Bipolar disorder 101: Current treatment recommendations

Tuesday, March 13, 2012

Early treatment intervention, including mood stabilizing medication and therapy, is critical for people with bipolar disorder, say mental health professionals, both for the safety of themselves and others.

"Treatment makes a huge difference. It could mean the difference between life and death for people with bipolar disorder and whether they can function in life or not," says Edythe Harvey, MD, medical director of The Menninger Clinic's Hope Program for Adults. Left untreated she says erratic and impulsive manic behavior—for example, driving 100 miles per hour in a school zone—puts both the person with bipolar disorder, and the public, at risk.


People with bipolar disorder are often reluctant to seek help because they feel euphoric and productive, Dr. Harvey says. Because they feel so good, they rarely contemplate suicide in the manic phase, but are more likely to consider it when depressed. A recent study published in the Journal of Affective Disorders found that patients who didn't start taking mood stabilizers for five years or more after they first showed signs of bipolar disorder had increased risk for suicide attempts.


Since lithium was introduced in 1971, mood-stabilizing medications have been the treatment of choice for bipolar disorder. When coupled with antipsychotic medications, "they work very well to help stabilize the moods of individuals with bipolar disorder," Dr. Harvey says. Anti-seizure medications also have had some success in the treatment of bipolar disorder.


In accompanying talk therapy, Dr. Harvey explains individuals learn how to manage their medications, keep their moods stable by recognizing signals to changing cycles and function well in daily life and in relationships. Treatment can be on an outpatient or inpatient basis, depending on the severity of the bipolar disorder.