Getting the most from bipolar medications, how long you should keep taking them and when should you stop a medication for bipolar disorder.

Gold Standard for Treating Bipolar Disorder (part 9)

Dr. John Preston, the author of "The Idiot's Guide to Managing Your Moods" has the following suggestions for optimal medication use before you decide to stop or change a medication for bipolar disorder:

1. It's very important that you give your medications enough time to work. This can take much longer than you want it to, but it's often the case that some medications can take six weeks or longer to become effective.

2. Changing medications with the help of a prescribing healthcare professional can help you find something that works with fewer side-effects. There may be a host of new medications you haven't tried.

3. Augmenting a current medication can help significantly. For example, if your mood stabilizer is only partially working, adding one of the newer antipsychotics may provide more relief. Talk with your healthcare professional about your options.

4. Change the times you take your medications. If one causes drowsiness, take the drug before bed. If one is agitating or increases your energy, take it upon waking up.

5. Side-effects that lower sex drive, cause impotence or make a person unable to have an orgasm can often be eliminated by adding another drug or changing the medication. For some, depression itself lowers sex drive and certain medications can help restore it.

6. Instead of focusing solely on what the medication is not doing, instead look at your mood swing chart for a realistic picture of your mood swings as well as how you're relating to friends, family and co-workers. There is always a chance that you may think that your medications are not working, but they may be helping in areas you don't expect them to work. For example, you may be taking a mood stabilizer for depression that doesn't reduce the depression as you would like it to, so you go off the drug. You then start to have symptoms of anxiety, rapid-cycling, suicidal thoughts or focus problems that may be unrelated to depression. Improvement can be so gradual that you lose sight of how you were before the medication and stopping it can lead to some serious setbacks.

7. Many people say they have tried everything and yet if you look at their history very carefully, there is a chance the dose was not correct or that the person went off the medication too soon. Thus, it's very important that you talk with a healthcare professional and make a very careful evaluation of your medication type and dosage before you make a change or decide that medications will never work for you.

8. Side-effects can be sometimes be eased by using microdosing.

9. Treating bipolar disorder comprehensively can lead to reduced medications - which translates to fewer side-effects.

10. When it comes to medications, you have to ask yourself: "have I really explored all of my options?"

How Long Will I Have to Stay on Medications for Bipolar Disorder?

Many people with bipolar disorder will need to stay on maintenance medications for life. Of course, there is always the hope that medical research will improve this situation, but considering that mood swings are often triggered by outside events, medications are the best way for a person with bipolar disorder to maintain stability.

When Should I Stop a Medication for Bipolar Disorder?

There is little more frustrating or scary than taking a medication that either doesn't seem to work or one that has such serious side-effects that you feel the medication causes more problems than it helps. It can also be very frustrating when you express your concerns to a healthcare professional and they say, Let's just give this time to work; especially when you feel you can't take the medications for another day. This can often lead you to decide that you need to stop the medications on your own.

It's important to know that this can be very dangerous. Medications change your brain chemicals and affect the physical body. Your brain and body need time to adjust as the medicine is removed from your system. Going off a bipolar disorder medication too quickly and without supervision can result in suicidal thoughts, extreme bodily pain and a host of other symptoms. This is why you will have to talk with a healthcare professional to find out when and how to end the dose.

It can seem impossible to wait it out when a drug is making you iller than when you were off the drug, but you have to do things slowly in order to make sure you don't become even more ill as you stop using the bipolar medication.

What if I'm Feeling Better and Don't Really Need Medications for Bipolar?

Just because you're feeling better, it may not be time to stop your medication. The importance of maintenance medication for the treatment of bipolar disorder cannot be stressed enough. It's not unusual that people with bipolar disorder start to feel better on their medications and then feel that they are no longer needed. This thought then leads to the idea that things are currently better than they actually were in the past and that the mood swings were just a passing problem. This is rarely the case. If you were not doing well before taking medications and then suddenly feel better (and are sure it's not mania), there is a very good chance it's the effectiveness of the medications and not a spontaneous reduction in mood swings.

next: Are Bipolar Disorder Medications Safe If I'm Pregnant? (part 10)

For most people with bipolar disorder, medications provide only partial relief. But can you get better results from bipolar medication treatment?

