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    Bipolar Disorder: Managing the Balancing Act

    Bipolar disorder symptoms include dramatic shifts in mood and the ability to function. Successful bipolar disorder treatment requires a careful course of medication, psychotherapy, and discipline to stay on track--and avoid an emotional crash

    The 'Learning Curve' continued...

    "There are short periods of productivity on the way up, but once the highs get more severe, they are less productive," Calabrese says. And "once you are ill, you have to be able to stay on your medication for life, since in most instances when medications are stopped, people will relapse."

    "It's a human phenomenon," agrees Gary Sachs, MD, an associate professor of psychiatry at Harvard Medical School and director of the Bipolar Mood Disorder Program at Massachusetts General Hospital, both in Boston. "There is a willingness to take a treatment when you're acutely ill, but then when symptoms are no longer [obvious], it's hard to get your arms around the idea of taking a drug forever when you are not perceiving any benefit."

    Just as with Bernard, "as patients experience more and more relapses, the wisdom to take medication becomes clearer," says Sachs. Some people, he adds, may get the message after three lapses -- and for others it can take 13.

    James E. Rosenberg, MD, director of neuropsychiatry at the Sports Concussion Institute at Centinela Freeman Hospital in Marina del Rey, Calif., says that people with bipolar disorder think, "'I am going to finally write the great symphony or make some brilliant discovery.' But in the long term, people with untreated mania may find they no longer have family, are HIV positive from engaging in risky, thrill-seeking activities, are in jail, or are bankrupt. There are horrible consequences that affect the rest of your life."

    For Molliner, the repercussions were mainly social. "I lost my identity as a 16-year-old adolescent girl. I didn't take final exams [the year] I got diagnosed because I was being treated, and everybody I went to high school with knew why, and the shame that went with that was the biggest repercussion," she says. "I felt like I didn't fit in and never would."

    More Than Pills

    In addition to medication, there is also family support, counseling, and keeping regular routines to help people with bipolar disorder live with the condition. Molliner has been successfully living with bipolar disorder for 10 years, but that's not to say she does not feel the onset of symptoms and moods from time to time. "I know I need [help] when I sense symptoms coming on in my sleep. I let the people in my life know that I sense it coming on. In doing that, I feel empowered," she says. Exercise helps, too.

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