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Understanding Bipolar Disorder -- Treatment

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Nondrug Treatments of Depression

Whilemedications are the first line of treatment for bipolar disorder, ongoing psychotherapy is important to help patients understand and accept the personal and social disruptions of past episodes and better cope with future ones. Several specific forms of psychotherapy have been shown to help speed recovery and improve functioning in bipolar disorder, including cognitive-behavioral therapy, interpersonal/social rhythm therapy, family therapy, and group therapy. In addition, because denial is often a problem -- sticking with medications can be especially tricky in adolescence -- routine psychotherapy helps patients stay on their medications. 

Electroconvulsive therapy (ECT) is sometimes used for severely manic or depressed patients and for those who don't respond to medication or for those women who, while pregnant, experience symptoms. Because it acts quickly, it can also help patients who are considered to be at high risk for committing suicide. ECT fell out of favor in the 1960s, but the procedure has been greatly refined since then. The patient is first anesthetized and a muscle relaxant is given. Then, a small electric current is passed through electrodes placed on the scalp to produce a grand mal seizure of short duration -- less than one minute. During the course of ECT treatments -- usually two to four weeks -- lithium and other mood stabilizers are sometimes discontinued to minimize side effects, and then resumed after completion of the treatment.

The newer types of nonpharmocological treatments of depression are:

  • VNS (Vagus or Vagal Nerve Stimulation) involves implantation of a device that sends electrical signals to the vagus nerve in order to treat depression.
  • TMS (Transcranial Magnetic Stimulation) is a procedure which involves the use of an electromagnetic coil to create electrical currents and stimulate nerve cells in the mood centers of the brain as a treatment for depression.
  • Light therapy has proved effective as an additional treatment when bipolar disorder has a connection to seasonal affective disorder. For those people who usually become depressed in winter, sitting for 20 minutes to 30 minutes a day in front of a special light box with a full-spectrum light can effectively treat their depression.

 

Home Remedies for Bipolar Disorder

If someone you live with has bipolar disorder, maintain a calm environment, particularly when that person is in a manic phase. Keep to regular routines for daily activities -- sleeping, eating, and exercise. Adequate sleep is very important in preventing the onset of episodes. Avoid excessive stimulation. Parties, animated conversation, and long periods of watching television or videos can exacerbate manic symptoms.

IMPORTANT! Help and Support

In the manic phase of bipolar disorder, patients may engage in risky activities, such as fast driving or certain risky sports. They should be monitored and prevented from taking chances, especially in a car. Drinks and foods containing caffeine -- tea, coffee, cola, and chocolate -- should be limited in the manic phase. Avoid alcohol at all times. It is very important for a patient experiencing manic symptoms to receive prompt psychiatric assessment. Family members may need to contact the doctor, because oftentimes patients in a manic or hypomanic episode have little insight into their illness and may refuse treatment. But prompt intervention, including possible medication adjustments at an early point in an episode, may prevent further problems and the need for hospitalization.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on April 10, 2014
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