Gold Standard for Treating Bipolar Disorder (part 8)

The goal of all medication treatment for bipolar disorder is a maximum reduction of symptoms. In a perfect world, this would be the case. In reality, most people find that while they can definitely get relief from many of their symptoms, there are still many that remain. There is also the chance that symptoms will get worse when you're faced with a life-stressing trigger. (Trigger management will be covered later in this section.)

If you feel that you're not getting enough help from your medications, especially when you think of the side-effects you're experiencing, it's time to talk to your medications healthcare professional. It may be that different doses or a complete medication change will offer better results, but as always, it's important that you keep track of your moods and how well you think the medications are working so that you can have a productive discussion with your doctor about your medication efficacy.

next: How Can I Get the Most from My Medications? (part 9)

Some people can't tolerate the side-effects of medications for bipolar disorder. Microdosing can help.

Gold Standard for Treating Bipolar Disorder (part 7)

Some people have a very hard time tolerating bipolar medications at suggested doses. One way to get around this is to take a very small amount of the drug from the beginning so that the body can acclimate as the dosage increases. This helps people who would normally not be able to receive the benefits of a drug because of excessive side-effects be on the drug long enough to see if it works.

How Do I Get Help If I Can't Tolerate Bipolar Medications?

Dr. Peter Hauser, Chief of Psychiatry Service at the Portland, Oregon VA hospital notes, "This is where the approach is more of an art than a science. When I work with a patient, I want to know what medications worked in the past. What medications worked and then stopped? Was there partial relief from medications? I also want to know what medications were detrimental so that we can work together to make informed decisions." Though it may feel you can't tolerate medications at all, working with an experienced healthcare professional who understands your situation can often help you find a medication that works and has less debilitating side-effects.

next: What if I'm Only Getting Some Relief From the Medications? (part 8)

A list of common bipolar medication side-effects, why some are so serious, and a mood and medication side-effects chart for you to use.

Gold Standard for Treating Bipolar Disorder (part 6)

Side effects are the number one reason people with bipolar disorder stop taking their medications. And for many, one bad experience leads to the idea that no medication will be helpful. This is an unfortunate decision, as many side-effects can either lessen over time or be managed with medication dosage changes, adding a new drug or switching to a drug that you are more able to tolerate. Because people with bipolar disorder usually take more than one medication, it's important that side-effects be monitored and taken seriously by a healthcare professional. The goal is to find a balance between the efficacy (effectiveness) of the medication and its potential side-effects.

Common Bipolar Medication Side-effects

• Dry mouth
• Nausea
• Increased appetite and weight gain
• Lack of appetite and weight loss
• Sexual side effects
• Fatigue, drowsiness
• Insomnia
• Waking up too early and unable to go back to sleep
• Blurred vision
• Constipation/diarrhea
• Dizziness
• Agitation, restlessness, anxiety
• Irritation and anger
• Aggressiveness
• Suicidal thoughts

The side-effects from bipolar medications can feel overwhelming at first. While some people experience few drug side-effects and are able to find relief from their first medications, others may have to work on the dosage and/or try other medications before finding one that can be tolerated. It's often true that side-effects can end or lessen over time. This is why it's so important for you to give your medications a chance, usually 8-12 weeks, before deciding they will never work.

It must be said that there are some side-effects that are intolerable such as suicidal thoughts or excessive weight gain. This is when contacting your healthcare professional is essential. You can then work together to find a medication that you are better able to tolerate.

Why Are Bipolar Disorder Side-effects So Serious?

Many people are used to and expect that drugs used to treat cancer will have side-effects such as hair loss and other physical problems. And yet when similarly intense side-effects result from bipolar disorder medications, people are often shocked and discouraged from treatment. Medications for bipolar disorder work by regulating brain chemicals such as serotonin, norepinephrine and dopamine. Unfortunately, it's impossible to harpoon a drug directly into the brain. It first travels through your body, possibly causing a host of problems, before it reaches its target.

