Bipolar disorder, also known as manic-depressive psychosis, is a mental illness characterized by atypical mood changes, energy swings and the ability to function. Unlike normal mood changes, with their ups and downs that are common to everyone, the symptoms of bipolar disorder can lead to very serious consequences. They are able to destroy personal relationships, affect the quality of work or school performance, and even lead to suicide. Fortunately for us, bipolar disorder still gives in to treatment, and patients with this disease are able to lead a full and productive life.
Every year1 about 5.7 million adult Americans, or 2.6% of the population aged 18 and over, are diagnosed with “bipolar disorder.” Bipolar disorder is usually manifested in late adolescence or in early adulthood. However, in some cases, the first symptoms appear already in childhood, and in others – the symptomatology is revealed only at later stages of life. Quite often bipolar disorder can not be diagnosed, and people have to suffer for years before they are properly diagnosed and begin the necessary course of treatment. As well as diabetes or cardiovascular diseases, bipolar disorder is a chronic disease that must be closely monitored throughout life.
“Manic depression breaks the normal course of moods and thoughts, provokes inadequate behavior, undermines the foundations of rational thinking and quite often destroys the will and will to live. This disease, organic by its nature, in practice proceeds as a psychological disorder; it is unique in its ability to enthrall and bring pleasure, but the consequences of it bring unbearable suffering and often lead to suicide.
“I am happy that I managed to avoid death from this disease, I am happy that I was able to get the best medical help, as possible, I am happy that I have such friends, colleagues and, of course, my family.”
Kay Redfield Jamison, Ph.D. An Unquiet Mind, 1995, p. 6. (Published with permission of the publishing house “Alfred A. Knopf”, branch “Random House, Inc.”).
Symptoms of bipolar disorder
Bipolar disorder is the cause of a sudden change of mood – from extremely excited and / or irritable, to minor and hopelessly helpless, with a subsequent return to the original state and often with periods of normal mood in between. Such alternations of moods are often accompanied by significant changes in energy and behavior. The periods of the excited state and the passive state are called “episodes of mania and depression.”
Signs and symptoms of mania (or manic episode):
- Increased energy, activity and anxiety
- Incredible excitement, overly elated, euphoric mood
- Increased irritability
- The confusion of thoughts and the rapid pace of conversation, jumping from one idea to another
- Distraction, inability to concentrate
- Decreased need for sleep
- Unreasonable confidence in their own abilities and abilities.
- Inadequate assessment of the situation
- Wastefulness, wretchedness
- A long period when behavior is very different from normal
- Increased sexual activity
- Drug use, especially cocaine, alcohol and drugs for insomnia
- Provocative, intrusive or aggressive behavior
- Denial of the fact that something is wrong
A manic episode becomes a diagnosis if an excited condition, accompanied by three or more symptoms, lasts for most of the day, almost every day for a week or longer. For the final diagnosis of irritation, four additional symptoms are necessary.
Signs and symptoms of depression (or depressive episode):
- A prolonged state of sadness, anxiety or emptiness.
- Feeling of hopelessness or pessimism.
- Feeling guilty, feeling worthless or helpless.
- Loss of interest or pleasure from activities that used to be fun, including sex.
- A lowered level of energy, a feeling of constant fatigue or “inhibition”.
- Problems with concentration, difficulties with memorization or decision making.
- Anxiety or irritability.
- Increased drowsiness or insomnia.
- Changes in appetite or / and unintended loss or weight gain.
- Chronic pain or other persistent symptoms of poor health, not a result of physical illness or injury.
- Thoughts of death or suicide, suicide attempts.
A depressive episode becomes a diagnosis if five or more symptoms manifest themselves throughout most of the day, almost every day for two or more weeks.
Hypomania is a weakened or moderately mild form of mania. A patient with signs of hypomania is able to feel good and even feel satisfaction from his own increased productivity and efficiency. Therefore, even if a family or friends are able to recognize that a bipolar disorder may be hidden behind a mood change, then the patient himself does not consider his condition abnormal. However, in the absence of proper treatment, hypomania is able to move into a heavier form of mania, and in some individuals may end with depression.
