Bipolar, Manic Depression Treatment
Bipolar depression treatment is tricky, because it is often misdiagnosed as simple depression. This can create a problem, especially because the depression medicines that are available tend to trigger manic episodes in these patients. Typical psychotherapeutic depression treatments are often inadeqaute.
A converse problem is also common: many patients who do not meet full criteria for bipolar disorder are diagnosed as such, and their real problems go untreated. This is particularly common in the case of borderline personality disorder and in the field addictions, because there is a good deal of overlap between symptoms of these types of diagnoses.
The medications used for bipolar, or manic depression, range from the classic lithium salts, which still tend to be quite effective but can have unpleasant side effects, to more modern atypical antipsychotic type medications that are used as mood stabilizers.
There are also a number of psychotherapeutic treatments for bipolar depression, and these are often combined with pharmocological treatment for optimal effect. There is a certain balancing act involved in working witha bipolar patient as a therapist, because what is needed is to help the patient learn to balance their extreme emotions against one another in order to maintain a more moderate level of interaction with the world.
Bipolar disorder is characterized by very high highs and very low lows–mania on the one hand, and depression on the other. There are a number of different theories about why this may be or how it may develop that do not require a neurochemical explanation.
Perhaps the best method of building up an understanding of the depressed bipolar patient is to consider that psychodynamics and neurochemicals are not at all separate, but simply different languages that say the same thing. On the one hand you have a patient who has exhausted his or her capability to deny the painful emotional realities of life and so has fallen into a state of depression. On the other hand you have a patient who has used up his or her supply of emotion-enhancing and energy-producing neurochemicals. These two explanations can be seen as identical.
When this is done, the treatment for bipolar depression sounds natural. You teach the patient to use up their resources more evenly, so that they won’t run out before more can be produced. This simply requires a realistic relationship to emotional life.