For many people, excessive weight gain, possible diabetes, lack of sexual desire or ability, physical discomfort from stomach problems or severe tiredness are unacceptable. For others, just being stable enough to function is a trade off for certain side-effects. This is another area where you need to talk with your healthcare professional and work together to find medications that truly work for you. Taking the time to do this is a better choice than going off your first medications and assuming that other medications will have the same problems. Though it may take much longer than you hoped, there is always a chance that you will find medications that do help you find stability with a minimum of side-effects.

Tracking Your Moods and Medication Side-effects

Tracking the ups and downs of bipolar disorder on a mood chart is an excellent way for you to see your specific mood patterns so that you can receive more effective treatment. You can write down what has happened on the days of severe mood swings as well as chart your medication side-effects. This can be invaluable information for you and your medications healthcare professional.

next: What is Microdosing? (part 7)

When it comes to finding the right bipolar medications, it's really a matter of trial and error.

Gold Standard for Treating Bipolar Disorder (part 5)

This is a difficult question for many healthcare professionals as well as people with the illness. It's known that the first bipolar disorder medications tried are not always successful and that a trial and error process is usually indicated. Some people try medications for a year or more until they find something that works for them. Considering bipolar medication side-effects and the impact on the body when stopping or changing medications, it's important that you work with your healthcare professional closely when you're asked to try a new medication.

How Long Does it Take for Bipolar Disorder Medications to Work?

Medications work differently in each person. This can lead to a lot of frustration if you feel your medications aren't working, but the reality is that finding a combination of medications that works for you can involve a lot of trial and error. This does sound discouraging, but the alternative is often worse than trying the medications. If you're working with your healthcare professional on the right course to take, he or she should be able to let you know what to expect. This highlights the reason it's so important that you have a medications healthcare professional who really knows how to prescribe and monitor medications correctly

next: What About Side Effects? (part 6)

Discussion of mood stabilizers to treat bipolar disorder and why people with bipolar have to take so many pills.

Gold Standard for Treating Bipolar Disorder (part 4)

Bipolar disorder is a complex illness that often responds to a variety of medications. When a person is initially diagnosed with bipolar disorder, the first medications chosen depend on a number of factors. For example:

1. Is the person currently depressed or manic?
2. Is psychosis involved?
3. Is the person in the hospital?

In general, the first choice medication is a mood stabilizer. If you're stable enough, you and your medications healthcare professional can work together to find the best initial medication that works for you. Dr. Jim Phelps, the author of "Why Am I Still Depressed? Recognizing and Managing the Ups and Downs of Bipolar II and Soft Bipolar Disorder" suggests that "Reducing mood swings is the most important element in treating bipolar disorder. Because of this, using antidepressants which may cause mania as a first treatment option is not in the best interest of reducing the mood swings. Medications treatment for bipolar should focus on stabilizing the mood through the use of mood-stabilizing drugs including the use of antipsychotics." Your healthcare professional should know the protocol of the type and order of medications used to treat bipolar disorder.

Why Am I On So Many Pills?

As you probably know from experience, bipolar disorder is much more than mania and depression. People with the illness can experience psychosis, anxiety, obsessive-compulsive behaviors, ADHD symptoms and much more. This means that a variety of medications may be needed to get your mood swings under control.

You can download a file called the Quick Reference Guide to Psychotropic Medications that lists in detail the various medications used to treat bipolar disorder. This will help you identify the medications you may currently be taking, as well as help you ask informed questions of your prescribing healthcare professional. It's very important that you're involved in your own treatment and do your own research on bipolar disorder medications and how they work to manage mood swings.

How Much Do I Really Need to Know About My Medications?

You would rarely put food in your mouth without checking what it is. Nor should you simply take medications without knowing exactly why you're taking them and how they will affect your body.

The more you know about the bipolar medications you're taking, the better able you will be to know what side-effects to expect, whether the medications are effective and finally, how to better advocate for yourself to make sure you're getting the best treatment. This does not mean you should second guess your healthcare professional; it simply means that you will know the questions to ask when you want to take part in your own treatment instead of blindly accepting treatment you don't understand.

next: How Many Medications For Bipolar Should I Try? (part 5)

Overview of the most effective treatment for bipolar disorder and who should be managing your treatment for bipolar.

