Treating Severe Manic Depression
Manic Depression is an old term for what is now called Bipolar Disorder. Presently there is no cure for bipolar disorder, but with proper treatment most people with bipolar disorder can get control of their mood swings and live a comfortable life. This is also true for people with the most severe forms of Bipolar Disorder, though long-term treatment will be needed to maintain control of symptoms. The most effective treatment plan includes medication and psychotherapy for preventing relapse and reducing the severity of symptoms.
Treating severe manic depression is best done by someone with extensive experience in using medications to treat mental illness. This person is a Medical Doctor (M.D.) and in treating severe manic depression it is usually a Psychiatrist (also known as a Psychopharmacologist). In treating severe manic depression not everyone responds to medications in the same way, so several different medications may need to be tried before the best course of treatment is found. Throughout the process of treating severe manic depression, if a person’s symptoms change or if side effects become serious, the doctor may switch or add medications.
Some of the types of medications generally used in treating severe manic depression include mood-stabilizing medications, neuroleptics and anti-depressants. Often the first choice in treating severe manic depression is to use a mood-stabilizing medication. These include but are not limited to: Valproic Acid or Divalproex Sodium (Depakote), Lamotrigine (Lamictal), Gabapentin (Neurontin), Topiramate (Topamax), Oxcarbazepine (Trileptal) and Lithium (sometimes known as Eskalith or Lithobid). All of these except Lithium are anticonvulsants. Anticonvulsant medications are usually used to treat seizures, but they also help in treating severe manic depression.
Another class of medications sometimes used in treating severe manic depression is the neuroleptics. Olanzapine (Zyprexa), Aripiprazole (Abilify), Quetiapine (Seroquel), Risperidone (Risperdal) and Ziprasidone (Geodon) are some of the neuroleptics that may be prescribed for treating severe manic depression.
Additionally, antidepressant medications are sometimes used in treating severe manic depression, particularly the depressive symptoms found with it. However, in treating severe manic depression, people who take antidepressants are often placed on a mood stabilizer too. The reason for this in treating severe manic depression is that taking only an antidepressant can increase a person’s risk of switching to mania or hypomania, or of developing rapid cycling symptoms. However, for many people in treating severe manic depression, adding an antidepressant to a mood stabilizer is no more effective in treating the depression than using only a mood stabilizer.
In treating severe manic depression we at Proliance Center take into consideration that individuals may have trouble sleeping and will usually sleep better after getting treatment for their bipolar disorder. However, if the sleeplessness does not improve, we may suggest a change in medications, or if the problem still continues, we may prescribe sedatives or other sleep medications.
In treating severe manic depression those taking medications for bipolar disorder should be closely monitored for new or worsening symptoms of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior. Additionally, those individuals should not make any changes in the medications or take any herbal or natural supplements without talking to the prescribing doctor. The reason for this is because of the serious risk of interactions with other medications.
In addition to medication, psychotherapy, or “talk” therapy, can be effective in treating severe manic depression at Proliance Center. This is important in providing support, education, and guidance to people with bipolar disorder and their families. There are several different psychotherapies that are helpful in treating severe manic depression. These include Cognitive Behavioral Therapy (CBT), Family-Focused Therapy, Interpersonal Therapy, Social Rhythm Therapy, and Psychoeducation.
In treating severe manic depression it is important to keep in mind that people with bipolar disorder often have thyroid gland problems. For this reason in treating severe manic depression it is important to have a doctor check thyroid levels carefully. This is because too much or too little thyroid hormone can lead to mood and energy changes. As a result, in order to keep thyroid levels balanced a person with bipolar disorder may need to take thyroid medication in addition to medications for bipolar disorder.
Finally, for cases in which medication and/or psychotherapy do not work in treating severe manic depression, electroconvulsive therapy (ECT) may be useful. ECT, formerly known as “shock therapy,” once had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe bipolar disorder who have not been able to feel better with other treatments.