Up to five percent of the population may have some form of bipolar disorder, and people with this lifelong, genetic brain disease often suffer through many years of misdiagnosis and failed treatment. In fact, people with bipolar wait an average of 10 years between their first bipolar mood episode and receiving proper care specifically for the disorder.
This 10-year gap in treatment demands that patients and their families know how to obtain the right treatment professionals to adequately diagnose and treat bipolar disorder. In choosing the right care for your bipolar disorder, consider the following six points.
1. Be picky when choosing a mental health provider.
In getting care for bipolar, the first thing to consider is that not all psychiatrists, psychotherapists, and other mental health providers are alike. For example, many treat depression or general mood disorders, but that doesn’t necessarily mean they specifically focus on the special needs of people with bipolar disorder.
2. Avoid misdiagnosis by working with an expert in bipolar disorder.
About two-thirds of all bipolar patients are improperly diagnosed with some other mental disorder at some point in their lives, and the majority of those individuals are given a diagnosis of major depression alone (sometimes called non-bipolar or unipolar depression).
Many people who don’t realize they have bipolar will seek treatment because of their episodes of depression. Frequently that becomes the exclusive focus of the initial treatment sessions. The major problem here involves the use of certain antidepressant medications that can be effective for major depression but induce a manic episode in those who have unidentified bipolar disorder.
3. Aim for collaboration among your care team.
Picking the right treatment team is essential in providing the right diagnosis and care when mood swings are suspected. And I do mean team, because bipolar treatment requires a collaboration among professionals and select family members for optimal results.
It’s essential to have mental health specialists who understand that both mood stabilizing medications and a comprehensive therapy plan are needed to fully address bipolar disorder. Avoid those who take extreme positions about bipolar disorder.
If they either don’t believe in medications at all or believe only in medications — and not therapy — you won’t be getting the full, comprehensive approach needed for bipolar treatment success. Whether you start discussions with a therapist or with a physician, know that you will ultimately need both services at the same time.
If one provider offers both medications and therapy, that’s great. But these days, most providers are more specialized, with therapy and meds offered separately. Be prepared to talk with more than one provider as the bipolar treatment plan takes shape.
Again, look for providers who believe that bipolar is generally best approached with a combination of mood stabilizing medications and therapy, and not simply one or the other by itself.
4. Make sure your doctor and therapist are qualified to treat bipolar disorder.
When you first speak with either a therapist or a doctor, always inquire about his or her knowledge and experience in diagnosing and treating bipolar disorder specifically. Remember, it’s not enough to hear, “I work with mood disorders of all kinds.” Go deeper by asking how often that professional sees actual cases of bipolar disorder in his or her practice, and how those cases are typically managed.
When choosing a therapist, keep in mind that he or she will likely see you more frequently than the doctor. Thus, a therapist should have adequate knowledge about the effects of bipolar medications to help watch for drug-related effects, as well as appreciate how mood stabilization can create feelings of loss and changes in self-concept through treatment.
Overall, individual therapy for bipolar disorder should help patients to adapt to a healthier and more stable emotional life.
5. Consider how your doctor approaches your unique brain chemistry and circumstances.
Also inquire about how the doctor approaches your own circumstances, knowing that some patients have different reactions to medications. It’s reasonable to ask, “How have you approached patients who haven’t responded well to bipolar meds?”
Because everyone’s brain chemistry is different, some degree of trial and experimentation is a common part of psychiatry. But sometimes how a doctor handles your questions about your unique concerns can be as important as the information itself. It’s good to know that a provider’s experience not only involves the ordinary management of bipolar disorder, but also features working with more complex bipolar issues.
6. Involve family members in your treatment.
Because bipolar is a lifelong mental disorder, find out how select family members can be a part of treatment. At the minimum, providers should offer education on bipolar disorder and what to expect as the patient goes through the challenges of medications and stabilization.
Family members will need guidance to address denial and acceptance of bipolar in the early, or pre-stabilization, phase of treatment. And eventually, they’ll need information on how to distinguish between bipolar and the “true person” in the later, or post-stabilization, treatment phase.
This empowers patients and families to move beyond feeling afraid or ashamed, and to feel comfortable enough to discuss how treatment is progressing with each other. This ultimately results in better communication about emotions and relationship issues as bipolar therapy moves forward.