What Causes Bipolar Disorder
The cause of bipolar disorder isnt clear. Research suggests that a combination of different things can make it more likely that you will develop bipolar disorder.
Genetic factors
There is a 13% chance you will develop bipolar disorder if someone in your immediate family, like a parent, brother or sister has bipolar disorder.
This risk is higher if both of your parents have the condition or if your twin has the condition.
Researchers havent found the exact genes that cause bipolar disorder. But different genes have been linked to the development of bipolar disorder.
Brain chemical imbalance
Different chemicals in your brain affect your mood and behaviour. Too much or too little of these chemicals could lead to you developing mania or depression.
Environmental factors
Stressful life events can trigger symptoms of bipolar disorder. Such as childhood abuse or the loss of a loved one. They can increase your chances of developing depressive episodes.
You can find more information about Does mental illness run in families? by clicking here.
Who Will I See
You may see your GP at first, particularly if you have a depressive episode. But, if they make a diagnosis of bipolar disorder, they will have to refer you to a specialist a psychiatrist. NICE guidance suggest that mood-stabilisers need to be started by a specialist7, even if your care is later taken over by a GP.
When you see a psychiatrist, you will also meet other members of the community mental health team . They will be able to help with emotional support, information, psychological interventions, and help with sorting out practical matters.
Once any medication you are taking seems to established and effective, your GP can take over most of your care, although they will usually want you to stay in touch with a psychiatrist and the CMHT.
Suicide And Treatment With Antidepressants
Suicide cannot be treated but only prevented . Research on treatments aimed at suicide prevention, not surprisingly, is very limited because of clinical and ethical problems arising if an inactive or ineffective treatment, such as placebo, were compared to an experimental intervention, with death as a potential outcome. In addition, it is virtually impossible to know when a suicide has been prevented, whereas suicidal acts or surrogate measures can be counted. Rarity of suicide, even among psychiatric patients, encourages research reliance on more prevalent measures related to suicide, including suicidal ideation, threats, self-injurious acts, or emergency interventions. However, the typically distant relationship of such measures to suicide limits their value in testing for therapeutic effects on suicide itself. Relating treatments to suicidal risks is further complicated by uncertain long-term adherence to recommended treatments . Treatments for BD considered for possible suicide-prevention include antidepressants, anticonvulsants and lithium, antipsychotics, ECT, and psychosocial interventions .
Table 3 Treatments aimed at reducing suicidal risk in bipolar disorder patients
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What Can I Expect After Treatment
For most people, a good treatment program can stabilize severe moods and provide effective symptom relief. Treatment that is continual has proven more effective in preventing relapses. Those who also have a substance abuse problem may need more specialized treatment.
Last reviewed by a Cleveland Clinic medical professional on 01/27/2018.
References
Which Talking Therapies Might I Be Offered
There are several talking therapies you might be offered to help you manage your bipolar disorder in the long term. These are a few that have been tested and shown to work well for some people, although other therapies may work too:
- Cognitive behavioural therapy looks at how your feelings, thoughts and behaviour influence each other and how you can change these patterns.
- Interpersonal therapy focuses on your relationships with other people and how your thoughts, feelings and behaviour are affected by your relationships, and how they affect your relationships in turn.
- Behavioural couples therapy focuses on recognising and trying to resolve the emotional problems that can happen between partners.
Other types of talking therapies you may be offered are:
- Enhanced relapse prevention/ individual psychoeducation this is a brief intervention to help you learn coping strategies.
- Group psychoeducation this involves working in a group of people with shared experiences, led by a trained therapist, to build up knowledge about bipolar disorder and self-management.
- Family-focused therapy this involves working as a family to look at behavioural traits, identify risks and build communication and problem-solving skills.
Some of these treatments are more widely available than others. What you are offered can also depend on what you and your doctor agree would be most useful for you.
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Coping With Bipolar Disorder
Living with bipolar disorder can be challenging, but there are ways to help make it easier for yourself, a friend, or a loved one.
- Get treatment and stick with itrecovery takes time and its not easy. But treatment is the best way to start feeling better.
- Keep medical and therapy appointments and talk with the provider about treatment options.
- Take all medicines as directed.
- Structure activities: keep a routine for eating and sleeping, and make sure to get enough sleep and exercise.
- Learn to recognize your mood swings and warning signs, such as decreased sleep.
- Ask for help when trying to stick with your treatment.
- Be patient improvement takes time. Social support helps.
- Avoid misuse of alcohol and drugs.
Remember: Bipolar disorder is a lifelong illness, but long-term, ongoing treatment can help control symptoms and enable you to live a healthy life.
What Are The Long
Bipolar disorder is a life-long and often recurring illness. You may need long term support to help manage your condition.
What medication options are there?
Your doctor will look at what medication worked for you during episodes of mania or depression. They should ask you whether you want to continue this treatment or if you want to change to lithium.