In some cases, a severe form of mania or depression is accompanied by symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are hallucinations (sound, visual or other sensations of the presence of things, which are not really present at the moment) and delusions (distorted, unconditionally believed representations that are not based on any logical grounds and are not based on a person’s cultural experience). In bipolar disorder, psychotic symptoms tend to reflect the extreme condition of the patient at a given time. For example, in the manic phase, delirium can be observed when a person is sure that he / she is a president or a person with power or wealth. During the period of depression, there can be delusions of guilt or worthlessness, when a person is convinced of his economic collapse and lack of money, or committing a serious crime. With this symptomatology, patients suffering from bipolar disorder can erroneously diagnose schizophrenia – another severe mental illness. The phases of bipolar disorder can be imagined in the form of a spectrum or a continuous scale. At one end of this scale – a severe form of depression, above it is a depression of moderate severity. Then follows the state of depression, which, in case of its short duration, many are called “melancholy”, but which is professionally defined as “dysthymia” if it becomes chronic.
Then comes a normal or balanced mood, followed by hypomania (a weak or moderate-moderate form of mania), and at the end – a severe form of mania.
However, in some patients, the symptoms of mania and depression can be observed simultaneously. This condition is called mixed bipolar disorder. With this type of bipolar disorder, the symptomatology often includes excitement, sleep disturbance, significant changes in appetite, psychosis, suicidal thoughts.
The patient is in a state of sadness and hopelessness, but at the same time feels an extraordinary burst of energy.
Bipolar disorder is not always associated with a mental illness, its causes can be the abuse of alcohol or drugs, poor academic progress or failures at work, strained personal relationships. All these problems, in fact, can be signs of a latent illness of disturbed mood.
Diagnosis of bipolar disorder
Like other mental illnesses, bipolar disorder can not be diagnosed with the help of physiological research methods, such as, for example, a blood test or a brain scan. Thus, the diagnosis of bipolar disorder is made on the basis of a symptomatic picture, a medical history and, if possible, a family history. The criteria for diagnosing bipolar disorder are described in the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders, fourth edition, DSM-IV.
Evidence from patients with bipolar disorder is a valuable source for understanding the various phases of mood swings associated with the disease:
Depression: “I absolutely do not believe in my ability to do anything right. It feels like the course of my thoughts is slowing down and slowing down until eventually it comes to a state of total stupor … [It] haunts … a feeling of complete, desperate helplessness from all this … Someone says it’s , they say, a temporary phenomenon, it will pass and you will get better, but they certainly do not have the faintest idea of what I feel, although they flatter themselves with hope. If I can not feel, move, think or want, then why do I need all this? ”
Hypomania: “At first, when I’m excited, it’s amazing … ideas flicker one by one … as if watching the falling stars in anticipation of seeing the brightest … Shyness removes the hand, the right words and the necessary gestures are right there … uninteresting people and events suddenly acquire an incredible interest. You are overcome by irresistible desires, you want to be seduced and be seduced … You are full of feeling of lightness, strength, omnipotence, euphoria … you are capable of doing anything … but at one point it all ends … ”
Mania: “Thoughts flicker somehow too quickly and they become too much … the clarity of thoughts is replaced by a state of complete loss … you are unable to follow all this, begins to change memory … Your poisonous humor ceases to amuse. It becomes scary for friends … and you do not like everything yourself … everything literally annoys, angers, frightens you, you become uncontrollable and you feel trapped. ”
Some patients with bipolar disorder are susceptible to suicide. Any person who thinks about suicide, needs immediate help, preferably a psychiatrist or a therapist. It is necessary to take seriously any person who speaks of suicide. The risk of suicide is much higher in the early stages of the disease. Thus, early diagnosis of bipolar disorder and the definition of effective methods of its treatment can reduce the risk of death from suicide.
