Treating bipolar 1
Bipolar disorder - Diagnosis and treatment
Diagnosis
To determine if you have bipolar disorder, your evaluation may include:
- Physical exam. Your doctor may do a physical exam and lab tests to identify any medical problems that could be causing your symptoms.
- Psychiatric assessment. Your doctor may refer you to a psychiatrist, who will talk to you about your thoughts, feelings and behavior patterns. You may also fill out a psychological self-assessment or questionnaire. With your permission, family members or close friends may be asked to provide information about your symptoms.
- Mood charting. You may be asked to keep a daily record of your moods, sleep patterns or other factors that could help with diagnosis and finding the right treatment.
- Criteria for bipolar disorder. Your psychiatrist may compare your symptoms with the criteria for bipolar and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Diagnosis in children
Although diagnosis of children and teenagers with bipolar disorder includes the same criteria that are used for adults, symptoms in children and teens often have different patterns and may not fit neatly into the diagnostic categories.
Also, children who have bipolar disorder are frequently also diagnosed with other mental health conditions such as attention-deficit/hyperactivity disorder (ADHD) or behavior problems, which can make diagnosis more complicated. Referral to a child psychiatrist with experience in bipolar disorder is recommended.
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Treatment
Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist) who is skilled in treating bipolar and related disorders.
You may have a treatment team that also includes a psychologist, social worker and psychiatric nurse.
Bipolar disorder is a lifelong condition. Treatment is directed at managing symptoms. Depending on your needs, treatment may include:
- Medications. Often, you'll need to start taking medications to balance your moods right away.
- Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression.
- Day treatment programs. Your doctor may recommend a day treatment program. These programs provide the support and counseling you need while you get symptoms under control.
- Substance abuse treatment. If you have problems with alcohol or drugs, you'll also need substance abuse treatment.
Otherwise, it can be very difficult to manage bipolar disorder. - Hospitalization. Your doctor may recommend hospitalization if you're behaving dangerously, you feel suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a hospital can help keep you calm and safe and stabilize your mood, whether you're having a manic or major depressive episode.
The primary treatments for bipolar disorder include medications and psychological counseling (psychotherapy) to control symptoms, and also may include education and support groups.
Medications
A number of medications are used to treat bipolar disorder. The types and doses of medications prescribed are based on your particular symptoms.
Medications may include:
- Mood stabilizers. You'll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
- Antipsychotics. If symptoms of depression or mania persist in spite of treatment with other medications, adding an antipsychotic drug such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris) may help. Your doctor may prescribe some of these medications alone or along with a mood stabilizer.
- Antidepressants. Your doctor may add an antidepressant to help manage depression. Because an antidepressant can sometimes trigger a manic episode, it's usually prescribed along with a mood stabilizer or antipsychotic.
- Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer.
- Anti-anxiety medications. Benzodiazepines may help with anxiety and improve sleep, but are usually used on a short-term basis.
Finding the right medication
Finding the right medication or medications for you will likely take some trial and error. If one doesn't work well for you, there are several others to try.
This process requires patience, as some medications need weeks to months to take full effect. Generally only one medication is changed at a time so that your doctor can identify which medications work to relieve your symptoms with the least bothersome side effects. Medications also may need to be adjusted as your symptoms change.
Side effects
Mild side effects often improve as you find the right medications and doses that work for you, and your body adjusts to the medications. Talk to your doctor or mental health professional if you have bothersome side effects.
Don't make changes or stop taking your medications. If you stop your medication, you may experience withdrawal effects or your symptoms may worsen or return. You may become very depressed, feel suicidal, or go into a manic or hypomanic episode.
If you think you need to make a change, call your doctor.
Medications and pregnancy
A number of medications for bipolar disorder can be associated with birth defects and can pass through breast milk to your baby. Certain medications, such as valproic acid and divalproex sodium, should not be used during pregnancy. Also, birth control medications may lose effectiveness when taken along with certain bipolar disorder medications.
Discuss treatment options with your doctor before you become pregnant, if possible. If you're taking medication to treat your bipolar disorder and think you may be pregnant, talk to your doctor right away.
