying at home instead of in the hospital, which is extremely helpful if you do not have insurance or if your insurance doesn't cover hospitalization for mental health issues.

This is simply a brief overview of some of the treatment options that may be used with bipolar disorder.  Specific information about the various medications and therapies used in treating this disease will follow in subsequent posts.  Complete information regarding what will work best for you is available from your doctor.

 

Please contact me below or email me at angelasblogemail@gmail.com with any questions you may have or to share your own experiences with bipolar disorder and its treatment with me.

Peace and Love Always,

 

 

Sources:  webMD.com; mayoclinic.org

Photo Credits:  Metal Grate:  Photo credit: anjan58 via Visualhunt.com / CC BY-NC-ND;  Green and White Pills:  Photo via Visualhunt.com;  Psychiatrist and Patient:  Photo credit: Mecklenburg County via VisualHunt / CC BY-NC;  Doctor:  Photo via Visualhunt.com;  Stethoscope:  Photo via Visualhunt.com

Traditional Treatments for Bipolar Disorder--Medication

This is the second of a few posts regarding the treatment and care of Bipolar Disorder.

This blog is meant simply as a source of information and in no way should be construed as medical advice.  I am not a doctor, nor do I play one on TV.  I am simply a sufferer of Bipolar Disorder who has learned to cope with the illness over the last 20 years or so since my initial diagnosis.  I only want to share the information with you that I have compiled over the years, so that you may be better equipped to understand possible treatments that you and your doctor may discuss during the course of your treatment.

 

You cannot treat this illness on your own and you should not try to.  You need a doctor to oversee your treatments and to prescribe the care that is appropriate for your needs and situation.

Typically, an effective treatment plan involves a combination of at least one mood-stabilizing drug and/or atypical antipsychotic, plus psychotherapy, or "talk therapy".  I will discuss psychotherapy in the next post.  The focus of this post is the medications that may be used in treating bipolar disorder.

The most widely used drugs for the treatment of bipolar disorder include Lithium Carbonate and Valproic Acid (Depakote). Lithium Carbonate is a naturally occurring element that can be remarkably effective in reducing mania, although doctors still don't really know exactly how it works. It may also prevent the recurrence of depression, but is primarily valuable for the control of manic symptoms.  It is generally given in conjunction with other medicines known to have more value for depressive symptoms, sometimes including antidepressants.

 

Valproic Acid, or Depakote, is another mood stabilizer that is also helpful in treating the manic or mixed phases of bipolar disorder.  It can be used with Lithium or Carbamazapine (Tegretol), another mood stabilizer, to help control symptoms.
 

There are some other newer drugs that are coming into the picture when these traditional medications are not sufficient for symptom management.  Some of these include Seroquel, Abilify, and Latuda. Each of these medications fall into the class of antipsychotics and are usually used along with the traditional mood stabilizers to control symptoms. 

 

In general, doctors generally try to keep the use of antidepressants limited and brief as the use of some of these may actually trigger a manic episode or cause cycles between depression and mania to be more rapid.  One antidepressant that has shown effective for bipolar disorder symptom management is Effexor.  It can aid with chronic pain symptoms, such as those associated with fibromyalgia and neuralgia, as well as promoting better sleep, in addition to its antidepressive properties.

 

 

Some of these drugs, specifically Lithium and Depakote, can potentially become toxic if the doses get too high.  Due to this, they need to be monitored periodically with blood tests and clinical assessments by the prescriber.  Because it is often difficult to predict which patient will react to what drug or what the dose will ultimately be, the psychiatrist will often need to experiment with several different medications and dosages to find out what will be the most useful for each individual patient.

 

Because better sleep allows other medications to work better, sleep medications are often prescribed in addition to other meds.  These, too, should be monitored by your doctor to make sure you are getting the right amount of sleep.  Not enough could trigger a manic episode, while too much can cause a depressive episode or be a symptom of the depressive "pole" of the disease.

Some of the medications for bipolar disorder have potential side effects that may make treatment uncomfortable.   Learning to cope with these side effects is just as important as learning to cope with the underlying disease.  You should speak with your doctor about potential side effects so you know what to expect while taking these medications.  Often when we don't understand the side effects of medication, we are tempted to stop taking them.  Do not do this without supervision from your doctor as there is always the potential for withdrawal or the return of your symptoms.  The good news is that once your body adjusts to the medication after several weeks or months of treatment, the side effects will improve or disappear.

