Bipolar disorder (BP), previously referred to as a manic-depressive illness in clinical psychiatry, has almost a century of research, treatment, and management in the USA and worldwide.
Its main symptom is the person’s alternating mood extremes, shifting from deep depressive states to manic euphoria.
BP takes a severe toll on a person’s life by impairing their psychosocial functioning and costing a patient 10-20 years of full, happy life.
However, the mental health issue still has fuzzy causes and is surrounded by ambiguity in terms of treatment and lifestyle management.
This article summarizes the available evidence on pharmacological and non-pharmacological treatments of BP based on the recent advances in understanding the disorder’s etiology, impact on the patient, and course throughout the patient’s lifetime.
BP: Genetic Causes
Bipolar disorder is a genetic disorder with around 70% heritability, and it shares several essential genetic alleles with other mental disorders, the closest being schizophrenia and major depressive disorder.
Since the genetic basis of BP is well-documented (though not yet fully understood), gene therapy advancements in BP management are underway.
Genome spots responsible for BP heredity have been recently identified in clinical studies, promising a new level of medical precision in BP treatment and prevention.
BP Treatments: From Lithium To Antidepressants And Antipsychotics
The main problem in treating BP with medications is the alternation of manic and depressive episodes, each of which is a unique state of the patient’s psyche that requires special treatment.
The long-standing tradition of using antidepressants with BP patients has recently been compromised, as this drug category increases the frequency and severity of manic episodes.
Besides, experts note that antidepressants destabilize BP patients’ moods.
Another category of frequently used medications is antipsychotics.
These drugs help during manic episodes only, and there is limited evidence of effective long-term antipsychotic use for BP patients.
According to The Lancet experts, lithium has long been the golden standard of BP treatment. Its spectrum of activity includes antimanic, antidepressant, and anti-suicide effects.
However, despite the well-recognized role of lithium in mood stabilization during BP, recent evidence suggests that the clinical community is gradually distancing from its application, mainly due to its varied side effects.
Lithium causes kidney and thyroid disease, which may worsen the patient’s quality of life and even cause the need for kidney transplantation after years of lithium intake.
The second-generation antipsychotics with a promise to address all aspects of BP include:
- Cariprazine
- Olanzapine
- Quetiapine
- Aripiprazole
- Risperidone
These new antipsychotics have lower side effects, such as weight gain or cholesterol increase, so they have healthy potential for application in long-term BP management.
Psychotherapy For BP
People with BP may resist pharmacological treatment modalities for many reasons, from health consciousness to the inability to adhere to a strict treatment regimen.
Psychotherapeutic interventions may meet the needs of such patients:
Psychoeducation
People may deal with their BP symptoms much better if they understand their mental condition and know what habits and activities can mitigate or aggravate the BP manifestations.
Psychoeducation is held in group sessions where people diagnosed with BP are taught to identify and manage their mood shifts and stress and follow proactive physical and mental hygiene tips.
They are also taught about healthy eating, regimen, and avoidance of stimulants to keep their symptoms under control.
CBT
Cognitive behavioral therapy is usually used in tandem with medications; it’s commonly applied in depression treatment and can help with manic episodes.
Yet, there is still limited evidence on CBT use, specifically with BP patients.
Its greatest value is in the ability to prevent relapses by equipping patients with coping mechanisms for mood swing detection and proactive responses to them.
Family-focused Therapy
BP takes a toll not only on the patient but also on the members of their families.
This form of therapy aims to improve family relationships and equip family members with vital skills for mood swing detection, social support BP patients need, and relapse prevention.
Interpersonal and Social-rhythm Therapy
IPSRT is an innovative approach to BP management that prioritizes sleep scheduling and social relationship improvement to hinder BP symptoms.
Yet, it has little evidential support for use with BP at present.
Peer support Groups
Support groups can have positive effects on the BP patient’s well-being and symptom severity.
Individuals with similar disease experiences communicate and support each other, which is an effective relapse prevention technique.
Treating BP With Lifestyle Changes: A Novel Approach
BP treatment with medications may be inconvenient for many; lithium and other drugs cause many side effects and can worsen the patient’s general health.
Psychotherapy can help to a limited degree, as the patient’s physical state is also vital for mood stability and relapse prevention.
Thus, modern experts recommend introducing lifestyle changes to attain progress in symptom control and relapse avoidance.
Here are a couple of vital lifestyle habits that can help you deal with BP much more effectively.
Sleep Schedule
Enjoying enough high-quality sleep is at the heart of the brain and nervous system’s health.
Thus, people with BP need to develop a fixed schedule for going to sleep and waking up to restore healthy sleep patterns and enjoy sufficient brain rejuvenation during the night’s rest.
It’s common for bipolar individuals to sleep very little during manic periods, which exhausts their nervous systems and leads to symptom aggravation, while depressive periods may cause excessive sleepiness and inactivity.
Thus, sleep control is vital at all life periods, as it may help BP individuals assume control over their life routines.
Healthy Nutrition
The food we eat determines brain health to a large degree. Thus, people with mental health issues need to prioritize healthy eating way more than healthy individuals do.
It’s vital to include omega-3 fatty acids into daily diets and enrich the food with vitamin D, B-group vitamins, and fiber for the right gut operation and brain nutrition.
Whole grains, fresh products, large volumes of greens, and salmon are mandatory for inclusion in the BP patient’s nutrition scheme.
Healthy Movement
Physical exercise and walks help BP individuals enjoy a better quality of life and complete all their daily routines without stress.
You may not exhaust yourself with everyday gym workouts (such overload may speed up the onset of a manic episode), but including a long walk into a daily routine will definitely help you stay fit and healthy.
Mindfulness
Practicing yoga, meditation, and other mindfulness techniques can help anyone get in closer contact with their bodies and minds, thus controlling the BP symptoms much better.
Such people are less vulnerable to mood swings and can avoid relapses for longer periods.
Proper Relaxation
CBD can help your body and mind relax during tense BP episodes or stressful events that may potentially cause a relapse.
There’s mounting research on the effectiveness of CBD intake during depressive episodes, as it’s a non-addictive compound with no psychoactive properties.
Thus, you can get CBD pre roll packaging to see how the soothing CBD extract calms your nerves and hinders symptom intensity.
Final Word: BP Research Is Ongoing
As you can see, BP is a chronic illness with large-scale, debilitating effects on people with this diagnosis.
The complexity of dealing with it is the swing between manic and depressive episodes, each of which requires a completely different treatment in pharmacological and non-pharmacological terms.
Luckily for individuals with BP, science is quickly moving forward, with new medications with negligible side effects being developed and more precise genetic interventions underway.
A healthy alternative to addictive and expensive medications is a healthy lifestyle, with changes tailored to the patient’s current episode and targeting emotional balance, mindfulness, and stability.
