Bipolar disorder is a mood disorder with alternating episodes of depression and mania, or periods of excitability or irritability. This condition does not go away and is not a result of a personality flaw, states the Depression and Bipolar Support Alliance. Successful treatment often consists of trial and error to find a combination that works. Treatment can include mood stabilizing medications, electroconvulsive therapy, or ECT, antidepressants, anticonvulsants, and/or antipsychotics. The possible lasting effects are unstable moods, recurrences of depression and/or mania, and resistance to treatment.
Predictors of Recurrence
In an American Psychiatric Association report, a study combining medication, social skills training and intervention found 58 percent of 1,469 participants were successful in reducing symptoms of bipolar disorder. Half experienced a recurrence in the two years following the study. Recurrence was more likely in patients with residual symptoms at the end of the first two-year period. Researchers cited more in-depth treatment may prevent relapse in these individuals. The National Institute of Mental Health states that with time episodes can recur and become more severe. Delay or lack of treatment can increase the likelihood of the individual experiencing social and personal problems.
Treatment Resistance
In most cases, treating bipolar disorder consists of combining mood stabilizers and antidepressants. When this does not work, other medications may be added, such as anticonvulsants and antipsychotics. An August 2010 report by Medline Plus, a service of the U.S. National Library of Medicine, says that researchers have discovered the anesthetic Ketamine to be helpful with treatment-resistant bipolar disorder. This drug affects the brain system involving memory formation and information processing thought to contribute to bipolar disorder. Patients who received this treatment were resistant to mainstream drug therapy. Symptomatic relief lasted up to three days, giving hope for future research in isolating this area of the brain.
Electroconvulsive Therapy
Historically ECT caused legitimate criticism; today it is safe, humane and effective in treating severe bouts of depression. It is used in extreme cases when medication and traditional therapy failed. In this same-day procedure, under general anesthesia, a 30- to 90-second electric pulse passes through the brain, causing a mild seizure. Some memory loss and disorientation occurs but usually returns. In some cases memory loss can last up to several months. ECT has been successful in treating people with suicidal ideation and extreme episodes of mania. It is also used when medication is not an option, as in pregnancy.
Relationships
Living with bipolar disorder is not easy for the person with the illness or their family. According to Helpguide.org, manic episodes that consist of "reckless antics, outrageous demands, explosive outbursts and irresponsible decisions" make it difficult for a healthy family environment to exist. Proper treatment and support are imperative. Ways to help a loved one with bipolar disorder include family education, loving support, family members playing an active role in treatment and even family or individual counseling to assist with the effects of extreme moods.
Considerations
Bipolar disorder has been linked genetically, meaning higher risks occur in those with a family history of the disorder. Living with bipolar disorder is not easy, but with close monitoring and care, lasting effects can be eliminated or reduced. Patients often stop their medication abruptly when manic episodes occur. This can cause a bout of severe depression. Physician consultation is advised prior to stopping medication, when mood changes occur or suicidal thoughts are present.
References
- Depression and Bipolar Support Alliance: Finding Peace of Mind: Treatment Strategies for Depression and Bipolar Disorder
- National Institute of Mental Health: Bipolar Disorder
- MedlinePlus: Ketamine Eased Depression in Treatment-Resistant Bipolar Disorder
- American Psychiatric Association; "New Studies Help Patients with Treatment-Resistant Bipolar Disorder"; Release No. 06-07; February 1, 2006
- Mayo Clinic: Electroconvulsive Therapy (ECT)
