Mental health treatment has come a long way in the past few decades. Terrifying images of straight jackets, electroshock therapy and nasty nurses with hypodermic needles are thankfully a thing of the past and bad movies! But once diagnosed, what can you expect from your mental health professionals in terms of treatment for bipolar disorder?
First Things First
If you are experiencing any symptoms so severely that you may not be safe, hospitalization is the first treatment option that will be recommended. If you are feeling suicidal or homicidal, the hospital is the only place to go. You will stay there, start medication and group and individual therapy and be able to leave once you are stable enough to be safe without supervision. Many people with bipolar disorder never need to use this treatment option, but for those who do it is a life-saving intervention.
Outside of the hospital, there are two main types of mainstream, traditional treatment: medication and psychotherapy. These two types of treatment can be further broken down into specific classes of medications and types and modalities (i.e. individual, family, couple, or group) of psychotherapy. In addition, there are alternative or complementary treatment options for people diagnosed with bipolar disorder although many of these are not considered medical treatments but are more lifestyle or behavioral changes people make to live more comfortably with their diagnosis.
Most people with bipolar disorder are prescribed mood stabilizing medication. The best known of these mood stabilizers is Lithium, which has been used for decades in the treatment of manic depression or bipolar disorder. Lithium is still very commonly prescribed due to its efficacy, but other medications may be suggested due to Lithium’s serious side effects (dry mouth, increased thirst, tremors, memory loss, weight gain, acne etc.) and potential impact upon kidney function. The other medications commonly most used to treat bipolar disorder are anticonvulsants (medications used for seizure disorder) including carbamazepine and valproate. Both of these medications may cause unpleasant or serious side effects, most commonly gastrointestinal distress (nausea, vomiting), tremors, sedation, and rashes.
When starting a new medication for bipolar disorder, ask your doctor questions about side effects and what to watch for. Be sure to tell your doctor anything unusual you experience and ask for directions ahead of time regarding how to manage any discomfort you experience. You may expect that you doctor will start a new medication at a low dosage and increase the dose gradually as you demonstrate that you can tolerate the medication without discomfort. Often to fully gain control of your symptoms, doctors use multiple medications, and may even prescribe an additional medication to prevent or ameliorate side effects.
Psychotherapy to treat bipolar disorder is often helpful in addition to medications. Whether you take medications or not, a strong bond with a seasoned therapist can be important. Different types of therapy used to treat bipolar will focus on different aspects of the disease. For example, behavioral coping skills to manage manic or depressive episodes will be one aspect of treatment. Identifying triggers to mania or depression may be another aspect of treatment. Most therapists begin a treatment episode with the creation of goals. These goals should be clear, objective, measurable, and you and your therapist should be able to agree upon when you’ve reached them. That way you can decide what’s most important to you to work on first – maybe dealing with suicidal thoughts or maybe some of your impulsive behaviors during a manic episode.
Either way, you and your therapist can work out strategies for dealing with these behaviors as they come up. You practice in your life outside the therapy office and share your results with your therapist and together you keep tweaking and adjusting strategies and skills to be as effective as possible. You might work on coping skills and behavioral strategies at first, then shift to cognitive work as you get a handle on your behaviors. The beauty of psychotherapy is that it is as effective as you want it to be with no side effects. If you choose to work hard and stay focused in your therapy you can be guaranteed that things will get better.
Some therapists also suggest working with family members or the people you are closest to, as they often bear the brunt of your mood swings and dysfunctional behavior when you are ill. Family session and couples work can be incredibly helpful, as your family members start to understand your disease and how it works. This can help everyone let go of blame and feel more loving and forgiving of each other.
Other treatments that may be helpful include overall stress management strategies such as meditation or yoga, as well as taking a sensible and balanced approach to life: eating well, keeping good habits, developing meaningful friendships, and being creative and self expressive in some way. Being healthy is a mind, body, and soul affair: try to feed your whole self good “food” and be positive. Attitude will help you weather the tough times that bipolar disorder seems to serve up.