Introduction. Treatment options for Bipolar I and II disorder
Bipolar I disorder exhibits dangerous manic episodes, while bipolar II affects the sufferers mosty due to prolonged periods of depression. Untreated bipolar disorder, regardless I or II, leads to significant social and professional impairments.
Bipolar disorder, is treated with medications and psychotherapy. However, the first line treatment option for BP disorder is medication. The psychotherapy and the adjustment of the life style as well as the family support play important however the secondary role.
Treatment of BD with medication
Medication types and dosages depend on the specific symptoms. The treatment for Bipolar I or Bipolar II, may involve:
- Mood stabilizers like lithium, valproate, lamotrigine or carbamazepine. The mood stabilizers control mood swings. While lithium and lamotrigine protect the patient from manic as well as depressive swings, valproate and carbamazepine are effective only towards mania and hypomania.
- Antipsychotics such as olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, lurasidone, can be prescribed alone or in combination with mood stabilizers.
- Antidepressants may be added to manage the bipolar depression. They need to be used alongside mood stabilizers or antipsychotics to prevent triggering manic episodes. Only quetiapine is approved for the treatment of bipolar depression.
Additional treatment options for Bipolar Disorder I and II
- The psychiatric outpatient treatment is a long-term program highly beneficial to stabilize bipolar patients protecting them from relapses.
- In some cases, especially by patients affected by acute mania hospitalization is the only way to provide treatment in a safe environment.
- Psychotherapy, like CBT (Cognitive Behavioral Therapy) helps to identify and replace negative beliefs and behaviours. Social rhythm therapy establishes a consistent routine for better mood management.
- Dependency is often a psychiatric comorbidity coming along with Bipolar Disorder. Substance abuse worsen mania and depression. The psychotherapy for bipolar disorder with comorbid dependence requires comprehensive treatment involving psychiatric treatment, psychotherapy, support groups and family.
- Under the condition of high grade of compliance combined with psychiatric monitoring, psychotherapy, and by establishing daily routine bipolar patient can live normal and successful live.
- Self-management strategies involve maintaining a healthy lifestyle: sufficient sleep, a balanced diet, and regular physical activities.
Therapeutic alliance in the treatment for BD
The central role in the treatment for bipolar disorder plays the therapeutic alliance with the psychiatrist and the psychologist. The regular psychiatric consultations are essential to evaluate progress and to make necessary adjustments of the medication. Treatment with medication for bipolar disorder requires regular laboratory monitoring and controls of ECGs to avoid side effects.