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What is Bipolar Disorder – ARSMEDica

Treatment

The symptoms of bipolar disorder usually disappear with the right complex treatment: pharmacotherapy + psychotherapy. Medication selection ( psychopharmacotherapy ) is the cornerstone of treatment for bipolar disorder, but psychotherapy is also an important component of treatment, as can help many patients learn about their disease and adhere to medication, increase stress resistance, get rid of concomitant neurotic disorders, as a result, preventing the onset of attacks of mania or depression.

Pharmacotherapy is divided into relief (aimed at current symptoms of mania/depression) and anti-relapse or prophylactic, which is aimed at maintaining euthymia – a normal stable mood.

Medications known as mood stabilizers or “mood stabilizers” (such as lithium or valproic acid) are the most commonly prescribed type of medication for bipolar disorder. These drugs are believed to correct imbalanced signaling in the brain. Because bipolar disorder is a chronic condition in which mood episodes tend to recur, long-term prophylactic treatment is recommended. The choice of treatment for bipolar disorder is individual; people with bipolar disorder may need to be prescribed different types of medications before finding the one that works best for them.

Since bipolar disorder can cause serious disruption in a person’s daily life and create a stressful family situation, family members can also benefit from psychoeducation and psychotherapy, where they learn more about this disorder, learn how to properly support their loved one, and notice signs of the development of the disease. .

Treatment for cyclothymic disorder may include medication and psychotherapy. For many people with cyclothymia, psychotherapy can help manage the stress associated with mood swings. Keeping a mood journal can be an effective way to keep track of patterns in these mood swings.

Some aspects I would like to demonstrate on the example of one representative case …

Clinical case

(all details changed for confidentiality) short sleep, a feeling of longing, thoughts about the meaninglessness of life . At the reception, the sad eyes of the patient attracted attention, she answered questions after pauses, briefly, during the whole conversation she never smiled. Guilt and pessimism slipped through her story, about her favorite profession – teaching a foreign language, she almost did not talk about her interests, since, according to0003 “lost interest “.

The girl said that a year ago she already had a similar condition, in connection with which she turned to a psychologist who recommended that she go to a psychiatrist privately, who, after a clinical interview, diagnosed “a depressive episode” the psychiatrist prescribed an antidepressant, after taking which, after 5 days, the patient felt worse: anxiety, irritability arose, she began to experience anger towards loved ones, in connection with which she stopped taking the antidepersant on her own, the patient and her mother decided not to go to the doctor anymore, and the state of “agitation » were treated independently, with valerian and novopassitis. After 1.5 months, the condition as a whole stabilized and the patient decided that it was “such a period”, “crisis”. She went back to work and tried to forget everything.

However, after almost a year, the depression returned. Fearing that she might lose her job at the online language school due to worsening depression, the patient went to the doctor.

In her story, I was immediately alerted by her reaction to taking the antidepressant . The fact is that in case of bipolar disorder against the background of taking antidepressants, the so-called “inversion of affect” may occur, that is, the phase of depression can abruptly change to the opposite, manic, which is also manifested by irritability, anger, manifestations of aggression. So I began to ask carefully about the life of my patient prior to the development of depression. It turned out that when she graduated from high school, at the age of 23, she had a period of about a week when she hardly slept, but she had the strength, everything worked out, foreign words were easy to remember, she talked about it like this “doctor, it seemed to me that I then grew wings . .. my friends asked if I used something because I was too active.

The patient had a history of a hypomanic episode prior to two depressive episodes and was eventually diagnosed with bipolar type 2 disorder at the first meeting. In accordance with the recommendations, for bipolar disorder type 2, not antidepressants, but mood stabilizers (!) are prescribed, therefore, the drug lamotrigine and a short course of a tranquilizer to normalize sleep were chosen, and psychotherapy was recommended. By the fourth session of psychotherapy, when the patient had already learned about her diagnosis and started taking normotimic, we made a diary of her mood, identified and began to work on dysfunctional thoughts characteristic of depression, for example “I won’t succeed”, “everything will only get worse” – her condition improved significantly: she became more active, her sleep improved, she began to smile occasionally, there were no problems with work. Depression began to go away…

This clinical case is not about how exactly I made the correct diagnosis, while another doctor did not, but about the importance of differential diagnosis, timely access to a specialist (the psychologist recognized in time the need to refer the client for a consultation with a doctor). If the patient had told the doctor about her reaction to the antidepressant, perhaps a year ago she would have been diagnosed with bipolar disorder. It is also a story about the inadmissibility of self-treatment and the importance of psychoeducation and psychotherapy, even with selected psychopharmacotherapy.

