Bipolar disorder patient education

Drug treatment is a vital part of the management of bipolar disorder, both during episodes of depression or mania and as prophylaxis thereafter. Patients require explanation and education about the illness and about the treatments available, in order to be able to make informed choices and to avail themselves of the appropriate options fot treatment. 

Educate patients with bipolar disorder about their illness, drug therapy required for... 

Educate the patient on the nature of bipolar disorder and its treatment, what to expect with regard to response and side effects, and stress the need for adherence to treatment, even when feeling well. 

Patient education about the role of lithium in the prophylaxis of bipolar affective disorder and discussion of the pros and cons of taking the drug are particularly important to encourage compliance with therapy treatment cards, information leaflets and where appropriate, video material are used. 

Although medications are the primary treatment modality for bipolar disorder, it is important to consider the impact of medications in conjunction with other forms of treatment. For instance, milieu therapy, when inpatient care is necessary, will be most effective after initial medication response has reestablished some degree of cooperation and insight. Psychotherapy, especially cognitive, behavioral, and psycho-educational approaches, is effective with the medication-stabilized patient. Group therapy, which can include families, will often revolve around acceptance of the disease as well as of the need for long-term medication treatment, the side effects, and the implications of noncompliance. In instances of medication resistance or contraindications, ECT should be considered. 

Comprehensive patient education is critical in ensuring compliance and in ultimately limiting the devastating effects of bipolar disorder. Perhaps the most difficult fact for the patient to accept is the need for long-term treatment. In addition, patients must become active participants in identifying target symptoms and critical side effects, especially with lithium. 

Patients and family members should be educated about bipolar disorder and treatments. Long-term monitoring and... 

Severe psychiatric illnesses such as bipolar disorder often manifest themselves during adolescence and young adulthood, and result in disruption of educational, occupational, marital, and other pursuits. Residual symptoms are often common between mood episodes, and more than one-half of bipolar patients manifest some degree of functional disability after the onset of the hlness. Poorer outcome is associated with rapid cycling, mixed states, concurrent alcohol and substance abuse, nonadherence to treatment, and poor psychosocial support. 

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. 

Another psychiatrist related the story of a 30-year-old black woman i dio was talking fast, calling people at all hours of the day, seeming not to need sleep-classic symptoms of bipolar disorder. She had been diagnosed as schizophrenic, but the psychiatrist was dubious How could a woman with a collie education, who is euphoric,speaks rapidly,andhas a decreased need for sleep be schizophrenic The revised diagnosis was bipolar illness. Physicians can often have different impressions when a patient comes from a different cultural setting. 

How can good pharmacotherapists be found First, check with experienced and respected colleagues, take note of which pharmacotherapists are referring patients to you, attend local educational meetings with psychiatrists, or, if there is a medical school nearby, attend the psychiatry department s grand rounds. Local patient advocacy and support groups, such as the Depression and Bipolar Support Alliance (DBSA), the National Alliance for the Mentally HI (NAMI), the American Foundation for Suicide Prevention (AFSP), and the Anxiety Disorders Association of America (ADAA), are valuable sources of information from the patient s perspective. 

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