Non-adherence in the treatment of bipolar disorder is a very common phenomenon, which has been addressed by various researchers. The negative consequences may include relapse, hospitalization, impairment in everyday functioning, and it can be costly.
In a recently published pilot study by Wenze, Armey, and Miller (2014), the improvement of treatment adherence in bipolar disorder was tested using Personal Digital Assistants (PDAs). More specifically, the investigators wanted to test whether an intervention that utilized mobile technology and assisted the monitoring of bipolar disorder would be feasible and acceptable by bipolar patients.
In our clinical work at BipolarLab, we often come across bipolar patients who seek help when they are depressed. Depression may be the most common symptom, and the most frequent episode of bipolar disorder, but it is not always the most urgent phase to treat. Manic episodes may be more urgent, and more dangerous. Nevertheless, it takes an experienced, and a well trained bipolar patient to seek help once manic. Depressive episodes with increased suicidal ideation or psychotic symptoms can be equally urgent, but for the most common depressive episodes urgency is a matter of choice.
Reading so many articles about holidays and depression but at the same time working almost exclusively with bipolar patients, I wondered too. Is Christmas good for your Bipolar disorder? What can I really tell you or to our patients about this?
In other fields of medicine, this may not be the case, but in the mental health world, evidence based practice is a relatively new development.
“Evidence-based practice” means we conduct our clinical practice based on evidence that we’ve acquired from clinical research. Similar to drug research, your doctor will usually prescribe medications that’ve been tested thoroughly through many trials, and have been proven to benefit your health condition. Once upon a time, your therapy could’ve been based on Dr. Ego’s clinical expertise, big name or great insights, but thankfully these days such practices are slowly becoming a nightmare of the past (although, drug companies still invest on armies of Dr. Egos “aka opinion leaders” to influence your local doctor’s prescription practices).
However, evidence-based practice is a fairly recent development in the field of mental health, and especially in the field of psychotherapy. The rise of behavioral therapy in the 60s, partly as a reaction to the psychoanalytic status quo, and later its marriage with cognitive therapy, have given us a remarkable new tradition of true evidence-based psychotherapeutic practice.
I recently attended one of the lovely webinars hosted by the International Bipolar Foundation. The speaker, Dr Nassir Ghaemi (Professor at Tufts university), presented his book, a “First Rate Madness: Mood disorders and Crisis Leadership” and discussed the issue of leadership and mood disorders.
According to his talk, people with mood disorders, as well as in general mentally abnormal people, make better leaders — especially at times of crisis. He gave examples of many American and European political leaders who achieved “greatness,” and their psychohistory suggests also had a mental disorder – in most cases a bipolar disorder.
I have trouble digesting this argument; not for personal reasons, I also love my bipolar patients and wish to think and speak well of them, but for scientific reasons.
It’s that time of the year again – spring. Our interest in life literally springs up, our moods and love life improve and many patients with bipolar disorder begin to experience their first signs of hypomania.
Call it a seasonal effect, blame it on light or the forthcoming changes in our social routines, spring appears to be a period that every bipolar and their family should keep an eye on.
So what better time than now to write about our bipolar fleas – the early warning signs of manic and depressive relapses?