Prevention and care
The basic treatment for affective bipolar disorder is lithium, a salt that can stabilize mood. Until a few years ago, tricyclic antidepressants (TCA) and monoamine oxydase inhibitors (MAOI) were used to combat the depressive state.
However, it was found that antidepressants administered alone quickly provoked the appearance of a manic phase in individuals with bipolar disorder, while antidepressants combined with lithium treatment contributed to creating rapid cycles or mixed phases.
Currently, depressive phases being treated with lithium are considered to be like hypothyroidisms (real or mild) and weak doses of thyroid extracts (L. thyroxine) are recommended.
Similarly, in the case of rapid cycles and mixed phases created by administering antidepressants, thyroid extracts are recommended in progressively higher dosages.
Neuroleptics (also called major tranquilizers) are also recommended for manic phases. However, people with this disorder are very sensitive to neuroleptics and may present particularly marked side effects. Anticonvulsants are now prescribed more frequently, for example:
However, it was found that antidepressants administered alone quickly provoked the appearance of a manic phase in individuals with bipolar disorder, while antidepressants combined with lithium treatment contributed to creating rapid cycles or mixed phases.
Currently, depressive phases being treated with lithium are considered to be like hypothyroidisms (real or mild) and weak doses of thyroid extracts (L. thyroxine) are recommended.
Similarly, in the case of rapid cycles and mixed phases created by administering antidepressants, thyroid extracts are recommended in progressively higher dosages.
Neuroleptics (also called major tranquilizers) are also recommended for manic phases. However, people with this disorder are very sensitive to neuroleptics and may present particularly marked side effects. Anticonvulsants are now prescribed more frequently, for example:
- Clonazepam
- Carbamazepine
- Valproic acid
Interesting trials are being conducted with tryptophan, an amino acid, which could help decrease the dosage of lithium and thus reduce the risks associated with high dosages.
Biological treatment, combined with psychotherapy, enables the patient to embark on a psychological approach.
During a crisis, the psychotherapist uses a behavioural approach, which helps limit inappropriate acts on the part of the patient:
- by offering him support and information;
- by organizing meetings with his family ;
- by involving him in the process of accepting his illness.
When the crisis period is over, the patient may undertake the following steps:
- undertake deeper therapy;
- begin a therapeutic approach that involves loved ones;
- participate, with or without his loved ones, in support or mutual aid groups.