 

 

Keep in mind that finding the right medication requires patience as it can take some time and quite a lot of trial and error.  Some medications take weeks or months to take full effect and the dosages may need to be adjusted to find what works best for you with the least amount of side effects.  The medications may also need to be adjusted as your symptoms change.

 

As always, keep your doctor apprised of any changes in your mood or behavior so that he or she can adjust the medications as necessary to provide the best solution for your particular needs and situation.
 

Treatment and management of any illness takes time and effort and requires a strong and comfortable working relationship between you and your doctor.  We would certainly be shocked and very wary of the possible consequences of a cancer patient randomly deciding to discontinue treatment simply because they were "feeling better" or didn't think they needed it anymore.  The same is true of someone suffering from diabetes.  We would definitely advise the patient against stopping their medication and urge them to listen to their doctor and continue treatment. 

 

Bipolar Disorder is no different.  Although the visible manifestations of bipolar disorder channel it into the category of "mental illness", it is a physical disease, just like cancer or diabetes, and requires continued management of symptoms for a patient to maintain a normal and fulfilling life.  Without continued supervised treatment, as with cancer or diabetes, death is the potential outcome for the patient.  Due to the nature of bipolar disorder as a disease of the brain, the consequences of avoiding treatment may have additional far-reaching effects to the lives not only of the patient, but also to his or her family members if treatment is not fully undertaken and closely followed.  It is for these reasons that finding and staying with a comprehensive treatment plan is so important for a patient of bipolar disorder.

 

Like cancer and diabetes, bipolar disorder has no cure.  Its symptoms can only be managed and controlled for the lifetime of the patient.  Find a doctor.  Help him or her to find the best possible treatment for you and stick with it.  It is the only effective way to cope with this illness.  Bipolar disorder is a chronic and recurring condition that you will have for the rest of your life.  The only saving grace is that through treatment and management of your symptoms, you will be able to live a normal life.  It just takes some hard work and patience for this to come to fruition.
 

In an upcoming post, I will discuss some of the psychotherapies available to you for treatment of bipolar disorder.

 

Please contact me below or email me at angelasblogemail@gmail.com with any questions you may have or to share your own experiences with bipolar disorder and its treatment with me.

Peace and Love Always,

Sources:  webMD.com; mayoclinic.org

Photo Credits:  Colorful Brain Scan:  Photo credit: Image Editor via VisualHunt / CC BY-NC-ND;  All Other Photos:  Photo via Visualhunt.com

Traditional Treatments for Bipolar Disorder--Psychotherapy

This is the third in a series of several posts regarding different types of treatment for bipolar disorder.

As mentioned in my previous posts, I am not a doctor, nor do I play one on TV!  This blog is simply a point of information and support for you as a fellow sufferer of the symptoms of bipolar disorder.  It should never be construed as a substitute for a carefully constructed course of treatment by a doctor for this disease.  You cannot treat this illness on your own and you should not try to.  You need a doctor to oversee your treatments and to prescribe the care that is appropriate for your needs and situation.
 

 

There are many different types of psychotherapy that are used along with medication in treating bipolar disorder.  For an explanation of the types of medications used in treating bipolar disorder, please refer to my previous post.  In this post, I will be discussing those types of psychotherapy that are used in the treatment of this illness.  The principal aim of any type of therapy is to assist you in becoming more able to cope with difficult or uncomfortable feelings.  Therapy will also help you in repairing relationships, managing stress, and regulating your mood. 

One of the most effective is Cognitive Behavioral Therapy or CBT.  The focus of CBT is identifying unhealthy negative beliefs and behaviors and replacing them with healthy, positive ones.  It can help identify what triggers your bipolar episodes.  Through CBT, you also learn effective strategies to manage stress and to cope with upsetting situations.  This type of treatment can be done on an individual basis or in a group setting.

Psychoeducation is another type of counseling that helps you to learn about bipolar disorder so that you and your loved ones can understand it better.  Knowing what is going on can help you to get the best support and treatment and helps you and your family to recognize warning signs.  This is vital. As I have become more aware of what triggers my episodes and my general behavior and responses to different situations, I have become much better equipped to understand my illness and to manage it.  The more able you and your family are to understand bipolar disorder, the better you will be able to avoid problems and handle setbacks.
 