Gold Standard for Treating Bipolar Disorder (part 3)

A comprehensive approach that combines effective and tolerated medications, psychotherapy and essential lifestyle and behavioral changes is the best approach to treating bipolar disorder. Today, this is more possible as patient-centered treatment is considered the norm. This treatment style involves the person with bipolar disorder much more closely with his or her treatment than in the past. Optimally, people with bipolar disorder and their professionals work together to choose the best treatment options and change the options as needed, depending on reasonable feedback from the patient.

Who Should be Managing My Treatment for Bipolar?

As you start to take more charge of managing bipolar disorder, it's important that you choose professional people who can best support your choices. There is no doubt that finding the right support can be difficult, but you do have options. The following list can help you find someone who best fits your needs.

• a professional who knows how to correctly diagnose and treat bipolar disorder (usually a psychiatrist).
• a professional that understands the wide range of bipolar disorder medications and works with you to find the right medication combination.
• a team that has the time to suggest treatments other than medications alone, including one trained in psychotherapy and comprehensive treatments.

How Do I Choose the Best Medications and Professional?

Bipolar disorder is a complicated illness. The more experience a medications healthcare professional has with bipolar disorder symptoms and their considerable treatment challenges, the better chance you have of receiving optimal care. Depending on your state, physicians (MD's and DO's), nurse practitioners, physician assistants, and psychologists are authorized to prescribe psychiatric medications. Your healthcare professional should know what bipolar disorder is, how it's best treated and what medications should and should not be used in treatment.

next: What Medications are Currently Used to Treat Bipolar Disorder? (part 4)

Learn about the differences between Bipolar I and Bipolar II, the two main types of bipolar disorder.

Gold Standard for Treating Bipolar Disorder (part 2)

Having an exact bipolar disorder diagnosis is important as the treatment can be quite different for each diagnosis. There are two main forms of bipolar disorder:

1. bipolar I
2. bipolar II

Each form of the illness has a depression mood swing, but mania is the deciding factor for any bipolar disorder diagnosis. There are two forms of mania:

1. mania
2. hypomania

Mania is defined as a distinct period during which there is an abnormally and persistently elevated, expansive or irritable mood. Full blown mania has more severe symptoms while hypomania has similar symptoms but of less intensity. Both can cause considerable damage to a person's life. Within the bipolar disorder diagnosis, there is also a complication of the illness called rapid-cycling. If you have four or more severe episodes during a one-year period, then you're considered a rapid cycler. Some people experience ultra-rapid cycling (also known as ultradian rapid-cycling) where there may be a dozen or more episodes in a one-year period or for some, a shift in moods throughout the week or day.

Knowing what form of bipolar disorder you have and whether you have trouble with rapid-cycling is imperative, as it will change the way your illness is treated.

next: What is the Most Effective Treatment for Bipolar Disorder? (part 3)
 

Authoritative information regarding all aspects of treatment for bipolar disorder, from getting a correct diagnosis to bipolar medications, therapy and lifestyle changes. Written by award-winning mental health author, Julie Fast, exclusively for HealthyPlace.com.

Everything You Need to Know About Bipolar Treatment in Plain English

Bipolar disorder is a brain disorder that affects a person's ability to regulate moods. The main cause of bipolar disorder is a chemical imbalance in the brain, but the illness also involves genetic, environmental and other factors. Bipolar disorder is complex illness that affects an estimated 15,000,000 people in the United States alone and naturally leads to considerable problems in a person's life; especially when bipolar disorder is not being treated successfully. People with bipolar disorder are often seen as out-of-control, lazy, difficult or just plain crazy. This makes sense when looking from the outside, as a person with constantly changing moods can be very hard to live with. However, from an internal perspective, people with bipolar disorder know that these mood swings are not by choice and that extensive help is needed to get them under control.