Psychotherapy
Psychotherapy is a vital part of bipolar disorder treatment and can be provided in individual, family or group settings. Several types of therapy may be helpful. These include:
- Interpersonal and social rhythm therapy (IPSRT). IPSRT focuses on the stabilization of daily rhythms, such as sleeping, waking and mealtimes.
A consistent routine allows for better mood management. People with bipolar disorder may benefit from establishing a daily routine for sleep, diet and exercise. - Cognitive behavioral therapy (CBT). The focus is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. CBT can help identify what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.
- Psychoeducation. Learning about bipolar disorder (psychoeducation) can help you and your loved ones understand the condition. Knowing what's going on can help you get the best support, identify issues, make a plan to prevent relapse and stick with treatment.
- Family-focused therapy. Family support and communication can help you stick with your treatment plan and help you and your loved ones recognize and manage warning signs of mood swings.
Other treatment options
Depending on your needs, other treatments may be added to your depression therapy.
During electroconvulsive therapy (ECT), electrical currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can reverse symptoms of certain mental illnesses. ECT may be an option for bipolar treatment if you don't get better with medications, can't take antidepressants for health reasons such as pregnancy or are at high risk of suicide.
Transcranial magnetic stimulation (TMS) is being investigated as an option for those who haven't responded to antidepressants.
Treatment in children and teenagers
Treatments for children and teenagers are generally decided on a case-by-case basis, depending on symptoms, medication side effects and other factors. Generally, treatment includes:
- Medications. Children and teens with bipolar disorder are often prescribed the same types of medications as those used in adults. There's less research on the safety and effectiveness of bipolar medications in children than in adults, so treatment decisions are often based on adult research.
- Psychotherapy. Initial and long-term therapy can help keep symptoms from returning. Psychotherapy can help children and teens manage their routines, develop coping skills, address learning difficulties, resolve social problems, and help strengthen family bonds and communication. And, if needed, it can help treat substance abuse problems common in older children and teens with bipolar disorder.
- Psychoeducation. Psychoeducation can include learning the symptoms of bipolar disorder and how they differ from behavior related to your child's developmental age, the situation and appropriate cultural behavior. Understanding about bipolar disorder can also help you support your child.
- Support. Working with teachers and school counselors and encouraging support from family and friends can help identify services and encourage success.
More Information
- Bipolar disorder care at Mayo Clinic
- Bipolar medications and weight gain
- Bipolar treatment: I vs.
II - Cognitive behavioral therapy
- Electroconvulsive therapy (ECT)
- Family therapy
- Psychotherapy
- Transcranial magnetic stimulation
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Lifestyle and home remedies
You'll probably need to make lifestyle changes to stop cycles of behavior that worsen your bipolar disorder. Here are some steps to take:
- Quit drinking or using recreational drugs. One of the biggest concerns with bipolar disorder is the negative consequences of risk-taking behavior and drug or alcohol abuse. Get help if you have trouble quitting on your own.
- Form healthy relationships. Surround yourself with people who are a positive influence. Friends and family members can provide support and help you watch for warning signs of mood shifts.
- Create a healthy routine.
Having a regular routine for sleeping, eating and physical activity can help balance your moods. Check with your doctor before starting any exercise program. Eat a healthy diet. If you take lithium, talk with your doctor about appropriate fluid and salt intake. If you have trouble sleeping, talk to your doctor or mental health professional about what you can do. - Check first before taking other medications. Call the doctor who's treating you for bipolar disorder before you take medications prescribed by another doctor or any over-the-counter supplements or medications. Sometimes other medications trigger episodes of depression or mania or may interfere with medications you're taking for bipolar disorder.
- Consider keeping a mood chart. Keeping a record of your daily moods, treatments, sleep, activities and feelings may help identify triggers, effective treatment options and when treatment needs to be adjusted.
Alternative medicine
There isn't much research on alternative or complementary medicine — sometimes called integrative medicine — and bipolar disorder.
Most of the studies are on major depression, so it isn't clear how these nontraditional approaches work for bipolar disorder.