Interpersonal and Social Rhythm Therapy (IPSRT) is a form of psychotherapy that focuses on the stabilization of daily rhythms, such as sleep, wake and meal times.  A consistent routine allows for better mood management.  People with bipolar disorder may benefit from establishing a daily routine for sleep, diet and exercise and this type of therapy can help you to do just that.  Keeping  a "Life Chart" is another facet of this type of therapy.  This kind of chart allows you to record daily mood symptoms, treatments, sleep patterns and life events.  Having access to this information allows patients a better understanding of their own mood cycles and allows doctors to track and treat the disease most effectively.  By carefully regulating your lifestyle, you can keep symptoms and mood episodes to a minimum.

 

The focus of most of these therapies is to help you to become more proactive towards your illness.  To that end, there are a number of things you can do for yourself that will alleviate symptoms.  One of these is to maintain a calm environment. This is especially important for someone in a manic phase.  Avoid excessive stimulation.  Parties, animated conversation, and long periods of watching television can exacerbate manic episodes.  Alcohol or drug use can cause or worsen mood symptoms and reduce the effectiveness of prescription medications.  Even caffeine can increase symptoms, so it should be used in moderation, as well. 

 

Having some type of support system is also extremely helpful to someone with bipolar disorder.  It can make all the difference in your outlook and motivation.  You may participate in a bipolar support group to give you the opportunity to share your experiences and to learn from others who know what you are going through.  The support of family and friends is invaluable.  We often don't recognize our mood fluctuations as readily as someone else may.  A family member or trusted friend may recognize behavioral changes more quickly than we see them in ourselves.  Especially in a manic episode, we just think we feel good for once and may not seek assistance until it is too late.  Because we feel great, we may simply refuse treatment, even though prompt intervention is urgent to prevent further problems and the need for hospitalization.    Always remember that reaching out to people you love won't mean you are a burden to others.  In fact, it can show them that you are actively trying to take responsibility for your illness and to do everything in your power to better your situation.

 

Once again, these are merely suggestions for potential courses of treatment that your doctor may undertake with you.  They should be used in conjunction with medication and not as a substitute for it.  I have been involved in my own treatment for this disease for over 20 years.  It has only been through a carefully monitored combination of medications and psychotherapy that I have been able to cope with this disease and live a basically normal life as a functioning member of our society.  Even if you are unable to keep a regular job due to difficulty dealing with the symptoms of the illness, you can still have a more or less normal life, as long as you dedicate yourself to working long and hard to manage those symptoms.  I will never tell you it is easy, but like anything in life worth having, the long-term effort is always worth it.  The disease may ultimately dictate HOW we live our lives, but it doesn't have to define who we are as individuals.  We do this for ourselves and finding effective management of the illness is simply a means to that end.

 

Please contact me below or email me at angelasblogemail@gmail.com with any questions you may have or to share your own experiences with bipolar disorder and its treatment with me.

Peace and Love Always,

 

Sources:  WebMD.com;  MayoClinic.org

Photo Credits:  Psychiatrist and Patient:  Photo credit: Mecklenburg County via VisualHunt / CC BY-NC;  Crying Woman Statue (2nd photo from end of blog):  Photo credit: Niecieden via Visual hunt / CC BY-NC-SA;  All other statue photos:  Photo credit: x1klima via Visualhunt.com / CC BY-ND

New Options Available for Treatment of Bipolar Disorder

This is the fourth in a series of several posts on the treatment of bipolar disorder.

In previous posts, I have discussed traditional treatments for bipolar disorder, including medication and psychotherapy. These are still the primary courses of treatment for this disease.  The therapies that follow are those that are undertaken in the event that the traditional treatments have not proven completely effective.  The following treatments are, in some cases, experimental, but they have shown some promise in the management of bipolar symptoms.  They are by no means a "go-to" solution or cure for the illness and should only be even discussed after years of attempts by your doctor to manage your illness through traditional methods.  If traditional symptom management methods have failed, you and your doctor may determine that these new treatments should be tried. They are only last-ditch drastic measures to be used when everything else has failed.

 

Keep in mind that this blog is only one source of information and support for you as a fellow sufferer of bipolar disorder.  I am not a doctor, nor do I fully understand the medical ramifications of any of these potential treatment options.  Undertaking any type of treatment should be prescribed by and supervised by your doctor with the intent of providing the best possible outcomes for you as an individual.

