Treatments for Bipolar Disorder

Bipolar disorder, or manic depression, is a mental illness which causes mood swings and mood cycling. Mood cycling refers to the transition between mania and depression. Mania, or manic episodes, typically consist of feelings of elation and invincibility, and cause disorientation, lack of sleep, and obsessive behaviors. Depression typically consists of feelings of overwhelming sadness and low self worth.

There are many treatments available for bipolar disorder, ranging from medications to therapy. There are too many medications to be discussed here in depth. There are also many forms therapy can take, and techniques that can be learned to assist the patient in gaining some control over their bipolar disorder.

Typically, bipolar disorder is treated with more than one medication. This is due to the dual nature of bipolar disorder. Most patients need at least two medications: one to control depression and one to control mania. The combination of these two types of medication works to obtain balance in moods and stop mood cycling. Often, a third medication, called a mood stabilizer, is also prescribed. The most common mood stabilizer is Topomax.

Popular medications for treatment of mania in bipolar patients include lithium, valproate (Depakote), carbamazepine (Tegretol), olanzapine (Zyprexa), and ziprasidone (Geodon). Lithium has long been considered the miracle drug of bipolar disorder. It is a sodium based medication that helps to balance the chemical imbalance in the brain that causes manic episodes in bipolar patients.

Valproate, or Depakote, was originally developed as a seizure medication. However, its effects on bipolar patients who have rapid cycling bipolar (moods that cycle every few hours or days rather than weeks or months), it has been quite effective. Carbamazepine, or Tegretol, is another anti-seizure medication. While it appears to have similar effects on bipolar disorder as Depakote, it has not yet been approved by the Food and Drug Administration for use as a bipolar disorder treatment.

Olanzapine, or Zyprexa, and Ziprasidone, or Geodon, are both anti-psychotic drugs, and are particularly effective for treatment of bipolar disorder in which mania becomes so severe that psychotic symptoms are present.

Medications for treatment of depression are called anti-depressants. Common anti-depressants include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). All of these medications have been proven to be successful treatments for depression, although Celexa and Prozac are the most commonly prescribed.

Typically, treatment of bipolar disorder includes a combination of medications and therapy, or counseling. However, in some cases, medication may not be necessary for milder cases of bipolar disorder. In other cases, medication may not be desired by the patient, and the patient may wish to seek out other alternatives to medication for treatment of their bipolar disorder.

For these patients, Cognitive Behavioral Therapy (CBT) can be quite effective. CBT is a method of bipolar disorder treatment that involves teaching the patient techniques to recognize triggers and symptoms of their mood cycling, and use that information and recognition to prevent the triggers from occurring, or the mood cycling from being quite as severe. Most of these techniques require the patient to develop cognitive thinking skills as well as critical thinking and problem solving capabilities. If the bipolar disorder is severe to the point that the patient is unable to engage in these thinking abilities and skills, CBT may not be a viable form of treatment in and of itself.

Overall, there are many treatments available for bipolar disorder. There are many options for the patient that can be discussed with the patient’s doctors. If a patient is not satisfied with the form their treatment is taking, they should discuss it with their doctor, and not be afraid to change doctors in order to change treatment methods. All in all, effective and successful treatment of bipolar disorder rests in the hands of the patient.

CBT as Treatment for Bipolar Disorder

Bipolar disorder, known by many as manic depression, is a mental illness caused by a combination of factors, including neurological, biological, emotional, and environmental factors. It is most commonly described as mood cycling or mood swings, in which the patient cycles through moods of depression, mania, and normal behavior.

There are many treatment options for bipolar disorder. The most common treatment for bipolar disorder includes a combination of medication and therapy. However, some patients are not candidates for medication treatment. Patients that have a history of drug abuse, for instance, should in most cases not be placed on medication for bipolar disorder, as the risk for abuse is too great. Additionally, patients may not have a case of bipolar disorder severe enough to warrant medication. Other patients may choose to avoid the route of medication until it becomes absolutely necessary.

In response to these special cases in which medication treatment is not a viable option for bipolar disorder, that Cognitive Behavioral Therapy, or CBT, was developed. CBT is a type of therapy that assists patients in recognizing triggers and causes for their manic and depressive states. The patient can then learn techniques to avoid these triggers, and cope with symptoms during episodes. Seventy percent of bipolar disorder type one patients that undergo CBT experience one or fewer episodes within four years of starting the CBT treatment.

There are two main goals that are met by using CBT as treatment for bipolar disorder. The first goal is to recognize manic episodes before they become uncontrollable, and consciously change how they react to the episode. The second goal is to learn techniques, reactions, thoughts, and behaviors that can help to offset depression. These goals are realized through various techniques and activities prescribed by the therapist. With CBT, the treatment of bipolar disorder rests with the patient, who is given homework in the form of exercises and reading, which helps them to understand their condition and learn methods to cope with it.

The first step to successful treatment of bipolar disorder through CBT is to develop a treatment contract with the patient. This is a treatment plan that the patient agrees to follow, and also involves the patient’s promise to complete all homework assignments and take any prescribed medication as directed. Because the success of CBT depends largely on the patient’s responsibility and desire to cope with bipolar disorder, this is an important first step to successful treatment.

The second step to successful treatment of bipolar disorder through CBT is to monitor and grade moods. This is done with various worksheets that the therapist gives the patient. The patient may record their mood for the day, how many hours they have slept, their level of anxiety, and their level of irritability. Those with type two bipolar disorder may need to record their mood two or more times per day, as their moods cycle more often.

Understanding the pattern to mood cycling can help the patient then undergo the next step to CBT treatment for bipolar disorder. This step of CBT for treatment of bipolar disorder requires the patient to do homework in the form of worksheets and reading that will help the patient to understand how their thoughts effect their emotions. By understanding these things, the patient will be able to then practice altering their thoughts in a rational way to make emotions more rational as well, decreasing the number and severity of depressive and manic episodes.

The next step to CBT treatment for bipolar disorder is to learn how to recognize triggers. Triggers are the thoughts, emotions, situations, times of year, events, or environments that set off a depressive or manic episode. By learning how to understand and recognize their triggers, the patient can then learn to avoid the triggers entirely, thereby decreasing the number and severity of depressive and manic episodes.

Overall, CBT is a viable and quite successful treatment for bipolar disorder, and can be a healthy alternative to medication in some cases. If you feel you may be a candidate for CBT, you should contact your doctor or therapist to discuss this and other bipolar disorder treatment options.