6.1 Give examples of medical intervention for bipolar disorder

This guide will help you answer 6.1 Give examples of medical intervention for bipolar disorder.

Bipolar disorder is a mental health condition causing extreme mood swings. These include episodes of mania (feeling high, overexcited, or irritable) and depression (feeling low, hopeless, or tired). Medical interventions often focus on stabilising these mood swings and managing symptoms over time.

Treatment is very important in helping the individual to stay well. Let’s take a look at some of the common medical interventions used for bipolar disorder.

Medication for Bipolar Disorder

Medication plays an important role in managing bipolar disorder. These drugs help to stabilise mood, reduce symptoms, and prevent future episodes of mania or depression. Here are the main types:

Mood Stabilisers

Mood stabilisers are commonly prescribed to help stabilise an individual’s mood. These medications aim to reduce extreme highs (mania) and lows (depression), offering more stability to the person’s day-to-day emotions. Examples include:

• Lithium Carbonate: This is one of the most widely used mood stabilisers for bipolar disorder. It is especially effective for reducing mania and preventing future mood episodes. Regular blood tests are required with lithium because it’s important to monitor the levels in the body. Too much lithium can be toxic, while too little may not work.
• Sodium Valproate (Depakote): This is another mood stabiliser, often used when lithium isn’t suitable. It helps to calm hyperactivity in the brain and is usually taken daily. Sodium valproate isn’t suitable for women who are pregnant or planning to become pregnant because it can harm the baby.
• Carbamazepine: This drug is less commonly used but can be effective for bipolar individuals who don’t respond well to other medications. Like lithium, blood monitoring is necessary due to the risk of side effects.

Antipsychotic Medications

In cases of mania or mixed episodes (when mania and depression occur together), antipsychotics may be prescribed. These medications work by reducing hyperactivity and controlling manic symptoms. Examples include:

• Olanzapine: Often prescribed for manic episodes, it can quickly calm agitation and control extreme behaviours. It may also help in the longer term to prevent episodes.
• Risperidone: This is used in the short term to treat manic symptoms and can be very effective for reducing psychotic features such as delusions or hallucinations.
• Aripiprazole: Sometimes given to people who experience mixed episodes of mania and depression. It can help reduce mood instability.

Antipsychotics can cause side effects, including weight gain, drowsiness, and dry mouth. Doctors regularly review these treatments to ensure they’re working well and to manage side effects.

Antidepressants

Antidepressants may be used to treat the depressive episodes of bipolar disorder. These medications help to lift mood by balancing the chemicals in the brain. Examples include:

• Selective Serotonin Reuptake Inhibitors (SSRIs) like Sertraline or Fluoxetine. These are commonly used to treat depression and can help some people with bipolar disorder feel better.
• Mirtazapine: Another type of antidepressant that can improve sleep and lift mood.

Doctors use antidepressants carefully because they can sometimes trigger mania in people with bipolar disorder. They are often combined with mood stabilisers to reduce this risk.

Combination Therapy

Some individuals may need a combination of drugs to manage their symptoms. For example, a person might take both a mood stabiliser and an antipsychotic. This approach can target different symptoms at the same time, enabling better overall mood management.

Psychological Interventions in Bipolar Disorder Treatment

While medication is central to managing bipolar disorder, psychological interventions also play a key role. Combined approaches often improve outcomes for people living with this condition. Here are a few examples:

Psychoeducation

Psychoeducation involves teaching people about bipolar disorder, its symptoms, triggers, and treatments. This helps individuals understand their condition, empowering them to manage it better.

Cognitive Behavioural Therapy (CBT)

CBT helps individuals identify negative thinking patterns and replace them with healthier ones. It can be particularly useful in managing depressive episodes by teaching problem-solving skills and coping techniques.

Interpersonal and Social Rhythm Therapy (IPSRT)

This therapy focuses on stabilising daily routines and relationships. Regular sleep patterns, meal times, and social interactions are encouraged, as these can reduce mood instability in people with bipolar disorder.

Electroconvulsive Therapy (ECT) for Severe Cases

Electroconvulsive therapy (ECT) is sometimes used for severe bipolar disorder when other treatments haven’t worked. This involves passing small electrical currents through the brain to produce a controlled seizure. ECT is particularly useful during life-threatening depressive episodes or when an individual has severe mania or suicidal thoughts that do not respond to other treatments.

Though ECT can carry risks such as memory loss or confusion, it is performed under anaesthesia to make the procedure safe and painless.

Lifestyle and Self-Management

While medical intervention is essential in bipolar disorder, lifestyle changes and self-management can support these treatments. Healthcare teams often advise patients on healthy living practices such as:

• Maintaining a regular sleep pattern
• Reducing alcohol and drug use (which can worsen symptoms)
• Managing stress through relaxation techniques

Monitoring Physical Health

Drugs like lithium and sodium valproate require regular monitoring to check for potential side effects. Support workers can help service users by encouraging them to attend medical appointments such as blood tests. Monitoring physical health also includes checking thyroid, kidney, and liver function, as some bipolar medications can affect these areas of the body.

Supporting Medication Adherence

One major challenge is medication adherence – ensuring the person regularly takes their medication. As a support worker, you can help by engaging in open, non-judgemental conversations about how the medication makes the individual feel. This allows you to address concerns like side effects or forgetfulness.

Key Points to Remember About Medical Interventions

• Individual Treatment Plans: No single medication works for everyone. Treatment plans are always adjusted to suit the individual.
• Long-Term Treatment: Bipolar disorder often requires lifelong treatment to keep symptoms under control.
• Side Effects: All medications carry the risk of side effects. Monitoring and communication between healthcare professionals and the patient reduce these risks.
• Combination of Treatments: Medication is most effective when combined with psychological therapies and support for a healthy lifestyle.

How Support Workers Can Help

As a support worker, your role is not to prescribe or adjust medication, but to assist with the person’s overall wellness. This includes:

• Encouraging individuals to attend medical appointments.
• Helping someone establish a medication routine, such as reminders or visual schedules.
• Observing and reporting changes in symptoms to the healthcare team.
• Providing emotional support during challenging times.

Summary of Examples of Medical Interventions

In short, medical interventions for bipolar disorder include:

• Mood stabilisers (e.g., lithium, sodium valproate)
• Antipsychotic medications (e.g., olanzapine, risperidone)
• Antidepressants (e.g., sertraline, mirtazapine)
• Combination therapy when needed
• Electroconvulsive therapy for severe cases

Each person’s treatment plan is unique. Your role as a support worker is to encourage treatment adherence, monitor wellbeing, and communicate any changes with health professionals.