TREATMENT OPTIONS FOR BIPOLAR DISORDER

Bipolar disorder is a chronic mental illness and is diagnosed according to if the major symptoms are mania or depression or anything in between. It needs to be treated for a life time like diabetes or hypertension and it is important to continue the treatment even during periods when one feels well as that the chances of recurrence are ever-present. It is important to treat the manic symptoms in addition to the depressed .Most patients like their manic periods as they feel omnipotent and indestructible at that time .Unfortunately this period is always followed by a period of depression as well as dealing the consequences of their manic –might be social or financial. It is good to see a psychiatrist for the management of bipolar disorder as they are particularly skilled in diagnosing and treating this disorder in addition to guiding the other modalities of treatment. Also as there is lot of overlap between the chronic mental illness and substance use it is important to deal with that as they can worsen bipolar disorder

Medications are the most important part of the treatment and they include: Mood stabilizers-Lithium is the oldest and most commonly used mood stabilizer Anti-seizure medications-Depakote,Tegretol,Trileptal, Lamictal are commonly used .Tegertol is not used as much now due to side effects Atypical antipsychotic medications are also used including olanzapine, risperidal ,quetiapine Antidepressants are used but usually time limited to treat depressive symptoms .however they should be used along with a mood stabilizer if needed at all. There are many medications available and many choices. If one does not work try another .also most medications have side effects and health risks including risk of hepatits ,metabolic syndrome which includes diabetes ,obesity and hypertension. Also management of bipolar disorder in a pregnant patient needs a careful evaluation of the risk and benefits of treatment.

Psychotherapy is another important part of treatment and there are many options for that as well. They include family therapy, group therapy, supportive therapy and cognitive behavioral therapy.

It is very important to treat bipolar disorder and for the patient to stay adherent to the treatment plan as that can reduce the morbidity associated with this disorder.

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