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Bipolar (Manic-Depressive) disorder
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Bipolar (Manic-Depressive) disorder

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MENTAL HEALTH

Mental Disorders

From MayoClinic.com

Treatment

Medication and psychotherapy are the main treatments for bipolar disorder. Occasionally, doctors use electroconvulsive therapy (ECT).

Medication

Most people with bipolar disorder take medication to regulate their moods. Lithium (Eskalith, Lithobid) has been widely used as a mood stabilizer. In April 2002, the American Psychiatric Association suggested using lithium or lamotrigine (Lamictal) as first-line treatment for people in the acute depressive phase of bipolar disorder who were not already taking a mood stabilizer medication.

Also used widely as mood regulators are the anti-seizure medications valproic acid (Depakene) and divalproex (Depakote). Sometimes, doctors also use antidepressant medications to treat bipolar disorder. These may include paroxetine (Paxil), fluoxetine (Prozac, Sarafem), sertraline (Zoloft) or bupropion (Wellbutrin), among others. In other circumstances, doctors may use antipsychotic medications such as risperidone (Risperdal), olanzapine (Zyprexa) or quetiapine (Seroquel), among others.

According to the American Diabetes Association, certain antipsychotic drugs may increase the risk of diabetes, obesity and high blood pressure. A study published in the February 2004 issue of Diabetes Care recommends that doctors screen and monitor people who take Risperdal, Seroquel and Zyprexa for bipolar disorder.

You may need to take medications for several weeks before they reach their full effect.

Psychotherapy

This approach is often used simultaneously with medication. Your therapist will help you detect patterns leading up to episodes of bipolar disorder, trying to identify triggers for the episodes. These patterns might include your use of medications or anything that happens to you physically or emotionally. Psychotherapy helps provide strategies for managing stress and coping with uncertainties. This, along with basic education about the nature of the disorder, helps you understand why you may well need to keep taking medication over many years.

Electroconvulsive therapy (ECT)

Doctors use this form of treatment mainly in people who have episodes of major depression associated with suicidal tendencies or in people whose medication has proved to be ineffective. In this treatment, electrodes are taped to your head. Then, while you're anesthetized and after you've received a muscle relaxant, a small amount of electrical current is passed through your brain for less than a second. This current produces a brain seizure, but because of the muscle relaxant, your body remains calm.

ECT profoundly affects brain metabolism and blood flow to various areas of the brain. But how that correlates to easing depression remains unknown. ECT works quickly — usually showing a response after several treatments, generally within the first week — and significantly lowers the risks of untreated depression, including suicide.

Self-care

Bipolar disorder isn't an illness that you can treat on your own. But you can do some things for yourself that will bolster your treatment program:

  • Take your medications. Even if you're feeling well, resist the temptation to skip your medications. If you stop, you may again encounter signs and symptoms of bipolar disorder.

  • Pay attention to warning signs. You and your caregivers may have identified a pattern to your episodes of bipolar disorder and what triggers them. Call your doctor if you feel you're facing an episode. Involve family members or friends in watching for warning signs.

  • Avoid drugs and alcohol. Drugs, especially stimulants including diet drugs, and alcohol may be part of what triggers episodes of bipolar disorder.

  • Check first before taking other medications. Call the doctor who's treating you for bipolar disorder before you take medications prescribed by another doctor. Sometimes other medications trigger episodes of bipolar disorder or may interact with medications you're taking to treat bipolar disorder.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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