RCPsych: New leaflet offers help in coping with Bipolar Disorder

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New leaflet offers help in coping with Bipolar Disorder

"Sometimes I just feel the blackest despair, that life has no meaning at all...and then a few weeks later I can be as high as a kite, running around feeling great. It's like a roller coaster."

Bipolar Disorder is the title of a new leaflet in the 'Help is at Hand' series from the Royal College of Psychiatrists. It is designed to help anyone who has the condition themselves, and for their friends and relatives.

About 1 in every 100 people have bipolar disorder at some time in their life. It usually starts during the teenage years, and affects men and women equally.

Bipolar disorder used to be called 'manic depression', and as the name suggests, its symptoms are mood swings - from feelings of intense depression and despair to feeling 'high' and elated. Some people experience a mixture of the two; for example, depressed mood, with the restlessness and overactivity of a manic episode.

The leaflet describes the different types of bipolar disorder, and explores what may cause it. Research suggests that it has more to do with genes than upbringing, and that brain chemicals are involved. Episodes can sometimes be brought on by stressful experiences or physical illness.

There are several prescription medications to stabilise mood, including lithium, a naturally occurring salt, which has been used for 50 years. People taking lithium need regular blood tests to make sure that they are getting the right dose.

Other mood stabilisers include the anticonvulsants sodium valproate and carbamazepine, and some antipsychotic medicines. Sometimes a combination of drugs is needed. The leaflet describes how these different medications should be used.

Psychological treatments for bipolar disorder can be useful in between episodes of mania or depression. They include learning about the disorder (psychoeducation); mood monitoring and strategies; help in developing coping skills; and cognitive behavioural therapy (CBT) for depression.

Women with bipolar disorder should discuss any pregnancy plans with their psychiatrist. Although lithium is safer than the other mood stabilisers, the risk to the baby needs to be weighed against the mother becoming depressed or manic. During pregnancy, everyone involved - the obstetrician, GP, psychiatrist and community psychiatric nurse - need to work together.

The leaflet gives detailed information about how doctors treat a manic or depressive episode, as well as advice on self-help. Self-monitoring encourages people to learn how to recognise the signs that their mood is swinging out of control, so that they can get help early.

Depression or mania can put a great strain on relationships, and it is important that friends and family understand the illness and what they can do to help. People with bipolar disorder need to balance their life and work, leisure and relationships.

Where possible, they should try to avoid stressful situations. Taking regular exercise, and doing things that are enjoyable, also help to stabilise mood.

It is important to continue with medication until the doctor thinks it is safe. If a person has been admitted to hospital for bipolar disorder, they can have a say in their treatment by writing an 'advance directive' with their doctor and family stating how they want to be treated if they become ill again.

The leaflet gives advice for family and friends on how to deal with a mood episode, helping the person to stay well, staying well themselves, dealing with an emergency, looking after children and explaining bipolar disorder to children.

It also provides information on support groups and caring organisations, and suggestions for further reading.

Bipolar disorder is available free on receipt of a stamped addressed envelope from the Royal College of Psychiatrists, 17 Belgrave Square, London SW1X 8PG. Tel: 020 7235 2351, E-mail: leaflets@rcpsych.ac.uk

For further information please contact Deborah Hart or Thomas Kennedy in the External Affairs Department.

Telephone: 020 7235 2351 Extensions. 127 or 154

E-mail: dhart@rcpsych.ac.uk or tkennedy@rcpsych.ac.uk.


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