Treatments for bipolar disorder | Mental health | NCLEX-RN | Khan Academy`

Treatments for bipolar disorder | Mental health | NCLEX-RN | Khan Academy`


– [Voiceover] Bipolar Disorder
is treated with medication and with specific
psychological interventions. In terms of the medication
the most common treatment is also the oldest one
and that’s treatment . with Lithium Salts. And, this has actually
been the primary treatment for Bipolar Disorder
for the last 50 years. And, that’s because it’s
still the most effective treatment that we have. It’s still the most effective
at managing manic episodes. But, as it turns out
researchers still aren’t 100% certain why it’s so effective. They’re not certain about how
it works on neuronal level. One theory is that Lithium
enhances serotonin release by increasing production of the components that make up serotonin or
maybe that it increases serotonin release in other ways. But, there are also
theories that focus on other neurotransmitters. So, there are some theories
that say Lithium enhances the reuptake of
Norepinephrine and in doing so it would decrease the effect
of Norepinephrine over time. There are other theories
that state that Lithium actually exerts it’s effects
on areas of the neuron other than the synapse. So, one theory is that it
influences the sodium channels along the axon, the ones
that help move the action potential down the neuron. And, who knows, maybe in
a year or two research will lead us to a newer,
more accurate hypothesis and then I will have to remake this video. But, for the time being know
that whatever the mechanism is it is a very effective mood stabilizer. It has other things going for it as well, it’s also relatively fast
acting, so it starts to work in as little one to two weeks. And, it also avoids some
of the worst side effects that we might see in
other Bipolar medications. Specifically, it doesn’t bring
about a depressive episode or cause general sedation. And, you can see why
this might be a concern for Bipolar medications
that in bringing people down from mania they could inadvertently
push them too far down or too far in the other direction. But, with that said Lithium
does have other side effects. The first one I want to
talk about isn’t so much a side effect as it is a
problem with mood stabilizers more generally, and that’s
that individuals sometimes treat Lithium the same way that
they might treat medications for a headache. So, if you have a headache
you might take something to make it go away and once
you feel better you don’t take any more of the drug. But, Lithium and also
other mood stabilizers they don’t work this way,
individuals need to keep taking them for the
medication to be effective. They can’t just stop taking
them once they feel better. In terms of side effects of
taking Lithium specifically a big one is the effect that
Lithium can have on memory. It can cause memory loss
and can also cause problems with creating new memories. Another side effect is that
Lithium can sometimes blunt normal mood changes and
this can lead to a huge decrease in quality of life. So, imagine not being able
to feel happy at your own birthday party, or not
feeling sad when a partner loses a job. These kinds of mood changes
are a part of everyday life and it’s very apparent to
people when they’re missing. Some individuals might
also be hesitant to give up their manic episodes because
they see them as something positive, even though they
can be incredibly destructive they can also increase
a person’s productivity and their creativity. So, individuals might be
resistent to taking medication to stop something that they
don’t believe is a problem. But, maybe the biggest side
effect of Lithium has to do with toxicity. Lithium can effect kidney
and thyroid functioning, and this can become even worse
when a person is dehydrated which is something that
Lithium itself causes. So, individuals who take
it have to be very careful about staying hydrated at all times, even more so than the rest of us. And, because of this toxicity
problem people taking Lithium need to be carefully
monitered by doctors. The last side effect I want
to talk about isn’t really a side effect at all, it is
actually more of a limitation. And, that’s that Lithium doesn’t
treat depressive episodes. So, it helps with mania,
but it doesn’t help with the depression part of Bipolar Disorder. And, because of this
individuals taking Lithium generally have to take an
antidepressant as well. And, this can lead to two problems. One is that some
antidepressants like SSRIs which are the most common
treatment for depression they can actually trigger
manic episodes for some individuals with Bipolar Disorder. And so, this can limit treatment options. And, the second point is that in addition to the side effects from
Lithium the patient will also have to deal with any side
effects for this additional antidepressant. I wanna point out that there
are some other medications that people are using to
treat Bipolar Disorder. There has been success with
treatments that involve anticonvulsants and
antipsychotics, and also some benzodiazepines. But, at least in the short
term, like I said before, Lithium is still the preferred treatment. So, now I wanna move on to
talk about psychological treatments. And, you might remember
from your psychology class or from other videos in this
series that there are some psychological interventions
that are very effective for treating Major Depressive Disorder, sometimes as effective as medication. But, the same is not
true of Bipolar Disorder. Psychotherapy in all forms
from Psychodynamic Therapies to more modern forms of
pychotherapy, they are not effective in treating Bipolar Disorder. Talking about Bipolar
Disorder and trying to find the cause isn’t very
helpful for this disorder. One type of therapy that is
very effective in treating depression is CBT, or
Congnitive Behavioral Therapy. And, this type of therapy
addresses problematic thoughts and behaviors. So, it’s a very action oriented therapy. But, even though it is
effective in treating depressive symptoms of Bipolar
Disorder it is not effective in treating manic episodes. But, even if these
psychological interventions don’t help treat the
symptoms of Bipolar Disorder directly, they can still
be a very important part of the treatment of Bipolar
Disorder more broadly. For example, CBT can provide support for an individual after a
manic phase has ended. So, it can help them to fix
the social and financial situations that might
have been brought about from the manic episode. But, it turns out that the
most effective type of therapy for Bipolar Disorder is
actually family therapy. There’s a lot of research
that shows that stressful situations can trigger manic
episodes for individuals with Bipolar Disorder. And, we know that this is especially true for social stressors. And, because living with
someone with Bipolar Disorder might be stressful for the
family that family might sometimes inadvertently be
triggering for the individual with that disorder. And so, it turns out
that one of the best ways to manage Bipolar Disorder,
both short term and long term, is by providing the family with
the tools necessary to help them provide support
and to help them provide a stable home environment.