The signs and symptoms of suicidal intent:
- talk about suicidal intent or desire for death
- feeling hopeless; feeling that nothing will ever change and it will not get better
- feeling helpless: whatever a person does, nothing can help
- feeling like a burden to family and friends
- alcohol or drug abuse
- bringing affairs to order (putting in order finances, distribution of personal property, ie preparation for death)
- posthumous memorial
- the desire to be in danger, to fall into situations in which there is a likelihood of dying
If you have suicidal intentions or you know someone who is in this condition:
- immediately call a doctor, an ambulance, or “911” for emergency treatment
- Do not stay alone or leave a person with suicidal intentions of one
- make sure that there is no access to medicines, weapons or other things that can be used for self-harm
In some cases, suicide is planned thoroughly and in advance, while in others it is an impulsive and ill-conceived act. In any case, the measures proposed in the previous paragraph can be a long-term strategy for patients suffering from bipolar disorder. It should be remembered that suicidal intentions and suicide attempts are symptoms of a disease that can be treated. With proper treatment, you can get rid of suicidal intentions.
How is bipolar disorder?
Episodes of mania and depression usually repeat throughout life. In the intervals between the episodes, most patients with bipolar disorder do not have symptoms, however, about a third of patients have residual symptoms. A small proportion of patients experience chronic continuous bipolar disorder symptoms despite treatment.3
The classical form of this disease, in which episodes of mania and depression regularly recur, was called type I bipolar disorder. Some patients do not have a severe form of mania, but there are mild episodes of hypomania, alternating with depression.
This type of bipolar disorder is called type II bipolar disorder. If within a period of twelve months the patient has four or more episodes, then they speak of a rapidly circulating bipolar disorder. In some patients, episodes are repeated repeatedly for one week or even one day. Rapidly circulating bipolar disorder usually develops at a late stage of the disease and is more common in women than in men.
In case of effective treatment, patients with bipolar disorder are able to live a healthy and productive life. However, without treatment, the natural course of the disease tends to deteriorate. Over time, episodes of mania and depression in the patient become more frequent (faster circulation) and become more severe than at an early stage of the disease.4 But in most cases, proper treatment can reduce the frequency and severity of episodes and help patients with bipolar disorder live a full and happy life.
Is there bipolar disorder in children and adolescents?
Bipolar disorder can be in children and adolescents. Children at greatest risk are those whose parents suffer from this disease.
Unlike adult patients with bipolar disorder, whose episodes are quite clearly delineated, children and adolescents with this disease have an incredibly fast mood change from depression to mania, several times a day. 5 In children, mania often manifests itself in irritability and outbursts of anger, and not in euphoria and excitement, as in adults. Mixed symptoms are also quite common in young people with bipolar disorder. Those who are ill in late adolescence, episodes and symptoms are more classic, inherent in adults, the character.
In children and adolescents, it is difficult to distinguish bipolar disorder from other problems that may occur in this age group. For example, irritability and aggressiveness are characteristic of bipolar disorder, but at the same time they may be symptoms of attention deficit hyperactivity disorder, behavioral disorder, opposition-causing disorders, or other types of serious mental illness more characteristic of adults, such as depression or schizophrenia. Drug abuse also provokes such symptoms.
However, with any disease, the key to success depends on the correct diagnosis. Children and adolescents with emotional or behavioral problems should be checked by a psychiatrist. To every child or adolescent with suicidal tendencies that speaks of suicide or attempts to commit suicide, one must be taken very seriously and immediately provide him / her with professional help from a psychiatrist or psychologist.
Causes of bipolar disorder
On the example of numerous studies, scientists are trying to understand the causes of bipolar disorder. At present, most of them have come to the conclusion that bipolar disorder does not have one single reason. Most likely, many factors play a role here.