If you choose to use alternative or complementary medicine in addition to your physician-recommended treatment, take some precautions first:
- Don't stop taking your prescribed medications or skip therapy sessions. Alternative or complementary medicine is not a substitute for regular medical care when it comes to treating bipolar disorder.
- Be honest with your doctors and mental health professionals. Tell them exactly which alternative or complementary treatments you use or would like to try.
- Be aware of potential dangers. Alternative and complementary products aren't regulated the way prescription drugs are. Just because it's natural doesn't mean it's safe. Before using alternative or complementary medicine, talk to your doctor about the risks, including possible serious interactions with medications.
Coping and support
Coping with bipolar disorder can be challenging. Here are some strategies that can help:
- Learn about bipolar disorder. Education about your condition can empower you and motivate you to stick to your treatment plan and recognize mood changes. Help educate your family and friends about what you're going through.
- Stay focused on your goals. Learning to manage bipolar disorder can take time. Stay motivated by keeping your goals in mind and reminding yourself that you can work to repair damaged relationships and other problems caused by your mood swings.
- Join a support group. Support groups for people with bipolar disorder can help you connect to others facing similar challenges and share experiences.
- Find healthy outlets. Explore healthy ways to channel your energy, such as hobbies, exercise and recreational activities.
- Learn ways to relax and manage stress.
Yoga, tai chi, massage, meditation or other relaxation techniques can be helpful.
Preparing for your appointment
You may start by seeing your primary care doctor or a psychiatrist. You may want to take a family member or friend along to your appointment, if possible, for support and to help remember information.
What you can do
Before your appointment, make a list of:
- Any symptoms you've had, including any that may seem unrelated to the reason for the appointment
- Key personal information, including any major stresses or recent life changes
- All medications, vitamins, herbs or other supplements you're taking, and the dosages
- Questions to ask your doctor
Some questions to ask your doctor may include:
- Do I have bipolar disorder?
- Are there any other possible causes for my symptoms?
- What kinds of tests will I need?
- What treatments are available? Which do you recommend for me?
- What side effects are possible with that treatment?
- What are the alternatives to the primary approach that you're suggesting?
- I have these other health conditions.
How can I best manage these conditions together? - Should I see a psychiatrist or other mental health professional?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can have?
- What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:
- When did you or your loved ones first begin noticing your symptoms?
- How frequently do your moods change?
- Do you ever have suicidal thoughts when you're feeling down?
- Do your symptoms interfere with your daily life or relationships?
- Do you have any blood relatives with bipolar disorder or depression?
- What other mental or physical health conditions do you have?
- Do you drink alcohol, smoke cigarettes or use recreational drugs?
- How much do you sleep at night? Does it change over time?
- Do you go through periods when you take risks that you wouldn't normally take, such as unsafe sex or unwise, spontaneous financial decisions?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
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Bipolar disorder - Symptoms and causes
Overview
Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).
When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.
Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.
Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).
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Symptoms
There are several types of bipolar and related disorders.
They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.
- Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
- Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode.
- Cyclothymic disorder. You've had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
- Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.
Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.
Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.
Mania and hypomania
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both a manic and a hypomanic episode include three or more of these symptoms:
- Abnormally upbeat, jumpy or wired
- Increased activity, energy or agitation
- Exaggerated sense of well-being and self-confidence (euphoria)
- Decreased need for sleep
- Unusual talkativeness
- Racing thoughts
- Distractibility
- Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments
Major depressive episode
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships.
An episode includes five or more of these symptoms:
- Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
- Marked loss of interest or feeling no pleasure in all — or almost all — activities
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
- Either insomnia or sleeping too much
- Either restlessness or slowed behavior
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking about, planning or attempting suicide
Other features of bipolar disorder
Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others.
The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons.
Symptoms in children and teens
Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.
Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.
The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.
When to see a doctor
Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need.
And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out — and perhaps in financial, legal or relationship trouble.
If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.
When to get emergency help
Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week.
Or use the Lifeline Chat. Services are free and confidential.
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
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Causes
The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:
- Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
- Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition.
Researchers are trying to find genes that may be involved in causing bipolar disorder.
