Psychologists or psychiatrists diagnose and treat bipolar disorder. It would usually start with an interview and a clinical inventory or scale to assess the mental status and bipolar symptoms of the patient. The following are the clinical procedures that need to undertaken:
- MCMI III
- MMPI II
The tests mentioned above can be done in outpatient settings or in hospitals, either in writing or verbally. Mental illnesses and bipolar disorder are diagnosed using the guidelines contained in DSM-IV. According to this guideline, bipolar disorder is an unusually irritable or elevated mood that lasts for about a week together with three mania symptoms. However, four symptoms will be required just in case the person is irritable.
Adolescents and children present symptoms differently. Children exhibit psychotic features that are often misdiagnosed as schizophrenia. They are more aggressive and irritable, instead of being elated. The symptoms are also ongoing and chronic compared to adults that experience it in episodes.
Treatments of bipolar disorder are usually administered with medications. Mood stabilizers are used in combination with antipsychotics, antidepressants, and anticonvulsants. These medications regulate bipolar episodes.
Lithium. Oldest and frequently prescribed medication for bipolar disorder, but this is not recommended for patients having mixed mania. Sometimes, Lithium is used together with benzodiazepines or neuroleptics.
Carbamazepine. This is an anticonvulsant prescribed along with mood stabilizers. If the patient did not respond well with the lithium therapy, this medication can be used.
Valproate. If you're experiencing a rapid cycling of bipolar, this is a very effective medication. It can be used alone or in combination with other drugs.
Antidepressants may stimulate mania episodes in some patients, therefore used only for short term.
SSRIs. This is used to regulate depression and it includes flouxetine, sertaline, and paroxetine.
MAOIs. This drug blocks the monoamine oxidase's action; and to avoid side effects, you should not eat foods with high amounts of tyramine.
Electroconvulsive therapy. This is very successful in treating bipolar depression but this is employed only after pharmaceutical treatment options have been exhausted. The treatment is given together with anesthesia and muscle relaxant to avoid convulsions.
Neuroleptics. To control manic symptoms, drugs like haloperidol and chlorpromazine are used; but you must be aware that side effects are more severe with neuroleptics.
Counseling and Psychotherapy. Some experts claim that bipolar disorder is biological, and therefore, entails therapy. The therapy alone is not sufficient to substitute medications and so the patient must continue taking his medicines. It's a helpful tool for the patients and their families to encourage medication compliance and reduce suicide risks.
Bipolar medications are really important. When you're completely stabilized and controlled, don’t stop taking medications. Remember that bipolar disorder is for a lifetime, and so you must continue with your medication and treatment.