Treating Bipolar Disorder

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What sort of treatment can I get?


If you go to your GP, he or she may refer you to a psychiatrist who will be able to make a proper diagnosis and discuss the various treatments available. If a treatment does not suit you, say so and ask for other options.


Medication


Almost everyone who has a diagnosis of bipolar disorder will be offered medication. Though drugs cannot cure bipolar disorder, many people find that they help to manage the symptoms, and they should be seen as part of a much wider treatment that takes account of individual need. The drugs used include lithium, anticonvulsants and antipsychotics. It is very important to monitor your physical health when taking any of these drugs.

Lithium is often prescribed for bipolar disorder and comes as two different salts: lithium carbonate (Camcolit, Liskonum, Priadel) and lithium citrate (Li-liquid, Priadel). It does not matter which of these you take, but you should keep to the same one, because they are absorbed slightly differently. If you are taking lithium, you will have to have regular blood tests to make sure that the level of lithium in your blood is safe and effective. It is also important to maintain steady salt and water levels as far as possible. Common side effects of lithium include weight gain, thirst, and tremor. Long-term use is potentially toxic to the thyroid gland and the kidneys, and their function should be checked regularly during treatment. You should receive a lithium treatment card and purple information pack with your first prescription.

Some anticonvulsant drugs are also licensed for bipolar disorder. These are semisodium valproate (Depakote), carbamazepine (Tegretol) and lamotrigine (Lamictal). Lamotrigine has antidepressant effects and is licensed for the prevention of depressive episodes in bipolar disorder.

There are adverse effects associated with all of these drugs, which should be made clear before beginning treatment.

The antipsychotic drugs which are licensed for the treatment of mania are olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal) and aripiprazole (Abilify). These may be taken at the same time as an anticonvulsant or lithium. Psychotic episodes may be treated with older antipsychotics, such as haloperidol (Haldol, Dozic, Serenace) or chlorpromazine (Largactil). All of these drugs are associated with potentially serious side effects and should be used at the lowest effective dose for the shortest possible time.


Talking treatments


Hopefully the use of talking treatments will increase. They reduce the relapse rate considerably and many people find them a great help.

Counselling, psychotherapy or sessions with a psychologist can help people understand why they feel as they do, and change the way they think and feel. It may help people to overcome relationship difficulties often associated with the condition. It offers an opportunity to talk about the very stressful experience of bipolar disorder and so to cope better with it.

Cognitive Behaviour Therapy aims to help people to identify problems and overcome emotional difficulties. It's a practical talking treatment with the focus on changing the negative thought patterns that are often associated with depression. There are government initiatives to make CBT much more widely available in the community, including self-help computerised CBT programmes.

Group therapy can help too - either in or out of hospital or provided by a voluntary organisation.


Hospital admission


If you are particularly distressed, you may benefit from an environment that is not too demanding. At the moment, hospital is often the only place that provides this. It will give staff the opportunity to assess your needs and try to find the best way to help you. And, for those close to you, it may provide some relief.

You can be admitted to hospital voluntarily, in which case you are called an ‘informal patient’. Most admissions are informal but, if you are unwilling to go into hospital, you may be admitted compulsorily under the Mental Health Act 1983. Your community health council, a law centre, a solicitor, or Mind Legal Advice Service can advise you.

Unfortunately, being in a psychiatric hospital or unit can be a distressing experience. There may be little privacy, and people miss their own possessions and surroundings. It can also be frightening to be with other people who are acting in a way that is difficult to understand and is sometimes threatening.


Crisis services


Crisis services have been developed in some areas as alternatives to hospital. Sometimes they can offer accommodation (crisis houses), but otherwise they can offer support 24 hours a day in your own home, with the idea of avoiding admission to hospital. Crisis services rely less on drug treatments and more on talking treatments and informal support.


ECT


Electroconvulsive therapy (ECT) is a controversial treatment, which is given under general anaesthetic and involves passing an electric current through the brain in order to cause a fit. It's given for severe depression and may also be used, very rarely, for severe mania. It can cause short or long-term memory loss. It is used less commonly now than in the past, but some people find it very effective when nothing else has helped.


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The Have I Got A Problem website is a free online resource to help people better understand any issues or concerns they may have about mental health or addiction. The website includes resources specifically focused to; general Mental Health, Depression, Stress, Anxiety, Insecurities, Self-harm Schizophrenia, Bipolar, Anger Management, Eating Disorders, Coping, general Addiction, Alcohol, Smoking, Gambling, Drugs, Cocaine, Heroin, Marijuana (Cannabis) Ecstasy, PCP, Mephedrone, Ketamine & Crystal Meth.

The site was created to give the public information to help them understand mental health and addiction issues and to assist people in making better informed decisions about their life and personal choices.

www.haveigotaproblem.com was created and is run by 'Advising Communities’, which is a UK registered charity (Charity No. 1061055)

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