Risk factors
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:
- Having a first-degree relative, such as a parent or sibling, with bipolar disorder
- Periods of high stress, such as the death of a loved one or other traumatic event
- Drug or alcohol abuse
Complications
Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:
- Problems related to drug and alcohol use
- Suicide or suicide attempts
- Legal or financial problems
- Damaged relationships
- Poor work or school performance
Co-occurring conditions
If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful.
Examples include:
- Anxiety disorders
- Eating disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Alcohol or drug problems
- Physical health problems, such as heart disease, thyroid problems, headaches or obesity
More Information
- Bipolar disorder care at Mayo Clinic
- Bipolar disorder and alcoholism: Are they related?
Prevention
There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.
If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:
- Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them.
Call your doctor if you feel you're falling into an episode of depression or mania. Involve family members or friends in watching for warning signs. - Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.
- Take your medications exactly as directed. You may be tempted to stop treatment — but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.
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Treatment of bipolar affective disorder in St. Petersburg
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- Psychotherapy
- Treatment of bipolar disorder
Usually the symptoms of bipolar disorder are attributed to personality traits or mood swings, which are logically explained. And, as a rule, even close relatives may not suspect that a person suffers from one of the most common mental disorders. nine0011
Bipolar affective disorder is difficult to diagnose at an early stage of the disease. Therefore, we recommend that the patient himself or his relatives begin to keep a diary, recording daily the features of the psycho-emotional state and key events that affect the occurrence of depressive and / or manic episodes. Such a diary will help the doctor determine the type of disease and prescribe the necessary treatment for bipolar disorder, and in the future to monitor the dynamics of the state of health. nine0011
Bipolar affective disorder is treated as an outpatient or inpatient clinic. At the peak of a depressive episode, when there is a risk of suicide, as well as to reduce the timing of the selection of pharmacotherapy, treatment of bipolar disorder should be carried out in a hospital.
Bipolar personality disorder, left untreated, can progress and cause a deterioration in quality of life. Over a long distance, the disease inevitably leads to family conflicts, alcoholism or drug addiction, social degradation and, ultimately, suicide. nine0011
With the right treatment for bipolar disorder, you can stabilize your psycho-emotional state and eventually achieve remission. Usually, it takes 15 to 20 days of hospital treatment to stabilize the psycho-emotional state. Achieving remission is possible subject to compliance with the prescribed drugs, with periodic outpatient visits to the attending physician to correct therapy.
Bipolar disorder consultation:
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- Post-discharge management
- Psychotherapy for couples and families
- Psychosocial personality correction
| Service | Price | |
|---|---|---|
| Outpatient treatment | nine0043||
| Psychiatric consultation | 5 000 ₽ | |
| Psychotherapist appointment | 5 000 ₽ | |
Reception of the chief physician Bocharov A. V. (Associate Professor, PhD) | 6 000 ₽ | |
| Psychiatric consultation at home | 6 000 ₽ | |
| Treatment in a hospital | ||
| Delivery to hospital | Is free | |
| Standard Chamber | nine0046 | 8 900 ₽ |
| 3-bed superior room | 12 000 ₽ | |
| 2-bed superior room | 15 000 ₽ | |
| 1 local VIP room | 19 500 ₽ | |
| Doctor's appointment 2 weeks after discharge | Is free | |
Causes of bipolar disorder
The main causes of bipolar affective disorder include genetic predisposition, disturbances in the metabolism of neurotransmitters and changes in nerve cells, and severe stress.
In other words, the disease can occur in any person, regardless of age, gender and social status. nine0011
Genetic causes
Genetic causes of bipolar disorder are a risk factor for the development of the disease. It should be emphasized that the disease itself is not inherited. However, inherited features of the regulation of neurotransmitters in the brain increase the risk of developing bipolar disorder in close relatives (for example, siblings) by 4–7 times.