Winwick Hospital, Electroconvulsive therapy, 1957

 

There are a few therapies available for the treatment of bipolar disorder that may be useful when medication isn't working as intended. Electroconvulsive Therapy (ECT), or electro-shock therapy is one of these.  ECT has been a stand-by in psychiatric care for nearly a century.  Modern ECT is quite different than that which was used several years ago, however.  It is no longer as terrifying or debilitating as it once was.  In ECT, electrical currents are passed through the brain.  The procedure is thought to affect levels of neurotransmitters in your brain and typically offers immediate relief of even severe depression when other treatments don't work.  It does have some short-term side effects, though, like headaches, loss of memory, confusion, and disorientation.  These effects are usually temporary.  ECT is generally used for people who don't get better with medications, can't take antidepressants for health reasons or are at high risk of suicide.  It may be an option if you have severe depression or mania when you are pregnant and cannot take your regular medications.

Vagus Nerve Stimulation

 

A recent treatment development is Vagus Nerve Stimulation, or VNS.  This treatment involves surgical implantation of a small generator that is about the size of a silver dollar under the skin below the patient's clavicle.  Lead wires are threaded up the patient's neck and connected to the left vagus nerve near the carotid artery.  The generator delivers electrical impulses to the nerve lasting about 30 seconds every 3 to 5 minutes.  It works just like a pacemaker does for the heart.  This is not a quick fix for depression as it may take up to 9 months or more for a treatment response to occur.  Possible side effects include temporary hoarseness, cough and shortness of breath, but generally only during the 30 seconds the device is on.  As with pacemakers, eventually another surgery will be required to replace the battery when it wears out.  Doctors aren't quite sure how this procedure works, but it apparently does work over the long term.  The treatment has been endorsed by the American Psychiatric Association, but it is still awaiting final approval by the FDA.

Transcranial Magnetic Stimulation:  How it Works

Transcranial Magnetic Stimulation

 

Transcranial Magnetic Stimulation (TMS) is another option for people who haven't responded to traditional bipolar medications.  It is a fairly new treatment procedure, only achieving FDA approval for use in bipolar disorder in 2015. During TMS, you sit in a reclining chair with a treatment coil placed against your scalp near the forehead.  The coil sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.  Typically, you will receive five treatments per week for up to six weeks.

Light Therapy

 

Light Therapy has proven effective as an additional treatment for those who experience their severest depressions in the winter.  Patients sit in front of a special light box containing a full-spectrum light for 20 to 30 minutes a day.  This simulates the light of the summer sun, thereby improving symptoms of seasonal affective disorder related to bipolar depression.

 

Several other brain stimulation techniques are presently under study for treatment of bipolar depression, including cranial electrotherapy stimulation and deep brain stimulation.  All of these have similar characteristics for treatment as the procedures mentioned above, but may affect different areas of the brain.

Cranial Electrotherapy Stimulation

Deep Brain Stimulation

"X-Ray of Steve's DBS Implant":  Deep Brain Stimulation

 

Despite all the new types of treatment being studied presently, medication and therapy has proven consistently more effective overall and is still the first course of treatment for bipolar disorder. Patients normally undergo years of treatment with medication and therapy before these traditional protocols can be deemed ineffective and other, newer types of treatment be pursued.  There are no speedy fixes for this illness.  It takes a lifetime of focused effort by both the patient and the doctor to cope with and overcome the difficulties and behavioral issues of the disease.  But through advances in medical technology and diagnostic procedures, attainment of a normal and fulfilling life, despite the difficulties of dealing with bipolar disorder, is possible.

 

Please contact me below or email me at angelasblogemail@gmail.com with any questions you may have or to share your own experiences with bipolar disorder and its treatment with me.

Peace and Love Always,

Colorful Brain Scan

 

Sources:  WebMD.com;  mayoclinic.org.

Photo Credits:  Sad Wall:  Photo credit: bulletproofbra via Visual hunt / CC BY-NC-ND;   Winwick Hospital, Electroconvulsive therapy, 1957:     Photo credit: liverpoolhls via Visual Hunt / CC BY-SA;  Vagus Nerve Stimulation:  Photo credit:  Mayo Foundation for Medical Education and Research.  All Rights Reserved;  Transcranial Magnetic stimulation:  Diagram credit:  RTMS Therapy:  www.nicole-kidman.com;  Transcranial Magnetic Stimulation:  Photo credit:  www.hopkinsmedicine.org;  Light Therapy:  Photo credit:   www.belmarrahealth.com; 

Cranial Electrotherapy Stimulation:  Photo credit:  www.yourcharlestonhealth.com;   Deep Brain Stimulation:  Diagram credit:  www.webmd.com;  "X-Ray of Steve's DBS Implant":  Deep Brain Stimulation:  Photo credit:  www.madinamerica.com;  Colorful Brain Scan:  Photo credit: Image Editor via VisualHunt / CC BY-NC-ND