Because bipolar disorder tends to repeat in the family, scientists are trying to detect specific genes (microscopic “building blocks” of DNA inside each cell, responsible for the development and growth of the body and psyche) transmitted from generation to generation that can increase the chance of the disease. However, it’s not just the genes. The study of identical twins, having an identical genetic structure, shows that both genes and other factors play an important role in the onset of bipolar disorder. If the cause of bipolar disorder was only in the genetic code, then in the case of a twin disease, the second twin would also always be sick. However, the results of the studies indicate otherwise. Although, if one of the twins develops a bipolar disorder, the chances of a twin from another twin are much higher than those of other siblings.
In addition, it should be noted that the results of genetic studies show that the cause of bipolar disorder, like any other mental illness, is not in one single gene. 7 Apparently, bipolar disorder is the result of joint actions of numerous genes in combination with other individual human factors and environmental factors. Discover these genes, each of which makes its small contribution to the development of predisposition to bipolar disorder, is extremely difficult. But scientists hope that the recently introduced new research methodologies will open this mystery and lead to the development of more effective treatment of bipolar disorder.
Studies of the brain with the use of its images help scientists understand what disruptions in brain activity provoke the development of bipolar disorder and other mental illnesses. 8.9 New technologies allow scientists to obtain images of a live working brain, thus enabling them to study its structure and activity without the need for surgical or any other intervention. These technologies include a magnetic resonance imaging (MRI), positron emission tomography (PET), and a functional magnetic resonance imaging (MRI). There is sufficient evidence obtained on the basis of brain research that the brain of patients with bipolar disorder differs from the brain of a healthy person. In the course of further research, scientists will be able to make a clearer picture of the differences and understand the cause of this disease, which in the end will enable them to find the most effective ways of treatment.
How is bipolar disorder treated?
Due to correctly selected treatment, in most patients with bipolar disorder – even in its most severe forms – it is possible to stabilize mood changes and other symptoms of the disease. Since bipolar disorder occurs with relapses, preventive measures of treatment are not only shown, but are strongly recommended. Treatment combining drugs and psychotherapy is optimal to keep the disease under control.
In most cases, bipolar disorder is controlled much more effectively if the patient does not interrupt treatment, but constantly follows it. But even in these cases, episodes of mood change are quite likely. In such cases, you must always inform the attending physician. A timely change in the doctor’s course of treatment can prevent a full-scale episode.
Treatment will be more effective if you openly discuss with your doctor all doubts and proposed treatment options.
In addition, if the patient and his loved ones fill in the daily schedule of symptoms of mood, medication, sleep patterns, day events, they begin to better understand the disease. Such graphics also help the treating physician to monitor the progress of the disease and treatment more effectively.
Drugs for the treatment of bipolar disorder are prescribed by certified psychiatrists-MDs (MD), specialists in the diagnosis and treatment of mental illness. Although the therapist can also prescribe medication, nevertheless the patient with bipolar disorder is strongly recommended to be observed and treated by a psychiatrist.
In bipolar disorder, as a rule, prescribe the so-called “mood stabilizers.” 10 There are several types. Usually patients with bipolar disorder continue to take mood stabilizers for a long period of time (years). Other drugs are administered additionally as needed, usually for a shorter period of time, to relieve episodes of mania or depression that may occur periodically, even with mood stabilizers.
- Lithium is the first of mood-stabilizing drugs allowed by the US Food and Drug Administration (FDA) to treat mania. This medicine is an effective means of controlling mania or preventing relapses of both manic and depressive episodes
- Anticonvulsants such as valproate (Depakote®) or carbamazepine (Tegretol®) also have a mood stabilizing effect and can be used in particularly difficult to treat cases of bipolar disorder. The FDA authorized the use of valproate for the treatment of mania in 1995
- New anticonvulsants, such as lamotrigine (Lamictal®), gabapentin (Neurontin®), and topiramate (Topamax®), are under study to determine how well they affect the stabilization of mood cycles
- To achieve maximum effect, several anticonvulsants can be prescribed at once or they can be used in combination with lithium
- Children and adolescents with bipolar disorder are usually treated with lithium, but valproate and carbamazepine are also used. Scientists find out the safety and effectiveness of the use of these and other psychotropic drugs for children and adolescents. According to studies, valproate can lead to hormonal changes in adolescent girls and polycystic ovary syndrome in young women who started taking this drug before the age of 13. 13 Therefore, young patients taking valproate should certainly be under close medical supervision .
