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Current time:0:00Total duration:6:55

Video transcript

bipolar disorder is treated with medication and with specific psychological interventions in terms of medication the most common treatment is also the oldest one and that's treatment with lithium salts and this has actually been the primary treatment for bipolar disorder for the last 50 years and that's because it's still the most effective treatment that we have it's still the most effective at managing manic episodes but as it turns out researchers still aren't 100% certain why it's so effective though not certain about how it works on the neuronal level one theory is that lithium enhances serotonin release by increasing production of the components that make up serotonin or maybe that it increases serotonin release in other ways but there are also theories that focus on other neurotransmitters so there are some theories that say that lithium enhances the reuptake of norepinephrine and in doing so it would decrease the effect of norepinephrine over time there are other theories that say that lithium actually exerts its effects on areas of the neuron other than the synapse so one theory is that it influences the sodium channels along the axon the ones that help move the action potential down the neuron and who knows maybe in a year or two research will lead us to a newer more accurate hypothesis and then I will have to remake this video but for the time being know that whatever the mechanism is it is a very effective mood stabilizer it is other things going for it as well it's also relatively fast-acting so it starts to work in as little as one to two weeks and it also avoids some of the worst side effects that we might see in other bipolar medications specifically it doesn't bring about a depressive episode or cause general sedation and you can see why this might be a concern for bipolar medications then bringing people down from mania they could inadvertently push them too far down or too far in the other direction but with that said let the M does have other side effects the first one I want to talk about isn't so much a side effect as it is a problem with mood stabilizers more generally and that's the individuals sometimes lithium the same way that they might treat medications for a egg so if you have a headache you might take something to make it go away and once you feel better you don't take any more of the drug but lithium and also other mood stabilizers they don't work this way individuals need to keep taking them for the medication to be effective they can't just stop taking them once they feel better in terms of side effects of taking lithium specifically a big one is the effect that lithium can have on memory it can cause memory loss and can also cause problems with creating new memories another side effect is that lithium can sometimes blunt normal mood changes and this can lead to a huge decrease in quality of life so imagine not being able to feel happy at your own birthday party or not feeling sad when a partner loses a job these kinds of mood changes are a part of everyday life and it's very apparent to people when they're missing some individuals might also be hesitant to give up their manic episodes because they see them as something positive even though they can be incredibly destructive they can also increase a person's productivity and their creativity so individuals might be resistant to taking medication to stop something that they don't believe is a problem but maybe the biggest side effect of lithium has to do with toxicity lithium can affect kidney and thyroid functioning and this can become even worse when a person is dehydrated which is something that lithium itself causes so individuals who take it have to be very careful about staying hydrated at all times even more so than the rest of us and because of this toxicity problem people taking lithium need to be carefully monitored by doctors the last side-effect I want to talk about isn't really a side effect at all it is actually more of a limitation and that's that lithium doesn't treat depressive episodes so it helps with mania but it doesn't help with the depression part of bipolar disorder and because of this individuals taking lithium generally have to take an antidepressant as well and this can lead to two problems one is that some antidepressants like SSRIs which are the most common treatment for depression they can actually trigger manic episodes for some individuals with bipolar disorder and so this can limit treatment options and the second point is that in addition to the side-effects from lithium the patient will also have to deal with any side effects for this additional antidepressant I want to point out that there are some other medications that people are using to treat bipolar disorder there has been some success with treatments that involve anticonvulsants and antipsychotics and also some benzodiazepines but at least in the short-term like I said before lithium is still the preferred treatment so now I want to move on to talk about psychological treatments and you might remember from your psychology class or from other videos in this series that there are some psychological interventions that are very effective for treating major depressive disorder sometimes as effective as medication but the same is not true of bipolar disorder psychotherapy in all forms from psychodynamic therapies to more modern forms of psychotherapy they are not effective in treating bipolar disorder talking about bipolar disorder and trying to find the cause isn't very helpful for this disorder one type of therapy that is very effective in treating depression is CBT or cognitive behavioral therapy and this type of therapy addresses problematic thoughts and behaviors so it's a very action-oriented therapy but even though it is effective in treating depressive symptoms of bipolar disorder it is not effective in treating manic episodes but even if these psychological interventions don't help treat the symptoms of bipolar disorder directly they can still be a very important part of the treatment for bipolar disorder more broadly for example CBT can provide support for an individual after a manic phase has ended so it can help them to fix the social and financial situations that might have been brought about from their manic episode but it turns out that the most effective type of therapy for bipolar disorder is actually family therapy there's a lot of research that shows that stressful situations can trigger manic episodes for individuals with bipolar disorder and we know that this is especially true for social stressors and because living with someone with bipolar disorder might be stressful for the family that family might sometimes inadvertently be triggering for the individual with that disorder and so it turns out that one of the best ways to manage bipolar disorder both short term and long term is by providing the family with the tools necessary to help them provide support and to help them provide a stable home environment