When Bipolar Mania Gets Out of Control
For many with bipolar disorder, mania feels dangerously good.
Fine-Tuning Treatment for Bipolar Disorder continued...
Even with medication, some people continue to have manic or depressive
episodes, says Harvey. "As with any mental illness, stress can be a
trigger. If you're taking lithium, profuse sweating can affect your lithium
level -- especially if you're very sensitive to medication."
Insomnia is often the first sign that a manic episode is looming, she says.
"I give patients a small sedating dose of non-addictive medication that
they can take to help them sleep, to try to squash that problem. It's usually
an antipsychotic, because if they were becoming manic, that's what we would use
Patients need to learn about their bipolar disorder, Harvey says. "They
need to understand the disorder itself, the medications and side effects that
might occur, why different types of medications are important, the importance
of taking medications on a regular basis."
The Ripple Effect of Bipolar Disorder
Treatment should be more than just taming mania and depression. "Just
getting rid of symptoms doesn't help with finding a job," Harvey says.
"You may need to see a case manager for work rehabilitation. Getting back
to work and social functioning should be part of treatment."
Indeed, bipolar disorder has "a huge ripple effect in your social
relationships, occupational functioning, everything else," says Bearden.
"People need programs that provide structure and help people get back to
At Menninger, Harvey's team works intensely with patients in relapse
prevention, she tells WebMD. "Rehab specialists are important. This has
been extremely disruptive in their lives. How does it affect their families?
Will they still have their jobs? What kind of treatment support do they need?
What support groups or resources do they need?"
For some patients, depression is difficult to treat, says Bearden. "It's
hard to make the depression completely go away. In between manic episodes, they
still have some residual depression."
That's why a close relationship with a psychiatrist is critical, she says.
"If the doctor is trying different medications, adjusting dosages, it gives
them a sense they are being listened to. It gives them hope that things can get
better ... and that improves participation in treatment."
If you live anywhere near a university that is conducting clinical trials,
that's a good way to get free medications and free treatment, Bearden advises.
Look for studies that are comparing medications that are already FDA-approved,
comparing one medication against another, so you won't get a placebo.
"A clinical trial is a great way to get good-quality treatment,"
Bearden tells WebMD. "A lot of people are wary about participating in a
trial, but if it's done by an academic institution, it's generally
high-quality. And they'll get frequent follow-up visits, which, regardless of
the type of treatment, is one of the major factors in success."