- [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.