- Patients with bipolar disorder who want to become pregnant or are already pregnant face a difficult choice, as mood stabilizers can have a negative effect on the fetus or on a breast-fed baby.14 Thus, before taking a responsible decision, it is necessary to discuss with the expert all the pros and cons “Against” all possible ways of treatment. Currently, at the testing stage are new drugs that significantly reduce the risk during pregnancy or lactation.
Treatment of bipolar disorder
According to the results of the study, patients with bipolar disorder undergoing treatment with antidepressants are at risk of developing mania, hypomania or a rapidly circulating form of the disease. 15 In order to protect patients with bipolar disorder from such effects, it is usually necessary to use mood-stabilizing drugs, either in combination with antidepressants, or by themselves. At present, lithium and valproate are the most common drugs that stabilize the mood. Nevertheless, experiments are continuing to evaluate the effectiveness of the use of new medications for mood stabilization.
- Atypical antipsychotics, including clozapine (Clozaril®), olanzapine (Zyprexa®), risperidone (Rispendal®), quetipine (Seroquel®), and ziprasidone (Geodon®) are being studied for possible use in the treatment of bipolar disorder. There is reason to believe that the use of clozapine can help patients who do not respond to lithium or anticonvulsant drugs.
Other studies have confirmed that olanzapine is effective in acute mania, and has recently been approved for use in this capacity by the FDA. Olanzapine also helps in the treatment of psychotic depression.
- Aripiprazole (Abilify®) is another atypical antipsychotic drug used to treat the symptoms of schizophrenia and manic or mixed (manic and depressive) episodes of type I bipolar disorder. It is available in tablets and in liquid form. Injections are used to treat symptoms of excitement in schizophrenia and manic or mixed episodes of type I bipolar disorder.
- If there is a problem of insomnia, high-performance benzodiazepine drugs, such as clonazepam (Klonopin®) or lorazepam (Ativan®), can help. However, since these drugs are addictive, they are prescribed only for a short time. Instead, in some cases, they are prescribed soothing, such as zolpidem (Ambien®).
- During the course of treatment of bipolar disorder, it is necessary to repeatedly change medicines for the purpose of the most effective treatment. All drug changes and changes in drug doses should occur according to the prescription of the treating psychiatrist.
- Do not forget to tell your psychiatrist about all your medications, including over-the-counter medications, homeopathic remedies, vitamins and other supplements. This is very important, as some drugs and supplements are incompatible and can cause adverse reactions.
- To avoid relapse or a new episode, you must strictly adhere to the treatment plan. Discuss with the attending physician all the questions about the medicines.
In patients with bipolar disorder, thyroid dysfunction is often observed. Increased or decreased levels of thyroid hormones in itself can affect mood changes and energy levels. Therefore, it is very important that the thyroid parameters are under constant monitoring by the attending physician.
The rapidly circulating form of bipolar disorder is often accompanied by diseases of the thyroid gland. In such cases, along with medications for bipolar disorder, it is necessary to take medications to treat the thyroid gland. It should also be borne in mind that in some patients, lithium can cause a decrease in thyroid activity. In this case, in the course of treatment, it is necessary to introduce medications to regulate thyroid function.
Side effects of drugs
Before you start taking new medications, always consult a treating psychiatrist and / or a pharmacist about possible side effects. Depending on the drug, side effects can be expressed in the addition of weight, nausea, tremor, decreased sexual activity or possibility, anxiety, hair loss, difficult movements and dry mouth. Be sure to tell your doctor about all side effects that occurred during the taking of a medicine. To remove or reduce side effects, the doctor can change the dosage of the drug or change it to another. Do not change medication or stop taking them without consulting a psychiatrist.
