Treatment for resistant bipolar depression Some people need multiple medications to stay well Expand This can be disabling and your doctor will have to weigh the risk of inducing a high or rapid cycling in you if using multiple treatments. Your doctor may, by combining drugs, boost their effectiveness. Combinations your doctor may investigate include multiple mood stabilisers, two antidepressants or lithium plus lamotrigine. In severe cases electroconvulsive therapy (ECT) may be necessary. The law governing the use of ECT is very strict in the UK and it is used infrequently, but can be very effective for some people who have not responded to other treatments.
Medications used when high (hypomania/mania) Antipsychotics used to treat hypomania and mania Expand Antipsychotics Antipsychotics are the most commonly used drug to treat a high. These drugs are divided into groups based on their side effects. No drug has a more tolerable side effect, but rather they have different side effects. Newer drugs are equally effective in treating bipolar but all have different side effects that are not necessarily less troublesome than older ones. Psychiatrists use the wider range of antipsychotics available to suit individual patients. Antipsychotics have been shown to act as mood stabilisers in some cases. Some of the mood stabilisers are effective in treating a high if given at higher doses. The following is a list of common antipsychotics that your psychiatrist may use: Aripiprazole Haloperidol Olanzapine Quetiapine Risperidone Clozapine Other anti-manic drugs that are not antipsychotics include clonazepam, lorazepam, lithium and valproate. Other drugs Other drugs may also be used as anti-manic drugs, but there is less evidence for their effectiveness. These include topiramate, lamotrigine, levetiracetam, oxcarbazepine, ritanserin, ziprasidone and gabapentin. How do bipolar drugs work? The exact mechanism is not known. They have a sedative effect on the brain and alter the balance of a brain chemical called dopamine which is known to be abnormal in mania and psychosis.
Questions to ask your Doctor about your medication A leaflet designed to help you ask the right questions when visiting your doctor. Expand This is a list of questions to help you ask your doctor about your bipolar medication. It is important you understand why and what you has been prescribed and how to take it. About your medication What is the name of this medication? What category of medicine is it? (e.g. antipsychotic; mood stabiliser) What should I expect it to do? How long will it take to achieve that result? How long will I have to take it? Side effects What short-term side effects does it have? What side effects should I let you know about? What symptoms indicate that the dosage should be changed or the medication stopped? Does it have any long-term side effects? Is this medication addictive? What may happen if I forget to take my medication? If I miss taking a dose, what should I do? Can I drive and/or operate machinery while taking it? Changes I may need to make Can I drink alcohol while taking it? Must I follow any dietary restrictions? Will it react with any other prescription medications? Will it react with any over-the-counter medications (e.g. painkillers, cough mixture)? Is it safe to take while pregnant or breastfeeding? Monitoring and review Will I be monitored while I’m taking it? How often will I need tests while I’m on it? When will my treatment be reviewed? Will it be difficult to withdraw from this medication? Do you have any printed information on it, or know where I can get this information? Download this information as a PDF Check out our blog: Medication and treatment for more stories and information
Does bipolar affect women differently? What is different for women that live with bipolar Expand Bipolar disorder affects men and women in roughly equal numbers, but there are gender differences in the ways that the illness manifests itself. Women with the disorder tend to have more depressive and fewer manic episodes and are more likely to have bipolar II. They also appear to be more prone than men to rapid-cycling. Some research suggests this might be connected to abnormal thyroid levels as such imbalances are more common in women than men. Other associated conditions that are seen more often in women with bipolar than men include anxiety, migraines, obesity and panic disorders. Hormones are suspected of playing a significant role in bipolar disorder in women, evidenced by the mood swings often experienced in connection with menstruation, perimenopause and menopause. It is thought this may be connected to fluctuating levels of oestrogen but research needs to be done to find out how this is implicated and the mechanisms that are involved.
If I am ill what powers do my family have? Who can help with decisions when you are unwell Expand Under the Mental Health Act we all have a nearest relative who will be involved in decisions about whether we are hospitalised. We do not get to choose our nearest relative. If you or your nearest relative are both unhappy about them taking on this role, they can write a letter naming another individual to act as your nearest relative. They should inform at least one of your doctors or other people responsible for your care. Your nearest relative has several powers and responsibilities: They can apply for you to be admitted to hospital. The approved social worker must tell the nearest relative if they have applied (or are applying) for you to be detained under section 2. The approved social worker must talk to the nearest relative if they plan to detain you under section 3 (unless it is not practical to do this or would cause unreasonable delay). Your nearest relative can object to the application to detain you. However the approved social worker can ask the court to appoint someone else as your nearest relative if the objection is unreasonable. Your nearest relative can apply for you to be discharged from hospital. However the doctor in charge of the treatment can stop this.
Money and Debt Helpful links to other websites and organisations that can offer you support with money issues. Expand PayPlan is a free debt advice provider and can help you make a plan to get your debts and payments under control. It can also provide personalised advice on a range of money-related subjects, such as bailiffs, legal action and benefits. We are working with Pay Plan to help their advisors understand the problems people with bipolar often face and to provide a faster referral process for our bipolar community. If you would like to speak with one of their advisors, please email [email protected] or click here. StepChange Debt Charity Free advice on problem debt based on what's best for you The Money Advice ServiceFree and impartial money advice, set up by government Turn2UsA national charity that helps people in financial hardship to gain access to welfare benefits, charitable grants and support services. Debt Support TrustSupporting people in managing their debt problems by offering debt advice today, whilst finding solutions to minimise severe personal debt problems in the future. National DebtlineA free, confidential, debt advice service helping people deal with their debts. Financial OmbudsmanA service to help resolve individual disputes between consumers and businesses – fairly, reasonably, quickly and informally. Money Saving ExpertOffers money saving tips and advice. Also offers a free booklet on financial affairs specifically aimed at people with mental health conditions.
