Bipolar Disorder
Bipolar disorder (or manic-depression) is a mental illness characterised by mood swings, which include episodes of mania (or hypomania) and depression.
Symptoms
Mania
- Increased energy, activity or irritability.
- Overconfidence and an exaggerated sense of personal greatness.
- Reduced need for sleep.
- Speech is fast-paced, making it difficult to follow the flow of thought.
- Risk of making dangerous and impulsive decisions, for example, regarding finances.
Depression
- Persistent sadness or a feeling of emptiness.
- Loss of interest in activities.
- Changes in sleep and appetite.
- Feeling guilty or unworthy.
- Thoughts of suicide or death.
Treatment Options
Medication
- Mood stabilizers (e.g., lithium, valproic acid and lamotrigine).
- Antipsychotics (e.g., aripiprazole, olanzapine, quetiapine, cariprazine).
- Antidepressants (in combination with mood stabilizers).
Psychotherapy
- Cognitive-behavioural therapy (CBT).
- Psychoeducation for the recognition and management of symptoms.
Complementary Treatments
- Physical exercise and special diet.
Hospital care
- In severe cases, temporary hospitalisation for stabilisation may be required.
Prognosis
The prognosis for bipolar disorder can be varied and depends on many factors. Although bipolar disorder is a chronic and relapsing condition, most people can live a full and productive life with proper treatment and support.
Positive Predictive Factors
- Compliance with Treatment: Regularly taking the medication and attending treatment sessions.
- Early Intervention: Early diagnosis and initiation of treatment.
- Support Network: Support from family, friends and support groups.
- Patient education: Understanding the disorder and methods to manage symptoms.
Negative Predictive Factors
- Chronic relapses: Frequent episodes of mania or depression.
- Comorbidities: Presence of other mental or physical disorders.
- Inadequate Treatment: Discontinuation of treatment or inadequate treatment approach.
- Lack of Support: Social isolation or lack of a support network.
Long-term Prognosis
- Relapse: Bipolar disorder tends to be chronic with relapses. Long-term treatment is often necessary to maintain mood stability.
- Recovery: Many patients can achieve long-term remission with appropriate treatment and support. Managing symptoms can significantly improve quality of life.
- Functionality: With proper treatment, most patients can maintain normal functionality, work, and have healthy relationships.
Continuous monitoring and adjustment of treatment are crucial to achieve the best possible prognosis for patients with bipolar disorder.
The help we can offer to patients with Bipolar Disorder in our practice involves a holistic approach that combines medication, psychotherapy and education. We are skilled in administering and monitoring medication treatments aimed at stabilizing mood. Proper medication management is critical to preventing relapse and achieving a stable mental state. The psychiatrist closely monitors our patients to adjust doses or change medications based on response, side effects and overall health.
In addition, our psychologists provide psychotherapy that has been shown to be effective for bipolar disorder, such as Cognitive Behavioural Therapy (CBT) and Interpersonal and Social Regulatory Therapy (IPSRT). CBT helps patients identify and modify negative thought and behavior patterns that may be exacerbating symptoms of the disorder. IPSRT focuses on stabilizing daily routines and social relationships, helping to reduce the effects of mood changes.
In addition, we consider it crucial to educate patients and their families about the nature of bipolar disorder, early signs of relapses and coping strategies, with the aim of achieving long-term stability and excellent quality of life.
Bibliography:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Geddes, J. R., Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet, 381(9878), 1672-1682. Miklowitz, D. J., Johnson, S. L. (2006). The psychosocial treatment of bipolar disorder. Clinical Psychology Review, 26(7), 1076-1111.