Hi friends,
Bipolar disorder is a severe mental disorder characterized by phases of mania and depression, often alternating with one another.
Depression, as most of you might know, is characterized by low mood, fatigue, poor self esttem, low confidence, pessimism, sleep and appetite disturbances, decreased libido and sometimes suicidal ideation. You might want to check the section http://drsathyaprakash.blogspot.in/2016/06/depression-one-disorder-many-disguises.html
for more details.
Mania, on the other hand, is characterized by features that are opposite to that of depression, i.e., elevated mood, increased self esteem, increased confidence, big plans, unusual positivity, lack of fatigue and so on.
THE MAINSTAY OF TREATMENT OF BIPOLAR DISORDER IS MEDICATION. BUT WHAT ELSE CAN BE DONE? That is what we shall be discussing today.
First of all, the patient and the family needs to understand the nature of the illness. It is a chronic illness, and multiple episodes are usually likely. Medicines often limit the number of episodes but an occasional episode can still occur. If this does, one must not look at it in a catastrophic manner. One must accept it as a one off event. Catastrophising and stopping medicines in anger is a grave error that many families unfortunately make. It is important to take the medicines and get appropriate blood tests done regularly.
Perhaps the most important step in limiting the severity of a new episode is the ability to pick up the early warning signs. It is important to understand that in every given individual, episodes tend to always start in a particular characteristic manner. For instance in a given patient, mania might always start with decreased sleep and increased smoking. In others it might start with a tendency to stay longer at the office and have more cups of coffee. Thus, the family or friends need to be aware of this individualized early warning sign and get alert as soon as they are identified. Once an early warning sign has been identified, besides a psychiatric consultation, a number of 'first aid measures' can be instituted. This typically includes trying the opposite of what the symptoms would indicate. For instance, in mania, the patient should be insisted upon to sleep for 10-12 hours a day, avoid physical activity, rest as if he has a flu (even though the tendency to move about may be irresistible) and interact minimally with others. In depression, in contrast, the patient should be advised to sleep no more than 6 hours, stay physically active, exercise, go out and meet friends and not stay on the bed. Many a time, these simple measures significantly reduce the severity and duration of an episode.
The other important aspect of preventing a bipolar episode is to sleep 8 hours a day and to keep the sleep-wake timing reasonably constant. it is very well known that manic episodes are triggered by sleeping less; often in relation to exams, functions, parties and so on.
The patient needs to stay away from all kinds of addictive substances but particularly alcohol and cannabis in all their forms. Weed, ganja, bhang, charas, sulfa, marijuana are all forms of cannabis and needs to be completely avoided.
Finally, to the extent possible, the patient should have a relatively predictable and consistent lifestyle. Marked variations in interpersonal ties (from meeting nobody for days to meeting a lot of people one fine day) should in general be avoided.
So that was about living with bipolar disorder friends, hope you found it useful!
Please let me know if there is any specific issue that you want me to address. Write in at stayhappy.prakash@gmail.com
So until next time, STAY HAPPY!
Dr. Sathya Prakash, MD, Dip. CBT
Consultant Psychiatrist, Psychotherapist and Behavioural Sciences Expert