Lithium usually works better than other types of medication for long-term treatment. Your doctor should give you information about how to take lithium safely. If lithium doesn’t work well enough or causes you problems, you may be offered:
- Valproate,
- Olanzapine, or
- Quetiapine.
Your doctor should monitor your health. Physical health checks should be done at least once a year. These checks will include:
- measuring your weight,
- checking your liver and heart, and
- checking your pulse and blood pressure.
What psychological treatments are recommended?
You should be offered a psychological therapy that is specially designed for bipolar disorder. You could have individual or group therapy.
The aim of your therapy is to stop you from becoming unwell again. This is known as relapse. Your therapy should help you to:
If you live with your family or are in close contact with them, you should also be offered family intervention.
Family intervention is where you and your family work with mental health professionals to help to manage relationships. This should be offered to people who you live with or who you are in close contact with.
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How Common Is Bipolar Disorder
At some point during their lifetime, 2.4% of people worldwide and 4.4% of people in the United States will be diagnosed with bipolar disorder. While the cause of bipolar disorder is unclear, having a first-degree relative with the condition is a recognized risk factor. Most people with a relative with bipolar disorder will not develop the condition, however.
Theresa Chiechi / Verywell
What Is A Manic Episode
A manic episode is an abnormally elevated or irritable mood and the patient can show some or all of the following types of symptoms:
Feeling very happy or overjoyed
Easily distractible and acting on impulse
Poor judgement and doing things that may have poor consequences
Grandiosity
Flight of ideas
Decreased need for sleep
Excessive talkativeness
Delusions , hallucinations or disturbed thinking .
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Treatment Of Bipolar Depression
The treatment of bipolar depression is a major challenge, with few treatments of proven efficacy and, in particular, substantial controversy about the role of antidepressant drugs. Authors of guidelines and consensus statements on this topic often ponder why antidepressants are so commonly used despite the scarce evidence for efficacy. Until recently, after the work of Emil Kraepelin, bipolar depressive episodes were deemed phenomenologically and biologically similar to unipolar depressive episodes. Even as late as the 1990s, inclusion and exclusion criteria in clinical trials of antidepressants in patients with depressive disorder did not usually either select or stratify according to polarity. Earlier trials suggested that when given with antimanic treatment, selective serotonin reuptake inhibitor antidepressants were more effective and no more likely to induce mania than placebo, and were less likely to induce mania than tricyclic antidepressants. In 2007, a large trial found no benefit associated with the addition of paroxetine or bupropion to a mood stabiliser another reported that paroxetine was no better at achieving a durable recovery than placebo.
Psychosocial Interventions For Alcohol And Substance Use Disorders
Many individuals with bipolar disorder also struggle with an alcohol or substance use disorder. Co-occurring disorders are best treated concurrently, meaning that treatment for bipolar disorder should be integrated with the treatment for the alcohol or drug problem.
Integrated treatment includes motivational enhancement and cognitive-behavioral interventions. Integrated treatments are effective at reducing substance use, preventing relapse, and keeping individuals in treatment longer. These interventions can be delivered one-on-one or in a group format.
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Top 4 Bipolar Diet Tips
Considerations Of Outpatient Treatment
Outpatient treatment for patients with bipolar disorder, or manic-depressive illness , has 4 major goals, as follows:
Look at areas of stress and find ways to handle them: The stresses can stem from family or work, but if they accumulate, they propel the person into mania or depression this is a form of psychotherapy
Monitor and support the medication: Medications make an incredible difference, and the key is to obtain the benefits while avoiding adverse effects patients are ambivalent about their medicationsalthough they recognize that the drugs help and prevent hospitalizations, they also resent that they need them the goal is to address their feelings and allow them to continue with the medications
Develop and maintain the therapeutic alliance: This is one of the many reasons for the practitioner to deal with the patients ambivalence about the medications over time, the strength of the alliance helps keep the patients symptoms at a minimum and helps the patient remain in the community
Provide education : The clinician must help educate both the patient and the family about bipolar illness patients and families need to be aware of the dangers of substance abuse, the situations that would lead to relapse, and the essential role of medications support groups for patients and families are of tremendous importance
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Patient self-management support
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Organizational support
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Community resource linkages
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Herbal Remedies For Bipolar Popular Natural Treatment For Bipolar Disorder
Herbal remedies for bipolar are one of the approaches to natural treatments for bipolar disorder have many herbs that have been used to treat neurological disorders over the centuries. Herbalists call these substances nerves, and some of these herbal remedies for bipolar are very effective in the treatment of specific symptoms of bipolar disorder.
