Bipolar disorder nonpharmacologic

Bipolar disorder (manic-depressive illness) is one of the most common of the severe chronic psychiatric disorders. The cyclic mood disorder is characterized by recurrent fluctuations in mood, energy, and behavior encompassing the extremes of human experiences.Bipolar disorder differs from recurrent major depression (or unipolar depression) in that a manic, hypomanic, or mixed episode occurs during the course of the illness. Bipolar disorder is a lifelong illness with a variable course and requires both nonpharmacologic and pharmacologic treatments for mood stabilization. ... 

Treatment of bipolar disorder must be individualized because the clinical presentation, severity, and frequency of episodes vary widely among patients. Treatment approaches should include both nonpharmacologic and pharmacologic strategies (Table 68-6). Patients and family members should be educated about bipolar disorder (e.g., symptoms, causes, and course) and treatment options. Longterm adherence to treatment is the most important factor in achieving stabilization of the disorder. 

TABLE 68—6. General Guidelines for Nonpharmacologic and Pharmacologic Treatments for Bipolar Disorder... 

Dual-diagnosis treatment program substance abuse plus standard pharmacologic/ nonpharmacologic treatments for bipolar disorder hepatic dysfunction from chronic alcohol abuse or from hepatitis may alter the metabolism of some agents Lithium long-term treatment associated with reduction of suicide risk and mortality... 

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