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In
situations where medication, psychosocial treatment, and the
combination of these interventions prove ineffective, or work
too slowly to relieve severe symptoms such as psychosis or suicidality,
electroconvulsive therapy (ECT) may be considered. ECT may also
be considered to treat acute episodes when medical conditions,
including pregnancy, make the use of medications too risky.
ECT is a highly effective treatment for severe depressive, manic,
and/or mixed episodes. The possibility of long-lasting memory
problems, although a concern in the past, has been significantly
reduced with modern ECT techniques. However, the potential benefits
and risks of ECT, and of available alternative interventions,
should be carefully reviewed and discussed with individuals
considering this treatment and, where appropriate, with family
or friends.20
Herbal or natural supplements, such as St. John's wort (Hypericum
perforatum), have not been well studied, and little is known
about their effects on bipolar disorder. Because the FDA does
not regulate their production, different brands of these supplements
can contain different amounts of active ingredient. Before trying
herbal or natural supplements, it is important to discuss them
with your doctor. There is evidence that St. John's wort can
reduce the effectiveness of certain medications.21 In addition,
like prescription antidepressants, St. John's wort may cause
a switch into mania in some individuals with bipolar disorder,
especially if no mood stabilizer is being taken.22
Omega-3 fatty acids found in fish oil are being studied to determine
their usefulness, alone and when added to conventional medications,
for long-term treatment of bipolar disorder.23
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| A
Long-Term Illness That Can Be Effectively Treated |
| Even
though episodes of mania and depression naturally come and go,
it is important to understand that bipolar disorder is a long-term
illness that currently has no cure. Staying on treatment, even
during well times, can help keep the disease under control and
reduce the chance of having recurrent, worsening episodes. |
| Do
Other Illnesses Co-occur with Bipolar Disorder? |
Alcohol
and drug abuse are very common among people with bipolar disorder.
Research findings suggest that many factors may contribute to
these substance abuse problems, including self-medication of
symptoms, mood symptoms either brought on or perpetuated by
substance abuse, and risk factors that may influence the occurrence
of both bipolar disorder and substance use disorders.24 Treatment
for co-occurring substance abuse, when present, is an important
part of the overall treatment plan.
Anxiety disorders, such as post-traumatic stress disorder and
obsessive-compulsive disorder, also may be common in people
with bipolar disorder.25,26 Co-occurring anxiety disorders may
respond to the treatments used for bipolar disorder, or they
may require separate treatment. For more information on anxiety
disorders, contact NIM
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