Listed below are herbal remedies for bipolar:
- Rhodiola another important herbal natural treatment for bipolar disorder -This herb for bipolar disorder has been used for years for effective stress management and has also shown very promising results for people suffering from depression. It doesnt work exactly like an anti-depressant. Still, it also possesses fewer side effects making it a viable option for people with bipolar disorder that are looking for a safe and effective alternative. It has mild stimulation properties and can be beneficial as a complementary for people that are on active anti-depressants. Using it with other herbs and natural remedies for bipolar disorder can also be helpful.
Mania And Mixed Depressive Episodes
Any antidepressant should be stopped. Haloperidol, olanzapine, quetiapine or risperidone can be used to treat a manic episode. If these do not work well, Lithium can be added.
Once the treatment has started, symptoms usually improve within a few days, but it may take several weeks for a full recovery. You should check with your doctor if you want to drive while taking this sort of medication.
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Options For Management Of Bipolar Disorder
Treatment options for management of BPAD can be broadly classified as mood stabilizers, antidepressants, antipsychotic medications, electroconvulsive therapy , adjunctive medications and psychosocial interventions . Use of various treatment options is guided by the phase of illness in which patient presents to the clinician and past treatment history.
Learning To Recognise Triggers
If you have bipolar disorder, you can learn to recognise the warning signs of an approaching episode of mania or depression.
A community mental health worker, such as a psychiatric nurse, may be able to help you identify your early signs of relapse from your history.
This will not prevent the episode occurring, but it’ll allow you to get help in time.
This may mean making some changes to your treatment, perhaps by adding an antidepressant or antipsychotic medicine to the mood-stabilising medication you’re already taking.
Your GP or specialist can advise you on this.
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Information For Family Carers And Friends
How can I get support?
You can speak to your GP. You should be given your own assessment through NHS mental health services to work out what effect your caring role is having on your health. And what support you need. Such as practical support and emergency support.
These are some other options for you:
- Join a carers service
- Join a carers support group
- Ask your local authority for a carers assessment
- Read about the condition
- Apply for welfare benefits for carers
Rethink Mental Illness run carers support groups in some areas. You can also search for groups on the Carers Trust website:
- Rethink Mental Illness: www.rethink.org/about-us/our-support-groups
- Carers Trust: www.carers.org/search/network-partners
How can I support the person I care for?
You might find it easier to support someone with bipolar disorder if you understand their symptoms, treatment and self-management skills.
You should be aware of what you can do if you are worried about their mental state. It can be helpful to know contact information for their mental health team or GP.
You could find out from your relative if they have a crisis plan. You could help your relative to make a crisis plan if they dont have one.
As a carer you should be involved in decisions about care planning. But you dont have a legal right to this. The medical team should encourage the person that you care for to allow information to be shared with you.
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What Is The Best Medication For Me
You need to discuss this with your doctor, but there are some general principles.
- Lithium is usually the first choice sodium valproate a second choice, although it can also be prescribed with lithium. Olanzapine can be tried if lithium and sodium valproate have not helped.
- Quetiapine can also be used, particularly where someone remains depressed between manic episodes8.
- Lamotrigine may be suggested for bipolar II disorder or bipolar depression, but not for mania.
- Sometimes a combination of these drugs is needed.
Much depends on how well you get on with a particular medication. What suits one person may not suit another.
Lithium reduces your chance of relapse by 3040%8, but the more manic episodes youve had, the more likely you are to have another one.
| Number of previous manic episodes | Chance of having another episode in the next year |
|---|---|
| Not taking Lithium |
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What Is The Treatment For Bipolar Disorder
In order to ensure that the affected person receives the best treatment, it is advised that the opinion and diagnosis of a doctor or medical professional who specialises in mental health conditions often known as a psychiatrist is sought.
Bipolar disorder, being a lifelong condition, needs treatment that is able to manage the symptoms thereof.
These treatments may include:
Medications
Medications are often given immediately to help balance mood swings and improve the persons everyday life.
Continuous treatment
Being a lifelong condition, a bipolar sufferer will need to continuously take medications, even when having a happy period. This is known as maintenance treatment. If this is not done, the risk of a relapse of symptoms or developing severe depression or mania increases.
Hospitalisation
One may need to be hospitalised if experiencing suicidal thoughts, wanting to inflict self-harm or psychosis. This helps the sufferer to stay in a stable environment, be under constant monitoring where they will also be kept safe and calm.
Day treatment program
Some bipolar patients may be put on a day treatment program that provides counselling and support in order to control and deal with their symptoms. This is known as outpatient care in which patients are treated under a physicians supervision and monitoring.
Treatment for substance abuse
Support groups
Treatment For Bipolar Disorder:
Before we dive into the treatment, it is important to know that the cause behind it is still unknown. The doctor having specialization in treating patients with mental conditions can only provide the best treatment. In most cases, psychologists, psychiatric nurses, and social workers are also included in the treatment. It is a lifelong condition, so a person cannot avoid it.
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