Mood swings are common in day-to-day living. But imagine having to lead a normal life amidst extreme mood swings. Exceptionally high energy levels characterize a manic phase. Then there comes an extremely depressing phase. For some these episodes alternate. How would managing such a life be? Yes, I’m talking about bipolar disorder (BD). In this article, we will look at how treatment options like mood stabilizers impact the life of a person with bipolar disorder.
Importance of Early Diagnosis and Treatment
Bipolar disorder typically starts between ages 15 and 25, with depression(about 75%) being the most common first symptom. People living with this disorder have greater chances of havingÂ
- Metabolic Syndrome (37%)
- Obesity (21%)Â
- Smoking (45%)
- Type 2 Diabetes (14%)
All of this can raise the risk of dying early. The annual suicide rate among individuals with BD is approximately 0.9%. At the same time, it is only about 0.014% of the general population. About 15% to 20% of individuals with it die by self-harm. Therefore, getting diagnosed and treated early leads to better outcomes. However, on average, it takes about 9 years after the first depressive episode to receive the right diagnosis and treatment.
Treatment Options for The Management of Bipolar DisorderÂ
Let us now learn about the various treatment options available for the management of it. The emotional highs and lows that occur during it can significantly disrupt an individual’s life. Therefore, choosing the right treatment option for their symptoms plays an important role in management. Also, adhering to treatments can reduce the rate of hospitalization by 60% over a decade. The different management techniques include medications, psychotherapy, and overall lifestyle modifications.
1. Medication
These medications work by modulating neurotransmitter activity in the brain, which helps to stabilize mood swings and improve overall functioning. Medication for bipolar disorder includes
- Mood stabilizers
- Antipsychotics
- AntidepressantsÂ
- Anticonvulsants
2. Psychotherapy
Mainly used interventions are CBT, Family-focused therapy and Interpersonal and social rhythm therapy.
3. Lifestyle Modifications
Lifestyle adjustments play a vital role in effective management. This includes a healthy diet, physical activity and proper management of sleep. Effective management of bipolar disorder typically involves a combination of medications, psychotherapy, lifestyle adjustments, and sometimes alternative treatments. The choice of treatments should be tailored to the individual’s specific needs. It should be revised based on the outcomes and side effects shown. Collaborating with healthcare professionals ensures a comprehensive approach to managing the condition and improving overall quality of life.
Impact of Treatment OptionsÂ
Advances in psychiatric treatment have greatly improved the management of this condition. While effective treatments such as mood stabilizers, antipsychotics, and psychotherapy can significantly improve quality of life, they are not without potential drawbacks. Understanding both positive and negative impacts is crucial for managing the condition effectively.
Mood Stabilizers and Their Impact
Mood stabilizers are usually seen as the main approach for addressing bipolar disorder. These medications help to balance mood swings and prevent the recurrence of manic or depressive episodes. But they can have side effects. Widely utilized mood stabilizers are:
1. Lithium:Â
- Positive Impact: One of the oldest and most effective mood stabilizers is Lithium. It helps reduce the severity and frequency of manic and depressive episodes. It is especially good at prohibiting relapse. It helps to maintain long-term stability. Lithium lowers the risk of suicide in people with bipolar disorder by about 60-70%.
- Potential Side-effects: Common side effects include giddiness, tremors, and gastrointestinal issues. Long-term use can lead to kidney problems, requiring regular monitoring.
- Evidence-based facts about lithium: It should be the foremost treatment option and is most effective for bipolar disorder. Its treatment can be varied by regular blood tests. Also, the slow-release approach has been seen to be more powerful. It also helped with decreasing self-harming risks among people living with bipolar.
2. Valproate (Valproic Acid):Â
- Positive Impact: An anticonvulsant that also acts as a mood stabilizer, valproate is effective(about 50% – 70%) in managing manic episodes and is sometimes used when lithium is not suitable.
- Potential Side Effects: This medication can cause drowsiness, dizziness, and hair loss. More serious side effects can be liver damage and pancreatitis. Regular blood tests are necessary to monitor these risks.
- Evidence-based facts about Valproate: It essentially helps with soothing brain cells. It restricts unusual brain signals thus preventing mood changes. It amplifies the secretion of calming neurotransmitters called GABA.Â
3. Lamotrigine:Â
- Positive Impact: Another anticonvulsant, lamotrigine is particularly effective in stabilizing mood and preventing depressive episodes in bipolar disorder. Lamotrigine can reduce the relapse rate by 50%.
- Potential Side-effects: While generally well-tolerated, lamotrigine can cause skin rashes, which in rare cases can progress to a severe condition called Stevens-Johnson syndrome.
- Evidence-based facts about Lamotrigine: It is considered efficient in reducing the recurrence of manic episodes. Though most medications are prescribed alongside therapeutic interventions, Lamotrigine is to be working without many advanced therapies.