Metabolic disorders in the brain
Another cause of bipolar disorder may be a metabolic disorder in the brain. An abnormal increase and decrease in the concentration of biologically active chemical compounds (mainly dopamine, serotonin and norepinephrine), which transmit nerve signals, is the cause of the manic and depressive phases. nine0011
Severe stress and the “biological defect” model
The psyche of each person has an individual threshold for resistance to stress. And the word "stress" does not necessarily mean difficult life situations - be it a dismissal, financial problems, family conflicts, divorce, or the death of a loved one.
Stress factors can be an upcoming birthday, puberty, marriage or the birth of a child.
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Fig. Zubin and Spring's stress-vulnerability model.
a) Low vulnerability, BD can only develop under severe stress.
b) High vulnerability, BAD develops even under low intensity stress.
c) Individual vulnerability, corresponds to the intensity of stress.
Symptoms of bipolar disorder
Treatment of bipolar disorder in our clinic
Typically treatment of bipolar disorder is carried out in the hospital of the clinic. The conditions of the hospital allow to reduce the duration of treatment - to conduct an examination, quickly normalize the patient's psycho-emotional state, select drugs and their minimum effective dosage, conduct dynamic monitoring and adjust pharmacotherapy.
Examination
On the day of hospitalization, the patient undergoes an examination, which includes:
- psychodiagnostics;
- consultation of a therapist;
- consultation with a neurologist; nine0004
- laboratory tests;
- EEG.
Lab tests include blood tests for hormonal status (generally, thyroid problems are found in people with bipolar disorder). Pathology of the thyroid gland directly affects mood swings, therefore, when treating bipolar disorder, it is important for a doctor to know the patient's hormonal background, for example: to prescribe drugs that normalize the thyroid gland, or to exclude lithium, which inhibits its work. nine0011
Drug treatment
Based on the results, the doctor will prescribe a treatment for bipolar disorder - select drugs that relieve autonomic symptoms and normalize the psycho-emotional state (normotimics, antidepressants). Usually, the first signs of improvement in mental health are observed on the fifth day after the start of drug treatment for bipolar disorder. However, the final correction of psychopharmacotherapy can take up to 10 days.
Psychotherapeutic assistance
After stabilization of the psycho-emotional state, the patient begins attending group psychotherapy sessions.
Group sessions with psychotherapists and psychologists of our clinic are held daily. Under the guidance of experienced facilitators, the patient will have the opportunity to work through their experiences and fears, get rid of pathological patterns, and receive professional help from psychologists and psychotherapists with clinical experience.
Post-discharge management
Discharge is usually after remission, 14-21 days treatment for bipolar disorder . Then the patient continues to take the prescribed drugs and visit the attending physician once every 1-3 months for 1 year. Subject to the achievement of stable remission, after 1 year, in some cases, it is possible to completely abandon the drug treatment of bipolar disorder.
Treatment of bipolar disorder in St. Petersburg is carried out at: st. Marata, 78. We take on complex cases, including the treatment of adolescent patients and patients with drug resistance. nine0011
Treatment of bipolar comorbidities
Psychotherapeutic treatment of bipolar disorder
Psychotherapeutic treatment of bipolar affective disorder, as an adjunct to pharmacotherapy, allows a faster deep remission.
Such treatment begins already in the hospital and can be continued after discharge. The number of sessions, their frequency and the form of psychotherapy (individual, family or hypnotherapy) you can choose together with the doctor. nine0011
In addition to individual psychotherapy sessions that correct the patient's personality, family consultations are possible. At family therapy sessions, relatives can better understand the nature of the disease and learn the right behavior that contributes to a speedy recovery. In addition, studies show that psychotherapeutic care reduces the number of hospitalizations for relapses.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy corrects abnormal behavior and thought patterns that occur in patients with bipolar affective disorder. In addition, during psychotherapy sessions, the patient will be able to learn to recognize relapses of the disease, cope with them on their own or seek help in time, preventing a full-blown episode.
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Family Therapy
If bipolar disorder has caused a deterioration in relationships with those closest to you, we recommend that you seek the help of a family therapist. The doctor will help relatives understand the features of the disease, resolve interpersonal conflicts and restore harmony in the family.