Along with medical treatment, the use of psychosocial methods is recommended, including certain forms of psychotherapy (or “colloquial” therapy). Such methods help patients with bipolar disorder and their families understand the specificity of the disease and obtain the necessary information. The results of the research showed that psychosocial therapy helps to stabilize the mood, reduce the number of hospitalizations and improve the vital activity in various spheres of human activity.12 As a rule, licensed psychologists and social workers are engaged in such therapy, coordinating their actions with the attending psychiatrist and jointly monitoring the progress in state of health of the patient. The number of sessions, their frequency and duration depend on the individual needs of each patient.
Among the psychosocial methods used in bipolar disorder include cognitive behavioral therapy, psychological education, family therapy and a new technique – interpersonal and socio-rhythmic therapy. Researchers at the National Institute for Mental Health (NIMH) study and compare the effectiveness of these methods in combination with various drugs for the treatment of bipolar disorder:
- Cognitive-behavioral therapy helps patients with bipolar disorder understand and change negative or distorted patterns of thinking and behavior associated with the disease.
- Psychological education introduces patients to information about the disease and methods of its treatment, and also helps to learn to recognize the signs of relapse, which allows you to seek help in advance and prevent the onset of a full-scale episode. Mental education is also useful for family members of the patient.
- Family therapy uses a strategy of lowering the level of tension in the family, which can aggravate the symptoms of the disease or caused them.
- Interpersonal and socio-rhythmic therapy helps patients with bipolar disorder improve interpersonal relationships and organize their daily routine. A regular schedule and an orderly sleep regime help prevent manic episodes.
- As with medical treatment, in order to achieve successful results of psychosocial therapy, it is necessary to strictly follow the prescribed course of treatment.
- Electroconvulsive therapy (ECT / ECT) is used when medication, psychosocial therapy, or a combination of these drugs do not have the desired effect or are too slow to stop serious symptoms such as psychosis or suicidal manifestations. The use of ECT can also help during acute episodes when the physical condition of the patient (including pregnancy) does not allow the use of medications. ECT is a highly effective treatment for severe depression, manic and / or mixed episodes. The possibility of long-term memory problems resulting from ECT, which until recently was a serious cause for concern, has now been significantly reduced by the latest ECT methods.
Nevertheless, it is necessary to discuss in advance all the pros and cons of using ECT and other alternative therapies with the patient himself, and, if necessary, with family members or friends.
- Medicinal herbs and natural supplements, such as Hypericum perforatum (Hypericum perforatum), have not been studied enough, and the specialists have little information about their effect on bipolar disorder. Since FDA regulation rules do not apply to such products, different manufacturers of these additives use different amounts of active ingredients. Before you start taking herbs or natural supplements, you should consult your doctor. There is evidence that St. John’s wort can lower the effectiveness of certain drugs (see: www.nimh.nih.gov/events/stjohnwort.cfm) leaving the OMH site. 20 In addition, like prescription antidepressants, in some patients with bipolar disorder, St. John’s wort may provoke mania, especially in cases where the patient does not take mood stabilizers.
- Studies are under way on the effectiveness of use in the treatment of bipolar disorder Omega-3 (contained in fish oil fatty acids) in combination with traditional medicines or separately.
Chronic disease, which is treated very effectively
Although episodes of mania and depression are in the habit of appearing and disappearing, it must always be remembered that bipolar disorder is a chronic disease that is not currently cured. The only way to keep this disease under control is to constantly take medication, even during periods when you are feeling well. Only in this case it is possible to reduce the chance of relapse and deterioration of the condition.
Among patients with bipolar disorder, alcoholism and drug addiction are very common. Studies have shown that there are a number of reasons for this, including self-medication, a change in mood from alcohol or drug abuse, and risk factors that affect both the development of bipolar disorder and drug dependence. 23 Treatment of alcoholism or drug addiction is an important part of the overall course of treatment.
