Bipolar Disorder
Bipolar disorder does not have a cure, but effective treatments to manage the disorder exist. The most effective treatment for bipolar disorder is a combination of medications and therapy.
Medication
Three main types of medications treat bipolar disorder: mood stabilizers, anti-depressants and atypical anti-psychotics. Depending on an individual's symptoms and responses to medications, one type of medication or a combination are prescribed.
Mood stabilizers reduce the frequency of episodes of mania--extreme highs, depression--extreme lows--or mixed episodes--including extreme highs and lows. Common mood stabilizers include lithium and anti-convulsants, such as gabapentin.
Anti-depressants treat episodes of depression. Because anti-depressants can induce an episode of mania when taken alone by bipolar patients, mood stabilizers are taken as well. Common antidepressants include paroxetine and bupropion.
Atypical anti-psychotics treat episodes of mania, depression and mixed states. Common anti-psychotics include olanzapine and risperidone.
To treat insomnia, which is common in bipolar patients, sleeping pills are prescribed.
Therapy
A combination of therapies are useful in treating bipolar disorder; these therapies include psychotherapy, psycoeducation, family therapy, cognitive behavioral therapy and social rhythm therapy.
Psychotherapy is a form of talk therapy that gives the patient a safe outlet to talk about feelings.
Psychoeducation teaches the patient about the disease and treatments. It also educates the bipolar patient about detecting the warning signs of future manic or depressive episodes.
Family therapy educates family members about bipolar and how to help their loved one. It also provides an outlet for the family to talk about and resolve problems and issues in the family relationship.
Social rhythm therapy assists bipolar patients in making a daily schedule of activities, such as a regular exercise routine and a regular sleep schedule, to help prevent the onset of manic and depressive episodes.
Electroconvulsive Therapy
Electroconvulsive therapy, or ECT, is used in patients who do not respond to medications or who cannot take medications due to health problems. During ECT, small electrical shocks are transmitted to the brain through electrodes placed on the head. ECT takes about 60 seconds. The patient is given muscle relaxants and anesthesia to prevent discomfort from the procedure. It is known that ECT is effective, but there is some disagreement in the medical community on exactly how ECT works. It is likely that ECT stimulates the release of chemicals in the brain. The ECT Handbook states that ECT modulates "monoamine systems in the brain" and "enhances the activity of dopaminergic systems."
Clinical Trials for Alternative Therapies
Scientists are constantly searching for new and better treatments for bipolar disorder. Omega-3 supplement therapy is showing some promise. A study published in the American Journal of Psychiatry found that "greater seafood consumption predicted lower lifetime prevalence rates of bipolar I disorder, bipolar II disorder, and bipolar spectrum disorder." The rich sources of omega-3 found in seafood are credited for the reduced rate of bipolar. A study published in Prostaglandins, Leukotrienes & Essential Fatty Acids, or PLEFA, determined that sufficient evidence exists to show that omega-3 fatty acids are beneficial in the treatment of bipolar disorder. Amino acid supplementation and vitamin B12 supplementation is also being studied for the treatment of bipolar disorder.
References
- The ECT Handbook 2nd Edition; The Third Report of the Royal College of Psychiatrists; Allan I. F. Scott; 2005
- American Journal of Psychiatry 160:2222-2227; Cross-National Comparisons of Seafood Consumption and Rates of Bipolar Disorders; Simona Noaghiul, M.D., M.P.H., and Joseph R. Hibbeln, M.D.; December 2003
- Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA) Volume 60, Issues 5-6; Omega-3 Fatty Acids and Bipolar Disorder: A Review; A. L. Stolla, C. A. Locke, L. B. Marangell, W. E. Severus; May-June 1999
