Harvard Mental Health Letter

Drug treatment of bipolar disorder

One of the most troublesome psychiatric disorders has begun to succumb, in part, to medications. Bipolar (manic-depressive) disorder is a challenge for physicians and psychiatrists because of its varied, severe, and constantly changing symptoms. But many drug treatments are available and can be adapted to the needs of individual patients.

Symptoms

The extremes of bipolar disorder's mood cycle are misery and elation. At the low end, patients lose interest in life and capacity for pleasure. They feel sad, worthless, and hopeless. They cannot concentrate, make decisions, or take initiative. They may be either agitated or lethargic, and they usually have physical symptoms — appetite loss, fatigue, pain, insomnia.

At the other extreme, they are energetic, restless, outgoing, and talkative. They get little sleep and don't mind. Their thoughts flow irresistibly, leaping from subject to subject. They imagine that they have special talents and can soon achieve wealth, power, or ideal love. They are tempted by extravagant spending, impulsive sexual advances, and grandiose unrealizable projects. Their euphoria may turn into severe anxiety, irritability, or rage; their high energy into purposeless agitation; and their racing thoughts and speech into sheer nonsense.

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