Bipolar Disorder Treatment

Do you experience changes in mood, thoughts, energy and behavior that is different than how you normally feel?

Do you ever feel invincible, like you have boundless energy, productivity and creativity? Then all of a sudden, you’re drowning in depression. You can't get up in the morning and you feel like life isn't worth living.

man sitting on a rock looking sullen

You have racing, running thoughts like your mind won’t turn off.

You may think you have special powers, are exceptional or that you are “the chosen one”

You can be awake for days, not feeling the need for sleep.

Others notice that you make plans that are grandiose or unrealistic

Other people tell you that you talking really fast and jumping from one idea to another. People cannot keep up with your train of thought.

Engage in reckless, sometimes dangerous behavior

Other people notice your bizarre behavior but you don’t seem to have insight into it because at the time you are detached from reality.

You feel better than you ever have and are reluctant to take medication because you don’t want the feeling to go away.

When you crash into a depressive episode it’s like you just want to be left alone and hide.

You don’t want to go anywhere, see anyone, or do anything. You want everyone to go away. 

It feels like a deadening lethargy coupled with an agitation and restlessness. 

You are irritable, angry, frightened, desperate and bleak. It’s the sense of having no energy, no interest, no passion, no life….

You feel like you’re either some lunatic running around full of adrenaline or some mopey, lazy slug.

Mood Disorders are among the most common of all mental health problems. 

Mood disorders affect a person's everyday emotional state. Nearly one in ten people aged 18 and older have a mood disorder. Mood disorders are characterized by elevated mood, such as mania or hypomania; depressed mood such as Major Depressive Disorder (MDD); and moods which cycle between mania and depression, known as Bipolar Disorder. There are several sub-types of mood disorders featuring less severe symptoms such as Persistent Depressive Disorder and Cyclothymia.

Mood Disorders are treatable and people often respond well to therapies, usually in a relatively short time period. 

 

Bipolar Disorder

This is a disorder associated with episodes of mood swings ranging from depressive lows to manic highs. Bipolar disorder can be extremely distressing and disruptive for those who have this disease, their spouses, family members, friends and employers. Symptoms are individual-based and mood shifts may occur as frequently as several times a day or as rarely as a couple times a year. Although there is no known cure, bipolar disorder is treatable, and recovery is possible. Individuals with bipolar disorder have successful relationships and meaningful jobs. The combination of medications and psychotherapy helps the vast majority of people return to productive, fulfilling lives.

Bipolar I

The essential feature of Bipolar I Disorder is a clinical course that is characterized by the occurrence of one or more Manic or Mixed Episodes. Often individuals have also had one or more Major Depressive Episodes.

Bipolar II

Similar to Bipolar I Disorder, with moods cycling between high and low, in Bipolar II Disorder, the elevated moods never reach full-on mania. Bipolar II is characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for Bipolar II Disorder requires that the individual must never have experienced a full manic episode.

Rapid Cycling

In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. 

Mixed Bipolar

In most forms of bipolar disorder, moods alternate between elevated and depressed over time. But with mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence.

Cyclothymia

Cyclothymia (Cyclothymic Disorder) is a relatively mild mood disorder. Cyclothymia is considered to be a more chronic but milder form of bipolar disorder. For cyclothymic symptoms to be diagnosed, hypomanic symptoms and depressive symptoms must be present alternately for at least two years.

Persistent Depressive Disorder (formerly Dysthymic Disorder)

Persistent Depressive Disorder experienced as a less severe but more chronic form of major depression. Symptoms usually last for at least two years, and often for much longer than that, and interferes with your ability to function and enjoy life. 

Symptoms of mania

The symptoms of mania, which can last up to three months if untreated, include:

  • Excessive energy, activity, restlessness, racing thoughts and rapid talking

  • Extreme “high” or euphoric feelings -- a person may feel “on top of the world”

  • Easily irritated or distracted

  • Decreased need for sleep – an individual may last for days with little or no sleep without feeling tired

  • Unrealistic beliefs in one’s ability and powers -- a person may experience feelings of exaggerated confidence or unwarranted optimism. This can lead to over ambitious work plans and the belief that nothing can stop him or her from accomplishing any task

  • Poor judgment -- a person may make poor decisions which may lead to unrealistic involvement in activities, meetings and deadlines, reckless driving, spending sprees and foolish business ventures.

  • Sustained period of behavior that is different from usual -- a person may dress and/or act differently than he or she usually does, become a collector of various items, become indifferent to personal grooming, become obsessed with writing, or experience delusions.

  • Unusual sexual drive

  • Abuse of drugs, particularly cocaine, alcohol or sleeping medications

  • Provocative, intrusive, or aggressive behavior -- a person may become enraged or paranoid if his or her grand ideas are stopped or excessive social plans are refused.

Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. 

black and white photo of a man darkened out

We can help restore your ability to function

Psychotherapy, also known as psychological therapy or talk therapy, is an effective treatment for people with mood disorders. It involves meeting with a therapist on a regular basis to talk about your condition and related issues. Psychotherapy can help you:

  • adjust to a crisis or other stressful event

  • discuss your feelings and fears with someone who will not judge you

  • replace negative beliefs and behaviors with positive healthy ones

  • improve your communication skills

  • learn to anticipate, manage and possibly prevent relapses

  • increase your self-esteem and self confidence

  • regain a sense of balance and control in your life

Cognitive-behavioral therapy (CBT) is highly effective and commonly used alone or in combination with medication for the effective treatment of depression. CBT helps people find new ways of dealing with negative thoughts and behaviors and helps them become more aware of how their beliefs or actions are contributing to their mental illness.  Essentially, it helps a person restructure the underlying belief systems that drive destructive thinking patterns.

Your treatment plan for a mood disorder will depend on several factors: Are you willing to take medication, engage in therapy or try alternative methods? Depending on the severity and type of mood disorder, you may have no choice but to take medication to manage your symptoms. Make sure you have ruled out a medical condition or current medication that you are taking that might be causing symptoms.

The most efficacious treatment combines medication with psychotherapy.  Typically, treatment entails a combination of at least one mood-stabilizing drug and/or atypical antipsychotic, plus psychotherapy. The most widely used drugs for the treatment of bipolar disorder include lithium carbonate and valproic acid (also known as Depakote).  You will have to see how your body responds to the medication that your doctor prescribes and whether or not you can tolerate any side effects. Not all treatments will work for everyone.  Common treatments of mood disorders include:

  • Mood stabilizers and/or Antipsychotic medications if indicated to treat disordered thought patterns and altered perceptions

  • Hospitalization for coexisting medical problems, serious complications, severe disorders, or substance abuse

  • Identification and treatment of coexisting conditions

  • Individual psychotherapy

  • Group therapy

Bipolar or Depression Support Groups can be a great way to engage with other people who may be dealing with similar situations. Here you can share and listen to other people's experiences and struggles in a way that helps reduce isolation and loneliness. 

And finally, keep in mind the importance of lifestyle changes to effectively help stabilize mood, such as:

  • A strict sleep schedule and good sleep hygiene

  • A daily routine

  • Exercise

  • Mindfulness meditation or relaxation techniques

The outcome of treatment is determined by several factors, including the severity of diagnosis, level of functioning prior to onset of symptoms, degree of motivation for treatment, level of social or family support and one's ability to comply with medication and/or psychotherapeutic regimen. With proper treatment, people with mood disorders are living full, healthy, and productive lives. 

Treatment adherence is vital to managing this disorder

 

You may be ready to take the next step toward counseling, but still have some questions or concerns…

Can’t I just take medication for my Bipolar? Why do I need therapy?

Successful treatment of bipolar disorder depends on a combination of medication, therapy, and lifestyle modification. Medication alone is not enough. In order to get the most out of treatment, it's important to communicate with your psychiatrist and therapists, have a strong support system and adhere to your treatment plan. A therapist can help you with understanding the trajectory of the illness and educate you on what you can expect with the highs and lows. A therapist will teach you how to cope with difficult feelings and emotions, and help you to better regulate your moods and stress levels. You will learn how to closely monitor your moods, sleeping patterns, energy level, and thoughts, thereby attenuating or preventing a full blown manic or depressive episode.

I’m not sure I need help. I’ll just give it time and it should resolve on its own.

For most people, symptoms do not resolve on their own. Sometimes, due to the gradual onset of symptoms, you lose perspective, and you don't realize that what you're experiencing is abnormal. Someone else has to tell you that your behavior is unbalanced. Sometimes you want to just "wait it out," and you don't get help because you don’t want people knowing that you have a mental illness or because you’re too depressed and lethargic to get out of bed. In the case of mania, you don’t seek help because you enjoy the euphoric feeling of being invincible. Until it gets you into trouble. Unlike normal stress and sadness, the symptoms of mood disorders persist and do not go away no matter how much the individual desires. Most people benefit from counseling as a way to better understand their mental illness and from learning to manage their symptoms and the course of their illness. Seeking professional help in terms of medication management or psychotherapy, in addition to lifestyle changes provides the most effective way to manage mood disorders. In some cases, mood disorders can be life threatening. 

Always seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Being a danger to yourself or others, including threatening, irrational or suicidal behavior

  • Feelings of wanting to die

  • Hearing voices or seeing things that do not exist

  • Inability to care for your basic needs

I’ve tried counseling before and it didn’t work for me.

There are many variables that can affect the success of counseling. One of the most important factors is the fit between the therapist and the client and how comfortable the client is with him/her. Other factors include the therapist’s experience and training in a particular area, realistic goals, length of therapy, motivation level and commitment of the client.  When seeing a new therapist make sure you share with them what you liked and didn’t like about your previous counseling experience. Most therapists are trained and experienced in a variety of different counseling approaches and styles, and can adapt to your personal needs.  The important thing is to communicate to your therapist if you feel like you are not progressing as you expected. And if the relationship is simply not working, the therapist will be happy to refer you to someone else.

I can help you reduce your symptoms and live the life you’ve always wanted. I encourage you to contact me here or by phone: 904-543-6055 to schedule an appointment or free 15-minute consultation. Your inquiries will always remain confidential, and I return calls within 24 hours, usually sooner!