Antipsychotics and Its ImpactÂ
When individuals suffer from very serious manic and depressive episodes, antipsychotics are recommended along with mood stabilizers.
Atypical Antipsychotics
- Positive Impact: Atypical Antipsychotics are effective in managing symptoms of mania and, in some cases, depression. In most cases, they are used in combination therapy with mood stabilizers.
- Potential Side-effects: Usual side-effects of these medications include drowsiness, weight gain, etc. A few other risky effects include involuntary movements, heart attacks and cataracts.
- Evidence-based facts about Atypical Antipsychotics: It primarily creates a balance in an altered brain neurocircuit. Some research has shown that antipsychotics are more effective in treating depressive than manic episodes.
Psychotherapy and Its ImpactÂ
While medication plays a crucial role in managing bipolar disorder, psychotherapy is equally important. It offers several benefits while used in conjunction with medications.
- Family Therapy: Involving family members in therapy can enhance understanding and support. This is crucial for effectively managing bipolar disorder.
- Interpersonal and Social Rhythm Therapy (IPSRT): This therapy focuses on fixing daily routines and improving interpersonal relationships. This includes turn can help prevent mood episodes.
- Cognitive Behavioral Therapy: It helps manage bipolar disorder by teaching people to identify and change negative thought patterns and behaviours. It also provides strategies for managing stress and improving coping skills. Patients receiving CBT alongside medication have a 50% reduction in relapse rates over two years.
Potential ChallengesÂ
While psychotherapy is a beneficial component of treatment, it can present challenges.
- Finding the right qualified therapist can also be challenging.
- Mental health-related discussions are still seen as taboo and people are hesitant to take up therapy.Â
- People living with bipolar disorder sometimes feel therapy sessions to be emotionally straining, leading to discontinuing sessions.
- Regular therapy sessions can be time-consuming and may not be easily accessible for everyone due to geographic or financial constraints.Â
Lifestyle Adjustments and Support
In addition to medication and therapy, lifestyle changes and support systems play a vital role in managing bipolar disorder.
- Regular Exercise: Physical activity helps stabilize mood and reduce symptoms of both mania and depression.
- Sleep Hygiene: Maintaining a regular sleep schedule is crucial, as irregular sleep patterns can trigger mood episodes.
- Healthy Diet: Proper nutrition can impact mood and overall mental health. A balanced diet is important for individuals with bipolar disorder.
- Support Networks: Support from friends, family, and support groups can provide emotional assistance and practical advice. It helps individuals manage their condition more effectively.
Potential difficultiesÂ
Lifestyle changes are recommended alongside medication and therapy but can be difficult to start and continue.
- Forming and maintaining a strong support network can be challenging.
- It may not always be feasible, especially for those experiencing significant social withdrawal.
- Sticking to a regular exercise routine, healthy diet, and sleep schedule can be difficult, particularly during mood episodes.
Mood stabilizers, antipsychotics, and psychotherapy offer substantial benefits in managing it. But, care has to be taken on dosages to prevent toxicity. Monitoring and adjusting treatment plans in collaboration with healthcare providers can help manage symptoms and create overall well-being.
FAQs
What is Bipolar Disorder?
- It is a mental health condition characterized by extreme mood swings, including emotional highs (mania) and lows (depression).
What are some treatment options available for Bipolar Disorder?
- Medication, psychotherapy and lifestyle modifications.
Mention some mood stabilizers used for bipolar disorderÂ
- Medication for it includes mood stabilizers, antipsychotics, antidepressants and anticonvulsants.
What are the potential side effects of Lithium used in treatment?
- Common side effects include weight gain, tremors, and gastrointestinal issues. Long-term use can lead to thyroid or kidney problems, requiring regular monitoring
References +
Clinical Practice Guidelines for Management of Bipolar Disorder. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310104/)
Bipolar Disorder (https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961)
Bipolar Disorder (https://www.hopkinsmedicine.org/health/conditions-and-diseases/manic-depression–bipolar-disorder)
Mood Stabilizing Medication (https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/mood-stabilizing-medication)
Facts and myths about the use of lithium for bipolar disorder in routine clinical practice: an expert consensus paper (https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-023-00481-y)
Everything You Need to Know About Valproic Acid Levels for Bipolar Disorder (https://www.healthline.com/health/bipolar-disorder/valproic-acid-levels-for-bipolar)
Lamotrigine in the maintenance treatment of bipolar disorder (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440301/)
How Atypical Antipsychotics Can Help Treat Bipolar Disorder (https://psychcentral.com/bipolar/atypical-antipsychotics-for-bipolar-disorder)
What Is Therapy for Bipolar Disorder?(https://www.verywellmind.com/therapy-for-bipolar-disorder-techniques-and-efficacy-6742122)
Diagnosis and Treatment of Bipolar Disorder: A Review
(https://pubmed.ncbi.nlm.nih.gov/37815563/)
The suicide prevention effect of lithium: more than 20 years of evidence—a narrative review (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504869/)
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947163/)
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