I hope this review article will be useful to you.

What is psychoeducation and how can it help in the treatment of bipolar disorder? | mental health articles | Emotional & Mental Health center

A diagnosis of bipolar disorder can be both scary and difficult to navigate. Psychoeducation aims to equip patients and their loved ones with the necessary information and coping skills.

Bipolar disorder is complex, chronic, stigmatizing and potentially damaging. Even though many people have already gone through several mood episodes – mania, hypomania, and depression – by the time they finally get a proper diagnosis, bipolar disorder remains a frightening label to come to terms with. This is true not only for people who live with bipolar disorder, but also for their loved ones.

Bipolar disorder can be successfully treated by allowing those who have it to live full and productive lives, but just think about medication for the rest of their lives, therapy, and how to make lifestyle changes that will help you keep your mood stable can be incredibly scary.

That is, more or less, where psychoeducation comes in.

So, what is psychoeducation?

Armed with knowledge and coping skills, we are ready for success. This is true for everything we want to do or have in our lives, and medical conditions are no different. That’s what psychoeducation is for. Currently, psychoeducation is an integral part of the treatment of many chronic mental disorders and helps people with chronic physical conditions, which can also have a profound psychological impact.

Psychoeducation programs can be offered by various professionals, usually psychologists, psychiatrists, and even people who specialize in psychoeducation, in group settings or individually. This very often includes the most important people in the patient’s life, as well as partners, children, and (especially when the patient is a minor) parents and siblings.

What things will you learn in psychoeducation for people living with bipolar disorder and their families?

While each program is unique, the main components of psychoeducation that you can definitely immerse yourself in while attending a psychoeducation program for people with bipolar disorder and their families include:

• Basic and more detailed information about the type of bipolar disorder you have been diagnosed. This may include causes, symptoms (including early warning signs indicating an impending manic, hypomanic, or depressive episode), and risk factors.
• Review of management strategies that have been shown to help people with bipolar disorder maximize their quality of life, including medication, talk therapy, and lifestyle changes. This will include information about the importance of sticking to your medications even if you feel better and what can happen if you don’t.
• Learn how to manage your mood, how to communicate more effectively with your family, and how to know when you need extra help.
• To equip people with bipolar disorder with the knowledge and skills they need to defend themselves effectively and families with the skills they need to stand up for their loved one. Things like building an effective mental health team or for parents to make sure their child with bipolar disorder meets their school needs fall into this category. Information about how to access the services you need is also part of the process.

How useful is psychoeducation for bipolar disorder, really?

Psychoeducation is really very useful for people with bipolar disorder and their loved ones.

Research has shown that when patients learn to understand their diagnosis, psychoeducation programs have an almost immediate positive impact on their self-esteem and are very helpful in minimizing the impact of bipolar disorder stigma on their well-being.

In the long term, completing a psychoeducation program means that patients are more likely to take their prescribed medications as recommended (even when they feel better, i.e. when many are tempted to stop smoking because they think the medications are more for them Not needed). People living with bipolar disorder who have received psychoeducation are less likely to need hospitalization.

Ideally, psychoeducation is an ongoing aspect of treatment that transforms people diagnosed with bipolar disorder from passive patients who are “made for them” into active advocates who understand the nature of their bipolar disorder, their treatment options. and how to get them.

Relatives, meanwhile, can also benefit greatly. Instead of being in the dark about bipolar disorder, its management, and the best way to communicate with your loved one about bipolar issues, you will be equipped and empowered.

For parents of underage children with bipolar disorder, this can make the difference between severely damaging your mental health when you’re desperately trying to figure out how to meet your child’s needs and knowing exactly how to cope and get the help you need.