What are Some of the Bipolar Disorder Treatment Challenges?

Bipolar disorder, especially mania, is tough to treat. Then there are complications from medication side-effects and bipolar patients involved in substance abuse.

Bipolar disorder, especially mania, is tough to treat. Then there are complications from medication side-effects and bipolar patients involved in substance abuse.

Gold Standard for Treating Bipolar Disorder (part 22)

One of the very unfortunate characteristics of bipolar disorder is that it can have significant and very frustrating treatment challenges. Some of these challenges are inherent to the illness while others are caused by the person with bipolar disorder's lifestyle choices.

Lack of Insight

Dr. William Wilson, Department of Psychiatry Professor Oregon Health and Science University in Portland, Oregon notes, "People with bipolar disorder can get overly confident that things are just going to be fine and they don't really need medications anymore. 'I've been rock solid stable for 13 years and I just don't need these medications anymore,' or they say, 'I'm ready to leave the hospital when it's very obvious they are still sick. This lack of insight is especially pervasive with mania.

Mania Treatment Challenges

Dr. John Preston, author of "The Idiot's Guide to Managing Your Moods" says, "Treating mania is difficult for many reasons. One of the main problems is that people who have hypomania (as opposed to full-blown mania) feel so good they never come in for treatment. They are often treated incorrectly with antidepressants for depression which then causes more mania. People with full-blown mania never get missed, but those with hypomania usually slip through the cracks. Another problem is a loss of critical thinking and perspective, where thought processes become disorganized when a person is severely manic and psychotic. When the episode ends, there is a good chance the person can't remember what happened and thus thinks the concerns of family members and healthcare professionals are unwarranted."

There is also the common, and often dangerous belief, that maybe the mood swings will not come back. They desperately hope they are right even when the symptoms are staring them in the face. People with lack of insight are not lying about their condition, they are just not being realistic or can't be because of the lack of memory of what the mood swing was really like.

Side-effect Complications

The main reason people stop their bipolar disorder mediations is side-effects, not lack of help from the medications. Effective medication treatment is essential to bipolar disorder. The tips provided by Dr. John Preston in the medications section of this article can help you make sure you have tried every avenue before you quit medications treatment because of side-effects.

Substance Abuse and Bipolar Disorder

Substance abuse is the number one factor that predicts a poor outcome in the treatment of bipolar disorder. This can't be taken lightly. If you're currently abusing alcohol or drugs, it's important that you know your chances for stability are greatly compromised. Yes, it's overwhelming to have to get help for addiction while treating bipolar disorder, but if you're on this webpage looking for answers, you can get the substance abuse under control so that the mood swings can be treated effectively. It will be extremely difficult, but others have managed and you have the same ability.

next: What is Treatment-Resistant Bipolar Disorder? (part 23)

APA Reference
Fast, J. (2009, February 13). What are Some of the Bipolar Disorder Treatment Challenges?, HealthyPlace. Retrieved on 2024, July 20 from

Last Updated: June 2, 2019

Medically reviewed by Harry Croft, MD

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