Comments

(14 Comments)

  • Julie Элизабет

    I'd just like to point out that CBT DOES help with mania. (It helps me, at least.) Also, DBT – Dialectical Behavioral Therapy – is really good for a large range of disorders (Bipolar 1 & 2, Borderline Personality Disorder, PTSD, etc.)

  • richmaloon

    1998 research at University of Wisconsin Medical School found reason why Lithium helps bipolar here: http://news.wisc.edu/research-explains-lithiums-dual-anti-manic-anti-depressive-effect/

  • 1cakesz

    You speak so well. Thanks for sharing

  • The Indian

    jog in fresh air .

  • noway noway

    drugs destroy my life

  • anuska mishra

    I'm not sure but ,if anyone else wants to learn about cure of depression try Nevolly Depression Remover Nerd (just google it ) ? Ive heard some incredible things about it and my mate got amazing success with it.

  • kathryn lapolla

    Well I was hopeful about finding treatment. Then I watched this video. Now feel even worse, thanks

  • Kethnie Moreau

    GREAT JOB! THANK YOU

  • Jake Jager

    I love there videos! They are very informative, however, I'm currently on a mood stabilizer called Lomictal. Can you possible make a credo explaining what areas of the brain it works in, any risk factors, etc. the other videos who've posted have really educated me on SSRI's, NDRI's as well as the dangers of using MAOI's. I know this is a big request but I really want to know more about how it works in your body. Keep up the amazing work 🙂 you guys are amazing!

    Thanks
    Jake

  • Cari

    Lithium is for depression then?

  • Jacob McIntyre

    Just my theory.
    I was more functioning on bipolar symptoms then on meds. The thing that helped me was to learn to channel the mania, like working a manuel labor job, going to the gym, aa meeting every night, playing xbox, listening to music, playing guitar, fishing,hiking. Driving around. Its best to honestly channel it. With the an anti phycotic that is in a low dosage then work your way up from there.
    Along with talk therapy a therapist. Its helped me. My problem mainly is sleeping. If i dont sleep it throws everything off. If i get a good sleep then im good.

  • Jacob McIntyre

    Thats why i use to drink like a 40 every night it calm me down and it would help me sleep. And i d use the energy to work.

  • robin guy

    I use meditation, diet, exercise and acupuncture to manage my bipolar 11 disorder. I found the drugs made me put on weight (which is depressing), plus I had mental side effects from the drugs (suicidal was one). Diet, exercise and staying away from negative people (or just people – sorry that's the bipolar in me talking). Possibly in order of treatment I'd say diet, acupuncture, meditation then exercise (taiji/martial arts, cycling/a bike and some weights) to keep balance. Focus on brain plasticity to stay in the centre, eat omega 3 food along with brain feeding carbs, limit inflammatory omega 6's (peanut butter etc) and get the right type of REM sleep, stay away from too much stimulating drinks (caffeine), drugs (you know what I meen) and drink at least 2 litres of water a day, and remember to love yourself and other people!!!

  • Bipolar Solutions

    Thanks for sharing this video on Bipolar!

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