The treatment of bipolar disorder must combine drug therapy and psychotherapy .
Every depressive and manic attack should be treated with the appropriate medications.
In the case of depression, we will give antidepressants or mood stabilizers, to help the patient to revitalize.
In case of mania, treatment with lithium, anticonvulsants or neuroleptics will help soothe and regulate the subject.These drug treatments should be prescribed with great vigilance, in order to avoid a decompensation to the opposite extreme (for example by making a depressive maniac). This is particularly the case of antidepressants, at risk of provoking a suicide attempt in the depressed person who finds himself uninhibited by treatment.
Then, treatment of bipolar disorder involves putting a preventive medication management. This treatment of relapses involves a healthy lifestyle and treatment by thymoregulator. Lithium is prescribed first. It is effective in approximately 80% of bipolar patients. The prescription of lithium has some contraindications that the doctor will have to seek before the implementation of the treatment. If lithium is contraindicated or poorly tolerated, treatment with valoproic acid, or atypical antipsychotic, will be proposed.Associated with drug treatment, psychotherapy is always necessary whether it is during acute attacks or during periods of lulls.
The ideal is to follow on the one hand a referring psychiatrist of the care, and on the other hand a psychotherapist, able to accompany the person towards a psychological well-being. Cognitive and behavioral therapies, psychoanalysis, art therapy, etc. are all treatments whose effectiveness depends on the therapeutic alliance and the patient's motivation to "change". Groups of supports, psycho-education, or mindfulness-based cognitive therapy also have an established interest in bipolar disorder.
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