Lithium is the oldest mood stabiliser and is one of the most widely used. It works well but also has many side effects, including possible kidney damage, so for less severe cases other drugs may be preferred.
Antipsychotics do what it says on the tin. They prevent hallucinations and other symptoms of mania that stem from psychosis. They help to balance the brain's thinking mood and perception, though scientists are yet to understand why. One of their main disadvantages is that they stimulate appetite, which may lead to weight gain. I myself have struggled with this and have put on more weight than I would like. Doctors tend to downplay this side effect, maybe to avoid patients being reluctant to take the medication, but it is important to be informed in order to be able to make healthy choices.
Anticonvulsants were initially created to treat epilepsy, but were found to treat bipolar as well. There are a high amount of people with both epilepsy and bipolar, and some even believe them to be two sides of the same coin. This may be why ECT (Electro Convulsive Therapy) is so effective in extreme cases. ECT introduces an electrical current to the brain which induces a seizure similar to those in epilepsy. Despite its bad rep in the media (think: One Flew Over The Cukoo's Nest), ECT is non-violent (it is done under general anaesthetic) and is the most effective treatment, but it does have side effects like headaches and memory problems.
Talking of side effects, it is important not to read the list before taking the treatment, as this may provoke the nocebo effect, which means that you will have negative side effects because you think that you're going to have them. With ECT though, doctors are legally obliged to tell you about the possible side effects, so it's a bit of a catch 22 situation.
All this being said, medication only does 40% of the work, so let's move on to non-medicinal treatments. The main ones of these are psychoeducation, CBT, family focused therapy, mindfulness, and then of course there's having a healthy lifestyle. I'll come back to the latter two in later posts.
Psychoeducation is the name for the workshops that I'm currently doing. In fact, all of my posts so far, excepting the poetry, have been themes that we've covered. Psychoeducation involves educating and providing information to patients with mental illnesses and to their family members. Patients are given information about the causes, symptoms, prognosis, and treatments for their condition. Learners find out not only what to expect, but also what they can do or avoid to improve their condition.
CBT stands for Cognitive Behavioural Therapy. This is a type of therapy that I've experienced myself to treat depression. It involves learning to challenge and transform negative thinking and behaviour and often involves writing down negative thoughts, then writing down alternative, more positive ones. For example, if a friend who systematically wishes you Happy Birthday doesn't do so one year, instead of thinking 'They must not care about me anymore' the patient learns to think 'Maybe they have a lot going on at the moment. I should get in touch and see how they are.'
Family-focused therapy was developed especially to treat bipolar disorder. It was designed based on the theory that a person's relationship with their family is vital to the success treatingof managing their illness. In FFTs family members are included in therapy sessions in order to improve family relationships, which has been found in several studies to help stabilise the person with bipolar and prevent relapses. FFT mainly focuses on educating the family about bipolar disorder, building better communication skills in order to deal with stress, and solving problems together as a family.
Treatment of bipolar disorder is varied and a symbiosis of medical and non-medical treatment is necessary in order to best treat the illness and help the person with bipolar to achieve stability and avoid relapses.
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