Bipolar Disorder - Treatment

Bipolar disorder is usually treated with some form of medication. Some drugs help to elevate a person's moods during the low part of a bipolar cycle. Others help to calm the person down during the high part of a cycle. Some examples of commonly used drugs include:

• Lithium. The common name for a group of chemicals that contain the chemical element lithium. These chemicals are among the oldest and most frequently prescribed of all drugs for the treatment of bipolar disorder. While they do not work equally well for all forms of the disorder, they can be very effective for many patients when taken according to the schedule prescribed by a doctor. Some side effects of lithium drugs include weight gain, thirst, nausea, and hand tremors (shaking). Long-term use sometimes leads to hyperthyroidism. Hyperthyroidism is a condition caused by an overactive thyroid gland. It can result in a variety of symptoms, both mild and serious.

• Carbamazepine. Carbamazepine (pronounced KAHR-buh-MAZ-uh-peen) is an anticonvulsant drug used to prevent convulsions (spasms). It is often prescribed to patients for whom lithium treatment is ineffective. Blurred vision and other eye problems are possible side effects of carbamazepine use.
• Valproate. Used primarily for the treatment of patients with rapid cycling bipolar disorder. These patients often do not respond to treatment with lithium. Side effects of valproate use include stomach cramps, indigestion, diarrhea, hair loss, appetite loss, nausea, and unusual weight loss or gain.
• Antidepressants. Sometimes used to treat bipolar disorder on a short-term basis. An antidepressant is a drug that tends to overcome a person's depression and lift his or her spirits. Antidepressants are not used on a long-term basis because they may intensify the manic period in a person's bipolar cycle. That is, the person may not be depressed, but he or she may become more manic. Some examples of antidepressants used to treat bipolar disorder are the drugs known as selective serotonin (pronounced sihr-uh-TOE-nun) reuptake inhibitors (SSRIs), monoamine (pronounced mon-oh-AM-een) oxidase inhibitors (MAO inhibitors), and tricyclic antidepressants.

Electroconvulsive Shock Therapy

Bipolar disorder is sometimes treated with electroconvulsive shock therapy, or ECT. ECT is a procedure in which intense electrical shocks are administered through electrodes attached to the patient's head. The patient is first given anaesthesia (pronounced an-is-THEE-zhuh) and a muscle relaxant. The muscle relaxant prevents the patient from going into convulsions that would cause broken bones and strained muscles.

No one knows how electric shocks affects the patient's brain. In some cases, however, the treatment is able to relieve the conditions of bipolar disorder. The side effects of ECT include headaches, muscle soreness, nausea, confusion, and memory loss.

Some doctors are reluctant to use ECT unless all other treatments fail. The procedure has many critics who regard it as inhumane. Most cases of bipolar disorder now respond to some form of drug treatment, making ECT unnecessary.

Other Drugs

A variety of drugs are available for treating other aspects of bipolar disorder. For example, some patients have very severe episodes of mania or depression. They may need to have drugs to get them through the worst parts of these episodes. One group of drugs, known as benzodiazepines (pronounced ben-zo-die-A-zuh-peenz), can be used to calm a patient who is having a severe attack of mania. The drug known as clozapine (pronounced KLO-zuh-peen) can also be used to help prevent manic episodes and to treat patients who do not respond to other drugs designed to stabilize their moods.

Counseling

Counseling can also be of some help with bipolar disorder. While it cannot cure the disorder because mania and depression are caused by biological factors, patients can sometimes better understand the nature of their condition and learn to adjust to it. Perhaps most important, counseling can help patients and their families to understand the need for a person to stay on a strict schedule of drug therapy.

Alternative Treatment

Bipolar patients can often benefit from some simple suggestions, such as maintaining a calm environment, avoiding over-simulation, getting plenty of rest and regular exercise, and eating a proper diet. Some practitioners believe that Chinese herbs can soften mood swings. Biofeedback can sometimes help patients control their symptoms, such as irritability, poor self-control, racing thoughts, and sleep problems. During biofeedback a patient watches the brain waves produced when he or she is behaving a certain way. The patient than learns to adjust that behavior to produce correct brain waves. A diet high in vitamin C is thought by some to help reduce depression.