Anxiety disorders, such as post-traumatic stress or obsessive-compulsive disorder (obsessive-compulsive disorder), are also common in bipolar disorder. 24, 25 Concomitant anxiety disorders can sometimes be controlled by the same means as bipolar disorder, but in some cases special treatment is required. For detailed information on anxiety disorders, contact NIMH (see below).
Helping patients with bipolar disorder and their families
Patients with bipolar disorder should lead an experienced psychiatrist, specializing in the diagnosis and treatment of this disease. Psychologists, social psychiatric service workers and nurses of psychiatric clinics help to provide various aspects of treatment and care for patients and their families.
You can get help in the following places:
- Treatment programs at universities or medical institutes
- In psychiatric departments of hospitals
- In private psychiatric offices and clinics
- In health care organizations (HMOs)
- In the offices of district or children’s doctors
- In community mental health centers
Patients with bipolar disorder may need help to get help
- Patients with bipolar disorder often do not realize how sick they are, or they see the cause of their illnesses not in a mental disorder, but in something else.
- To seek help from a doctor, patients with bipolar disorder may need encouragement and support from the family and friends. The therapist can play an important role, insisting on consultation with a psychiatrist.
- Sometimes it is necessary that a family member or friend accompany a patient with bipolar disorder to see a doctor and be treated.
- Sometimes a patient who is in a stage of acute attack should be hospitalized for his / her own safety and to provide the necessary treatment. In some cases it is necessary to hospitalize the patient against his / her will and without consent.
- It is necessary to constantly support and encourage the patient, after the start of treatment, because in some cases it may take quite a long time to find the right course of treatment.
- In some cases, patients with bipolar disorder during the period of remission can specify a plan of action in the event of a future manic or depressive relapse.
- Like other serious diseases, bipolar disorder severely affects spouses, family members, friends and employers.
- Family members of a patient with bipolar disorder often have to deal with serious problems in their behavior, such as unrestrained waste of money during episodes of mania, or withdrawal into themselves during depression, and the long-term consequences of such behavior.
- Many supportive bipolar disorders are supported by support groups supported by various organizations, such as the National Association for the Study of Depressive and Manic-Depressive Disorders (NDMDA), the National Alliance for the Treatment of the Mind Indigent (NAMI), and the National Association for Mental Health (NMHA). Such support groups also help families and friends of patients with bipolar disorder. The coordinates of these organizations can be found in the “Useful Information” section of our brochure.
Clinical studies on bipolar disorder
Some patients with bipolar disorder receive medication and / or psychosocial therapy if they agree to participate in clinical trials (clinical trials). During these tests, scientific studies of the disease and the ways of its treatment involving people are conducted. Clinical trials in psychiatry provide information on the effectiveness of a drug or a combination of several drugs, the benefits of behavioral therapy or psychotherapy, the reliability of a diagnostic procedure, or the success of a preventive method. Clinical trials help scientists to follow the course of the disease: how it starts, progresses, goes on recession, how it affects the body and mind. Thanks to information obtained during clinical trials, millions of Americans with mental illness today live a normal and productive life. However, not everyone can take part in such trials. Before deciding to participate in the study, each person should weigh the pros and cons.
In recent years, the NIMH has introduced a new generation of clinical trials, so-called real-world research. They received their name for several reasons. Unlike traditional clinical trials, they offer many different types of treatment and treatment combinations. In addition, they try to involve as many mentally ill people from different regions of the United States and treated in various health facilities as possible. To participate in these trials, they try to attract patients suffering from several mental illnesses simultaneously, as well as those who have concomitant physical ailments. The main objective of research in the real world is to improve the methods and improve the results of treatment for all those suffering from mental disorders. Apart from the fact that these studies record the dynamics of the symptoms of the disease, they also collect information on how treatment affects other important aspects of the “real world”, such as the quality of life, the ability to work and function in society. In the course of research, the effectiveness of costs for different types of treatment is also studied and factors that affect how patients adhere to the prescribed course of treatment are analyzed.