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The Smart Patient Guide


The following is an Editorial Resource from YourTotalHealth.

Reviewed by:  Steven A. King, M.D.

bipolar Treating bipolar disorder is complicated. Pure depression—sometimes called "unipolar depression"—often can be managed by undergoing counseling and/or taking antidepressant medication that can be prescribed by your family physician, internist or even your gynecologist. In contrast, treating bipolar disorder often requires the skills, experience and expertise of a psychiatrist to help you find just the right "cocktail" of medications combined with psychotherapy and lifestyle changes. Still, it can take months or even years of trial and error to figure out what works best. Some people who have bipolar disorder can manage their condition just by taking medication, but most people with the illness respond better if they also go through therapy and have support from the people around them. Here are some ways to make sure that you get the right kind of help and are able to stick with treatment:

Finding the Right Therapeutic Team 

  1. The Best Doctor Most people with bipolar disorder need a psychiatrist. If there are no psychiatrists in your town who are experienced in treating bipolar disorder, consider calling the closest academic medical center and asking if they have a bipolar clinic or a mood-disorders clinic. Even if the psychiatrists at that facility are outside of your insurance plan, it can be worthwhile to set up a consultation. "The psychiatrist can then confirm the diagnosis and establish a plan of medications and other treatments to try that your primary-care physician can carry out," says Dr. Duckworth. 

  2. The Best Therapist You may be treated by a psychologist, a social worker or another type of counselor who has experience working with people who have bipolar disorder. Many psychiatrists who prescribe medication also provide psychotherapy. Again, talk to your primary-care physician and psychiatrist about what type of therapy might be most useful for you and then see if you can get a referral, or call your local chapter of the . 

  3. Other Health-Care Specialists There are other specialists who should be kept in the loop along with your psychiatrist and therapist when necessary. For example, if you are pregnant or planning a pregnancy, your obstetrician should work with your psychiatrist to formulate a treatment plan that can keep your moods stabilized while taking care not to endanger your baby. If you have an underlying thyroid condition, your endocrinologist also needs to be part of your team.

Establishing Trust

Experts agree that optimizing treatment for bipolar disorder requires that you and your doctors work together as a team. That starts with strong two-way communication. How do you know if your doctor is right for you? "The old rule of thumb is: Does your doctor return your calls? Does your doctor keep appointments? Does your doctor remember you between visits? Do you feel your doctor listens to you?" says Michael Thase, M.D., professor of psychiatry at the University of Pennsylvania School of Medicine. "If you report that something is not right, does your doctor offer an explanation or work with you to remedy that? These are important questions to consider about your doctor, whether you have heart disease or some other physical illness or bipolar disorder." 

You need to hold up your end of the deal, too, by being honest with your physicians about your personal and family medical history and by telling them about changes in your symptoms and concerns. "Most people wonder, ‘Do I actually need this medicine?’ and some may even experiment with stopping their medications," says Dr. Duckworth. "When that is the case, I don’t want them to pretend to me that they are taking the medicine as prescribed, because if they get manic or have other symptoms and I think they’re on the medicine, I may give them a stronger medicine or a different medicine or a combination of medicine when, in fact, they were never taking their medicine." 

Another way you could help your physician help you is by keeping track of your symptoms and possible triggers for at least a couple of months, as well as reporting any side effects of medicines that you are taking.

What's Next: Form a Support Network

Review Date: May 01, 2009

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Ask Your Doctor

bipolar disorderBefore you go to your doctor’s office, be prepared to ask these questions, according to your situation:

 

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