As you start your bipolar disorder treatment plan, there are four questions you should be able to answer:

1. Do I have a correct and thorough diagnosis?

2. Who can help me manage bipolar disorder effectively?

3. What is my optimum medications treatment?

4. What can I do to manage the illness comprehensively along with my medications?

The following article will help you answer these questions as well as provide you with the information and tools needed to manage bipolar disorder successfully.

next: What Kind of Bipolar Disorder Do I Have? (part 2)

Videos on different aspects of bipolar disorder treatment - from where to get help for bipolar disorder to bipolar treatment frustrations and dealing with hopelessness. HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, provides answers. These videos on bipolar disorder accompany the special section on HealthyPlace.com entitled "The Gold Standard of Treating Bipolar Disorder" written by Ms. Fast exclusively for HealthyPlace.com.

Go here for video interviews on the personal aspects of living with bipolar disorder.

1. Getting Help for Bipolar Disorder (video): What's entailed in getting help for bipolar disorder? Here's HealthyPlace.com Consumer Expert and author, Julie Fast.

2. Who Should Diagnose Bipolar Disorder? (video): Family doctor. Psychologist. Psychiatrist. HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, talks about the best doctor to see for a diagnosis of bipolar disorder and bipolar treatment.

3. Bipolar Disorder: Getting a Correct Diagnosis (video): What's involved in getting a correct diagnosis for bipolar disorder? HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, has the answer.

4. Difficulty of Diagnosing Bipolar Disorder (video): Getting a proper and correct diagnosis of Bipolar Disorder can take a long time. HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, explains why.

5. Bipolar Disorder: Misdiagnosed with Depression (video): Many with bipolar disorder are misdiagnosed with depression. HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, explains why that happens.

6. Feeling Intimidated By Your Doctor (video): HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, discusses what to do if you feel intimidated by your doctor.

7. Management vs Cure for Bipolar Disorder (video): Can Bipolar Disorder be cured or is managing your bipolar symptoms the best you can hope for? HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, provides the answer.

8. Most Effective Treatment for Bipolar Disorder (video): HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, on the need for a comprehensive plan for treating bipolar disorder.

9. Comprehensive Treatment of Bipolar Disorder (video): Going to the doctor for bipolar medications doesn't constitute a total plan for treating bipolar disorder, says HealthyPlace.com Expert Bipolar Patient and author, Julie Fast.

10. Importance of Knowing Your Bipolar Medications (video): HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, discusses the importance of knowing about your bipolar medications.

11. Lifestyle-Behavioral Changes for Treatment of Bipolar Disorder (video): HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, on successful ways of managing bipolar disorder besides medication.

12. Bipolar Disorder is Difficult to Treat (video): HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, discusses the impact of bipolar disorder and how difficult bipolar is to treat.

13. Bipolar Disorder Treatment Frustrations (video): Getting treatment for bipolar disorder can be a frustrating process. HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, explains why.

14. Psychiatric Hospitalization for Bipolar Disorder (video): Learn about psychiatric hospitalization for bipolar disorder. Why it's needed and what psychiatric hospitalization is like.

15. Bipolar Relapse (video): What causes a bipolar relapse? HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, discusses the triggers.

16. What Does A Bipolar Relapse Look Like? (video): What does "bipolar relapse" really mean and what causes a relapse of bipolar disorder? HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, has the answers.

17. Bipolar Treatment: No Health Insurance (video): How do you get treatment for bipolar disorder when you don't have health insurance? HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, has some suggestions.

18. Bipolar Disorder: Dealing with Hopelessness (video): Many people with bipolar disorder feel hopeless and believe that things will not improve. HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, says living with bipolar disorder can produce those feelings, but there are things to feel hopeful about.

19. Self-Medicating Your Bipolar Disorder Symptoms Away (video): Many people with bipolar disorder self-medicate by drinking alcohol or smoking pot to deal with their bipolar symptoms. But is that okay?

20. Patient Refuses to Acknowledge Bipolar Disorder. Now What? (video): Here's what to do if your family member denies having bipolar disorder or another mental illness. HealthyPlace.com Expert Bipolar Patient and author, Julie Fast, has been through that.

Go here for video interviews with Julie Fast on the personal aspects of living with bipolar disorder.

next: Gold Standard for Treating Bipolar Disorder - Table of Contents
~ all bipolar treatment articles
~ all articles on bipolar disorder