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  • Gary Probst

When a Person Refuses Treatment for a Bipolar Disorder


When a Person Refuses Treatment for a Bipolar Disorder

Left untreated, bipolar disorder can result in serious problems that affect every area of your life. These may include:

  • Problems related to drug and alcohol use

  • Suicide or suicide attempts

  • Legal problems

  • Financial problems

  • Relationship troubles

  • Isolation and loneliness

  • Poor work or school performance

  • Frequent absences from work or school

Bipolar disorder is highly-treatable, although not curable. Lifelong management of the enzyme imbalances in the brain is required through medication. One problem with compliance among patients is the feelings of grandiosity they sometimes feel during a manic stage. Although the person may be conducting themselves in a destruction fashion, such as going on an alcohol binge or working days without sleep, they are likely harming themselves or others and setting themselves up for a long and difficult downswing on the depressive side of the disorder.

According to the Mayo Clinic, persons who may have a bipolar disorder need a medical exam, prior to any testing for the disorder. There are physical ailments that can also cause some of the symptoms. Once the physical shows no unusual situation, the doctor may refer you to a Psychologist or Psychiatrist for personality testing. The primary tests used to determine a potential bipolar disorder are multi-question paper or on computer questions and answers. The testing is easy for the patient and involves nothing physical.

One major symptom of a bipolar disorder is an erratic sleep pattern. People, in a manic episode, may go days without sleeping, causing them to launch into an actual psychotic episode, which may bring about hallucinations or extremely bizarre and atypical behavior.

Binging on food, alcohol, sex, gambling or shopping may also be tips to this disorder, if not a severe anxiety disorder. Bipolar patients who refuse the prescribed medication are actually harming their brains. Bipolar Disorder does not improve with age. Like a wine that turns to vinegar, the brain takes on damage from the mood disorders, potentially hurling the person into a near permanent state of psychosis.

There are a number of medications that can stabilize mood and help the patient avoid the manic and depressive stages of the malady. These are different from antidepressants and, in fact, using an antidepressant, such as an SSRI, may be harmful in ramping up the caliber of the manic episode. Note that some MD’s will supplement mood stabilizers with antidepressants to attempt balance in mood and avoid suicidal acts. There is no real right or wrong and MD’s and Psychiatrists do their best to balance. However, Bipolar Disorder is a difficult disease and everybody is different in reaction to medication. Here are some current medications for a mood disorder:

This list is courtesy of the Mayo Clinic:

Medications may include:

  • Mood stabilizers. Whether you have bipolar I or II disorder, you'll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).

  • Antipsychotics. If symptoms of depression or mania persist in spite of treatment with other medications, adding an antipsychotic medication such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris) may help. Your doctor may prescribe some of these medications alone or along with a mood stabilizer.

  • Antidepressants. Your doctor may add an antidepressant to help manage depression. Because an antidepressant can sometimes trigger a manic episode, it's usually prescribed along with a mood stabilizer or antipsychotic.

  • Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer. Symbyax is approved by the Food and Drug Administration specifically for the treatment of depressive episodes associated with bipolar I disorder.

  • Anti-anxiety medications. Benzodiazepines may help with anxiety and improve sleep. Benzodiazepines are generally used for relieving anxiety only on a short-term basis.

There is little to fear from these medications, if there is continual contact with the physician prescribing them. There is, however, much to fear by not taking the medications or taking them on an erratic basis. From experience within our clinic, Lamictal, known as Lamotrigine, seems to work quite well with minimal side effects, with the exception of an early-stage skin rash that can occur if the dosage is high at the initial treatment. If the dose is ramped in for the patient, the skin rash has been found to not be an issue of any consequence and rare.

One common error in diagnosis of a mental disorder is the counselor or physician not recognizing a bipolar situation. Often, the illness is diagnosed as a Major Depressive Disorder and larger doses of antidepressants are prescribed. This is not helpful, as larger doses of antidepressants can spin a bipolar sufferer into full blown psychosis, during the manic phase of the disorder.

Often counselors will diagnose a person with one of the Axis II, Cluster B, Personality Disorders, such as Narcissistic Personality Disorder; Borderline Personality Disorder or Histrionic Personality Disorder. There is a belief that many of the people who demonstrate symptoms of those disorders are also or perhaps only suffering from a Bipolar Disorder. If a person is demonstrating erratic behavior, seems to have mood swings and will show disregard for their own safety, at times, then they should have testing conducted to rule out a Bipolar Disorder.


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