[If you missed part one, you can read it here.]
By Ilse Watson
What types of medication is used to treat bipolar disorder?
Mood stabilisers. None of the mood stabilisers prescribed was specifically developed to treat bipolar disorder, but they do work to stabilise a patient’s moods.
- Lithium: It measures the blood levels as a guide to dosage. It is a life-long medication and can’t be stopped. It aims to keep the mood in the middle and works well for bipolar I and II. A blood test can be done to see if the dosage is sufficient. Lithium can have an anti-suicidal effect.
- Anticonvulsants: These were first developed for epilepsy. Examples of anticonvulsants are Lamictin, Epitec and Epilim. Epitec is best for bipolar disorder II and Epilim is best for bipolar disorder I. Epilim is a very good anti-manic drug.
- Tegretol and Trileptal: They work for mania but are unproven in depression. Topamax and Neurontin: They have a low success rate as a mood stabiliser. Interesting fact: Topamax is the best medicine to take for migraines.
Antipsychotics: These medications were developed to treat schizophrenia but are very effective to treat bipolar disorder and the psychotic symptoms patients experience.
- Zyprexia/Olanzapine (Olexar)
High dosages of antipsychotics are needed to treat mania and medium dosages are needed to treat depression. They serve as a good maintenance treatment. All of the above medications are effective for mania and they are not addictive.
Medication for depression – Antidepressants:
- Between psychiatrists and health care providers, there’s been much debate about their usage.
- They rarely provide stability if just taken on their own.
- They may destabilise some patients by causing more rapid cycling or irritability.
- Many psychiatrists feel that antidepressants can be left out when treating a patient with bipolar disorder.
Manage your medication
- Changing medicine is a complicated decision. It is VERY dangerous to make changes in your medicine on your own!
- Take responsibility for your medicines. Learn about your medicines, how they work, what to expect, possible side effects as well as dietary and lifestyle restrictions.
- Take medicines only as prescribed. Inform all your doctors who prescribe medicine for your of all the medicines you are taking.
- Use a daily reminder to ensure regular use.
- Don’t expect medicines to fix a bad diet, lack of exercise or an abusive or chaotic lifestyle.
- Many medicines used to treat “physical” illnesses can cause mood changes or interfere with your medicines. Discuss all medicine changes with all relevant prescribing doctors.
- Stopping and starting medicines can negatively influence the outcome of your condition. Stopping medication because you are “well” has been shown to increase your chance of relapse. Bipolar disorder is a recurring condition. Most people require long-term medication.
- Take your medication as directed even if you have felt better for a long time. [Source: SADAG]
What types of treatment is available for a person with bipolar disorder?
- Psychotherapy: Therapy is essential for dealing with bipolar disorder and the problems it has caused in your life. When working with a therapist, you learn how to cope with difficult or uncomfortable feelings, manage stress and regulate your mood. Three types of psychotherapy appear to be particularly useful. They are:
- Behavioural therapy – it focuses on behaviours that can increase or decrease stress and ways to increase pleasurable experiences that may help improve depressive symptoms.
- Cognitive therapy – it focuses on identifying and changing pessimistic thoughts and beliefs that can lead to depression.
- Interpersonal therapy – it focuses on reducing the strain that a mood disorder may place on relationships.
- Education: You need a thorough knowledge of your illness. The more you and your loved ones know about bipolar disorder, the better able you’ll be to avoid problems and deal with setbacks.
- Lifestyle management: Regulate your lifestyle by maintaining a regular sleep schedule, avoiding alcohol and drugs, following a consistent exercise program, minimise stress and keep your sunlight exposure stable all year round.
- A support system: It is imperative that you have a solid support system in place. Participating in a bipolar disorder support group gives you the opportunity to share your experiences and you can chat without being judged.
Bipolar disorder and suicide
The depressive phase of bipolar disorder is often very severe and suicide is a major risk factor. People suffering from bipolar disorder are more likely to attempt suicide than those suffering from regular depression and their suicide attempts tend to be more lethal. The risk of suicide is even higher in people with bipolar disorder who have frequent depressive episodes, mixed episodes, a history of alcohol or drug abuse, a family history of suicide, or an early onset of the disease.
How can you help yourself?
- Become an expert on your illness. Read books, attend lectures, talk to your doctor or therapist. The more you know, the more control you have over your life.
- Be your doctor’s partner. Take your medication as prescribed.
- Maintain a stable sleep pattern.
- Do not use alcohol or illicit drugs. These chemicals cause an imbalance in how the brain works.
- Be very careful about “everyday” use of small amounts of alcohol, caffeine and some over-the-counter medications for colds, allergies, or pain. Even small amounts of these substances can interfere with sleep, mood or your medicine.
- Support from family and friends can help a lot.
- Try to reduce stress at work. Avoiding relapses is of primary importance and in the long run will increase your overall productivity. [Source: SADAG]
What can family members and friends do to help? If you have a family member or friend who is bipolar, do the following:
- Become informed about his or hers illness.
- Learn the warning signs for how that person acts when he or she is getting manic or depressed.
- Learn the warning signs of suicide.
- Take any threats the person makes very seriously.
- When your friend or family member is recovering from an episode, let them approach life at their own pace and avoid the extremes of expecting too much or too little.
- Take advantage of support groups.
MOST IMPORTANT – BIPOLAR DISORDER IS A LIFE-LONG DISEASE AND CANNOT BE CURED. STAY ON YOUR MEDICATION (NEVER GO OFF IT WITHOUT DISCUSSING IT WITH YOUR PSYCHIATRIST), SEE YOUR PSYCHIATRIST AND PSYCHOLOGIST FOR THERAPY AND ENSURE YOU HAVE A GOOD SUPPORT NETWORK.
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