Bipolar disorder was once a deeply misunderstood diagnosis. For someone to receive it was an embarrassing and painful process without much hope of treatment. Today, luckily, things are much different. Bipolar disorder is now understood to be fairly common, affecting millions of people every year in the United States. Treatments for the disorder have also come a long way, and a diagnosis of bipolar disorder doesn’t have the same ring of finality that it used to. Symptom management and control of the problem is possible!
However, treatment resistant bipolar disorder is also something that has become prevalent in the changing mental health world. While not an official diagnosis, it’s an important subcategorization of bipolar disorder, and researchers are always working to understand it better and bring relief to people who suffer from this different form of the illness. Do you suspect you or someone you love may have treatment resistant bipolar disorder? Here’s what you need to know!
What is Treatment Resistant Bipolar Disorder?
Bipolar disorder on its own is a mental illness characterized by extreme mood swings. People with bipolar disorder fluctuate between manic states– where they are high energy and in extremely elevated emotional states, lacking impulse control and their normal reasoning– and depressive states– where their energy and mood is extremely low and depressed, and they may struggle to function as normal or even feel that life is worth living.
The main goal of treating bipolar disorder is to stabilize these mood fluctuations and help a person reach a predictable, consistent middle ground where they can function as normal for the majority of the time, and to help the unpreventable manic or depressive states become shorter and easier to manage. Pharmaceutical drugs, therapy, and certain lifestyle changes are the most common treatments for bipolar disorder. Treatment resistant bipolar disorder is not an official diagnosis or subset of the illness, and there’s no set standard for how resistant to treatment someone has to be to classify, but the general rule of thumb is that if someone doesn’t respond to at least two typical forms of treatment, they can be considered to have treatment resistant bipolar disorder.
Why Does Treatment Resistant Bipolar Disorder Develop?
The first question that probably comes to your mind when you hear that you or someone you love has treatment resistant bipolar disorder is why? Bipolar disorder can be a very manageable condition in some people, so why do others struggle to find relief?
The sad truth is that no one knows for sure, and there probably isn’t one answer. Mental health disorders of all kinds are extremely individualized; no one case is exactly like any other. The likely answer is that there are probably many things that can cause traditional treatments to fail, from other medications and conditions interfering, to lifestyle hindrances, to genetic differences, or any other number of reasons, but there is no conclusive evidence to prove or disprove any of these theories, although scientists are constantly seeking a deeper understanding of the disorder and the different ways that it affects people.
At the end of the day, some people with bipolar disorder are lucky enough to find a treatment that works for them among the most common and popular methods, and some people have a harder time finding one. Don’t mistake this to mean, however, that someone with treatment resistant bipolar disorder is doomed to be at the mercy of their mood swings forever! There are still options out there for someone who hasn’t had success with traditional treatment methods.
What are the Options for Treatment Resistant Bipolar Disorder?
Secondary Medications
With mental illnesses like bipolar disorder, treatment from a pharmaceutical standpoint is often the first line of defense, and one of the most effective. In the case of two or more drugs failing to produce the desired response, however, different approaches must be taken. Sometimes this involves stacking medications, and trying either previously used medications or new ones with the addition of a secondary drug, like buspirone, ketamine therapy, or thyroid hormone T3. Adding on these additional treatments can sometimes encourage a better response.
Nonstandard Treatments
There are forms of mental health treatment outside of medication and talk therapy that can be effective when treating bipolar disorder. They usually aren’t the first intervention taken in a treatment plan because they can be more drastic or demanding, but in cases of treatment resistant bipolar disorder, they might be able to produce results where other methods couldn’t. Treatments like this include ECT (electroconvulsive therapy) and using other drugs for off-label applications, like antipsychotics, stimulants, anticonvulsants, dopamine antagonists, and others that may have therapeutic effects for patients with bipolar disorder.
Clinical Trials
One of the benefits of living in this day and age is that mental health treatment is experiencing a boom compared to previous generations. New research is being done and new drugs are being developed all the time, and this can be a great option for someone with treatment resistant bipolar disorder. Signing up for a clinical trial, like the ones offered at the Lehigh Center for Clinical Research, can help you to get access to brand-new medications that have yet to hit the wider market and may be effective for treatment resistant bipolar disorder. You can learn more about clinical trials in the Lehigh Valley area here.