Individual sessions of psychotherapy help overcome mood swings during the formation of stable remission. By learning to control the psycho-emotional state, as well as working through pathological patterns, it becomes easier for the patient to cope with exacerbations of the condition, which may occur for some time after undergoing treatment in the hospital. nine0011
The consequences of not getting help
To describe what bipolar disorder is in simple terms, it is necessary to understand the specifics of the condition in which people with this disease find themselves. Living with bipolar affective disorder is not easy. People learn to live with bipolar disorder over the years, experiencing rapid ups and downs in both career and family life.
Imagine that you are walking on a zebra - now you are full of strength and enthusiasm, and the next minute you stop in a stupor and everything falls out of your hands: life loses its meaning, achievements no longer seem so significant, you want to escape from everyday life, hide from your eyes relatives, change their place of residence and work. nine0011
Add to this state of misunderstanding on the part of relatives and friends, who begin to consider you frivolous and incapable of finishing what you started to the end. At some point, you quarrel with relatives and, it would seem, nothing keeps you in this familiar and gray life. You can stay in this state for months, and then everything starts all over again. You are full of strength and enthusiasm - set yourself bold tasks, hardly sleep, call friends and want to hug strangers (just like that, because you are full of boundless love). nine0011
However, few "lucky people" with bipolar disorder manage to experience a depressive episode on their own from year to year.
Moreover, the depressive state distorts reality no less than the euphoria of the manic stage. It can take years or decades to learn how to "live" with bipolar disorder. But many do not succeed in doing this - and the lives of these people cannot be envied. Unfortunately, some of them are socially degraded or commit suicide.
Bipolar disorder in women
If you do not seek help in time, bipolar disorder in women can lead to family conflicts, divorce, promiscuity, and the development of borderline mental disorders. To a lesser extent, women with bipolar disorder are prone to alcoholism and drug addiction, although this scenario cannot be completely excluded.
Bipolar disorder in men
The development of bipolar disorder in men causes deterioration of relationships at work (possibly dismissal), family quarrels, seeking relationships on the side, addiction to alcohol and / or gambling (gambling, Internet surfing). Ultimately, domestic violence is not ruled out against the backdrop of a depressive episode.
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Remember, mental disorders, like somatic diseases, require treatment. When you find yourself in a difficult situation, when your loved one suffers from bipolar disorder, it is necessary to remain calm and show compassion. As a rule, patients themselves cannot adequately assess their condition, so it is often the relatives who need to take the first step to start treatment and sign up for a consultation with a psychiatrist.
Sources
Bipolar disorder, focus on depression — https://psychiatr.ru
Treatments for bipolar disorder - https://www.webmd.com
Social cognitive deficits in patients with bipolar disorder in remission - https://pubmed.ncbi.nlm.nih.gov
Psychiatric disorders - https:/ /www.who.int
Update date: 09/06/2022
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Bipolar disorder treated
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| Designation | Price, c. u. | Price, ₽ | Code |
RECEPTIONS
| Appointment (examination, consultation) with a psychiatrist (primary, repeated) | 352 U.E. nine0046 | 26 632 ₽ | CS44 |
| Appointment (examination, consultation) of a professor of psychiatry (primary, repeated) | 405 CU | 30 642 ₽ | CS54 |
| Appointment (examination, consultation) with a psychiatrist (short) (primary, repeated) | 190 c. u. | 14 375 ₽ nine0046 | CS55 |
| Group therapy / 1 session in a course of 6 sessions | 177 U.E. nine0046 | 13 392 ₽ | CS64 |
| Appointment (examination, consultation) of a professor of psychology (primary, repeated) | 405 CU | 30 642 ₽ | CS69 |
| Psychiatric pharmacogenetic counseling | nine0049 $57043 126 ₽ nine0046 | CS105 | |
| Appointment (examination, consultation) with a narcologist (primary, repeated) | 352 U. E. nine0046 | 26 632 ₽ | CS112 |
| Clinical psychologist software testing | 248 c.u. | 18 764 ₽ nine0046 | NFC7 |
| Evaluation of the psycho-emotional development of the child | 202 c.    Copyright © · The Wright Initiative · Articles · Site Map 
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