I have financial concerns Look for help if you have money troubles because of your bipolar Expand Managing bipolar can be hampered by the additional stress and practical problems presented by financial difficulties. Whether it is repairing the damage caused by excessive spending during manic episodes, dealing with loss of earnings as a result of the illness or taking steps to prevent future problems, financial health can be an important factor for your health and wellbeing. See our useful links to organisations that can help address your financial concerns
What do I need when returning to work after bipolar illness? Things to consider when going back to work after bipolar illness Expand A checklist of what to think about when preparing to return to work: Talk to your manager about a phased to work and build in a midway review point. If your employer knows about your diagnosis share and copy of the Bipolar UK Employers Guide with your manager. If your employer does not know about your diagnosis think about if now is the time - see the Bipolar UK Employees Guide for help. Make sure you take in any sick notes, not previously handed in, so that sick pay is not affected. Think about your journey to work and plan for back ups. If you have children. or caring responsibilities, are these affected? Check that your next of kin information is up to date with your employer. Ask about any employee assistance programmes to support your return to work. Consider if a temporary adjustment would help you. You can ask for an Occupational Health assessment on return, if you have had this in the past. Or ask for a Occupational Health assessment to develop any reasonable adjustments you might need. details of how to identify what reasonable adjustments you can request are in the Bipolar UK Employees Guide (p.13)
Finding Therapy links Links to other websites and organisations that can offer you information on self-management and therapy. Expand BACP - British Association for Counselling and PsychotherapyProvides information on counselling and psychotherapy, including a register of members BABCP - The British Association for Behavioural and Cognitive Psychotherapies Provides information on CBT and includes a register of practitioners Counselling Directory Information on finding a local counsellor.
Mental Health Act 1983 - patient information A leaflet to explain your rights if you are detained under the Mental Health Act. Expand The Department of Health and Social Care has issued leaflets for patients who have been brought to hospital by a police officer under section 135 or 136 of the Mental Health Act. The leaflets explain to the person: - why they are in hospital - what to expect during this section - their rights - what could happen afterwards - The leaflets contain form fields for healthcare professionals to enter the expiry date and time of the patient’s detention. Click here to download the leaflets
What is power of attorney? You can nominate someone to look after your finances when you are unable to Expand Helping a friend or relative who is struggling to manage their finances can be difficult, especially if they do not have the mental capacity to make their own decisions. For many people, the solution is to make a power of attorney - a way of giving someone the legal power to manage their finances. In most cases, making a power of attorney will mean an end to the problems that can arise in these situations. But sometimes things go wrong, which is why the ombudsman has provided tips for both banks and consumers on power of attorney – and how to avoid problems. For more information, please visit the Financial Ombudsman's website
debt & benefits advice links Links to other websites and organisations that can offer information and support about benefits. Expand PayPlan They are a free debt advice provider and offer expert advice around debt management to help you make a plan to get your debts and payments under control. If you would like to speak with one of their advisors, email [email protected] or click here. Department for Work and PensionsThis is a useful resource giving information about options for claiming benefits for both people with disabilities and their carers. It also provides instructions about how to go about claiming. Citizens AdviceFree, independent, confidential and impartial advice to everyone on their rights and responsibilities. Turn2UsA national charity that helps people in financial hardship to gain access to welfare benefits, charitable grants and support services. Advice NowInformation on the law and your rights regarding benefits and employment. Healthy Start A government based initiative that helps pregnant women on benefits or under the age of 18, and families with young children on benefits, get free vouchers every week to spend on milk, plain fresh and frozen fruit and vegetables, and infant formula milk. You can also get free vitamins.
Mental Health Charities Links to other mental health charities that can offer information and support. Expand Samaritans A 24/7 confidential emotional support service for anyone in the UK and Ireland. You can call them for free on 116 123 Bipolar ScotlandProviding support groups for people in Scotland who are affected by bipolar disorder and to all who care for them. MindOffer support and advice on a wide range of mental health issues, as well as an information and legal advice line. Rethink Mental IllnessWorks to help everyone affected by severe mental illness recover a better quality of life. SANE Working to improve quality of life for anyone affected by mental illness, including an emotional support line. Mental Health FoundationA mental health research, policy and service improvement charity committed to reducing the suffering caused by mental ill health and to help everyone lead mentally healthier lives. Disability Rights UKLeading change, working to create a society where everyone with lived experience of disability or health conditions can participate equally as full citizens. HafalA Welsh charity offering a range of services to people with serious mental health illness including direct support and advice, support in a crisis, advocacy, groups and employment and training projects. No PanicA charity for people suffering from panic attacks, phobias, obsessive compulsive disorders (OCD), other related anxiety disorders. GofalLeading Welsh mental health and wellbeing charity, providing a wide range of services to people with mental health problems. Mood SwingsNational Helpline and online support providing free and confidential information, advice and support to people with mood disorders, family, friends and health and social care professionals. Together UKProvides services in the community and hospitals and prisons for people with mental health needs and their carers.
If I am detained in hospital can my friends and family visit me? Who can see me when I am under section in hospital? Your rights as an inpatient explained Expand You have the right to visits from your family and friends. If the hospital or doctor do not think it is beneficial for you to receive visitors, they must have a very good reason related to your health and safety to stop visits. If visits are stopped, the decision should be recorded and the record should be made available to the Mental Health Act Commission.
Debt Respite Scheme (Breathing Space) The Debt Respite Scheme (Breathing Space) allows eligible people with mental illness in crisis to have legal protections from their creditors Expand You can only apply for Breathing Space by seeking advice from a debt adviser. This scheme is only open to people who are under crisis help from a mental health service. You can read the Guidance for money advisors and a factsheet from, the National Debtline