Bipolar disorder is a complex psychiatric disorder that affects the neurotransmitters in the brain, causing emotions to short circuit. Those affected by bipolar disorder become paralyzed in their state, unable to pull themselves out. Bipolar disorder is a highly recurrent illness, even when patients are receiving optimal, evidence-based treatment. Patients of bipolar disorder are usually on a cocktail of medications made up of mood stabilizers, anti depressants and anti psychotics. Before understanding how to deal with a bipolar disorder relapse, it is best to clarify what may cause a relapse.
The following behaviors can lead to depressive or manic relapse:
Stopping medication or reducing dosage.
Under or over-medication.
Illicit drugs such as cocaine, alcohol, amphetamines or opiates.
Inconsistent sleep schedule.
It is believed that lower dosages of caffeine can work as an antidepressant but it can also be mania-inducing. If the patient is unable to manage stress they can easily relapse when not medicated. Medication works to help the patient deal with stress, but if there is still a great deal of stress and no coping measures in place, relapse is likely.
Keeping Track
Treatment success is only seen over the long term. Relapse is fairly normal over the long term which is why psychiatrists work on psychotherapy measures in combination with the medication. It is important that the patient report mood changes immediately to make adjustments to the medicine before a relapse occurs. Medication adjustments are a normal part of long term maintenance treatment and should not be viewed as a failure of the treatment.
Long-term Use of Medicines
It can be difficult to follow long term treatments of any illness; such is the case with bipolar disorder treatments. While you may want to stop your treatment due to not having had a relapse in a long time or having negative side effects, you should know that stopping medication nearly guarantees a relapse within a matter of months, sometimes even weeks. You will even face an increased change of suicide if you stop taking some medicines (like lithium) without tapering off under the care of a doctor.
Discontinuing Medication
Discontinuing medication should always be done under the watchful eye of your psychiatrist. If you choose to stop taking medications, the risks are incredible that you will soon relapse. Sometimes the doctor will begin tapering medication after only one year if there has been only one episode of mania. Unfortunately, if you have a family history of bipolar disorder or severe episodes, you should consider very long-term maintenance treatment. Indefinite medication treatment is recommended in any patients who have had two or more episodes of either type.
You should really only discontinue a preventive/maintenance medication due to a medical condition or severe side effects. If you are a woman trying to conceive, you may want to consider reducing dosage or stopping medication but you should be aware that it can lead to a relapse.
Psychotherapy
Psychotherapy is a great addition to medication treatment and it can help prevent relapse. There are five major psychotherapy treatments for bipolar disorder along with medications. They are:
Prodrome Detection.
Psycho-education
Cognitive therapy
Interpersonal/Social Rhythm.
Family focused therapy
By engaging in any one of these therapies, the patient and their family clearly understands the disorder and its impact on each individual affected. They also get a clearer picture about things which may act as triggers of relapse. Hence, they are then in a position to control these triggers and prevent these relapses.
Most cases of relapse occur because of inconsistency in the medication or therapy plan. People close to the patients must take it upon themselves to ensure that the medication plan is adhered to and that all therapy sessions are attended. After all, bipolar disorder is not dealt with alone on medication or therapy. It is a mixture of both things which, when done meticulously over a period of time, reduces the severity of the disorder and decreases the chances of relapse.
