Bipo­lar ther­apy finds way out

A new treat­ment has re­duced the num­ber of manic episodes ex­pe­ri­enced by peo­ple with bipo­lar dis­or­der. Clara Pi­rani re­ports

The Weekend Australian - Travel - - Health -

FOR al­most 40 years, Jen­nifer Howell pre­tended to be some­one else. Since her teens, the now 61-year-old Melbourne wo­man ‘‘ acted happy’’ in front of fam­ily and friends, all the while ex­pe­ri­enc­ing episodes of ex­treme de­spair and sad­ness.

‘‘ I pre­tended to be a bright, happy per­son be­cause I knew that it was not ac­cept­able to be de­pressed. I was al­ways try­ing to be a nice per­son to cover up my feel­ings of ir­ri­tabil­ity. I didn’t un­der­stand why I felt like that. I was look­ing for rea­sons, but never quite grasp­ing the fact that it could be a men­tal ill­ness.’’

Un­able to work full-time, Howell worked in a variety of part-time jobs as she tried to un­der­stand why she never felt the same hap­pi­ness that seemed to come so eas­ily to oth­ers. Four years ago, she fi­nally had an an­swer. ‘‘ I went to see a new GP be­cause I had a bro­ken bone in my foot. Af­ter a few min­utes talk­ing to her, I be­gan to cry. Af­ter about five min­utes, she said I was re­ally de­pressed and she called a psy­chi­a­trist and I was di­ag­nosed with bipo­lar dis­or­der. That was the be­gin­ning of my re­cov­ery.’’

Bipo­lar dis­or­der, which af­fects more than 100,000 Aus­tralians, is caused by an im­bal­ance of chem­i­cals in the brain and re­sults in ex­treme mood swings.

The con­di­tion was pre­vi­ously known as manic de­pres­sion, be­cause a per­son’s mood can al­ter­nate be­tween the ‘‘ poles’’ of ma­nia (highs) and de­pres­sion (lows).

Th­ese mood swings can last for hours, days, weeks or months.

Howell was pre­scribed var­i­ous med­i­ca­tions, in­clud­ing Zoloft, which she says al­lowed her to feel hap­pi­ness for the first time in her life.

‘‘ I was on that for about three months and it al­lowed me to feel happy for the first time in my life. I’d never re­ally known what it felt like. But you can only stay on Zoloft for about six months.’’

Howell tried sev­eral med­i­ca­tions be­fore find­ing one that eased her wild mood swings. ‘‘ But med­i­ca­tion alone is not a long-term an­swer.’’ In June last year, Howell en­rolled in the trial of a ther­apy-based treat­ment aimed at teach­ing peo­ple with bipo­lar how to re­alise when they were about to ex­pe­ri­ence a manic or de­pres­sive episode, and take steps to pre­vent it.

The pro­gram was de­vel­oped by a team at the Men­tal Health Re­search In­sti­tute of Vic­to­ria, with fund­ing from the MBF Foun­da­tion and be­yond­blue.

‘‘ We de­vel­oped a pro­gram which as­sists peo­ple with bipo­lar to deal with their ill­ness in a more co­her­ent way, and en­able them to take con­trol of their life by iden­ti­fy­ing their own in­di­vid­ual pat­tern and early warn­ing signs of re­lapse,’’ says pro­fes­sor David Cas­tle who led the re­search.

‘‘ The pro­gram taught them skills to re­duce stress and to in­ter­vene early as soon as they no­tice signs of re­lapse. It’s im­por­tant, be­cause bipo­lar dis­ease is a lot more com­mon than we orig­i­nally thought. We used to think that about 0.5 per cent of the pop­u­la­tion had bipo­lar, but now we think it’s about 3 per cent of the pop­u­la­tion.’’

In a con­trolled ran­domised trial, the team re­cruited 84 peo­ple di­ag­nosed with bipo­lar dis­or­der. About half re­ceived weekly ther­apy ses­sions, in ad­di­tion to their med­i­ca­tion, for 12 weeks, while the re­main­der only took med­i­ca­tion. Those on the in­ter­ven­tion pro­gram had half the num­ber of re­lapses af­ter 12 months as the con­trol group which re­ceived med­i­ca­tion but no ther­apy.

Re­lapse rates for peo­ple tak­ing med­i­ca­tion for bipo­lar dis­or­der are as high as 75 per cent over five years.

The early warn­ings signs of a re­lapse vary be­tween in­di­vid­u­als, but Cas­tle says some signs in­clude a slight de­crease in ap­petite, need­ing less sleep and in­creased ir­ri­tabil­ity.

‘‘ Some­times they don’t seem to need as much sleep. It’s not that they can’t sleep, but that they don’t seem to need as much sleep. They have so much abun­dant en­ergy. They also ex­pe­ri­ence great ir­ri­tabil­ity.’’

Par­tic­i­pants were taught strate­gies to pre­vent the on­set of an episode in­clud­ing in­creas­ing med­i­ca­tion, rest­ing, avoid­ing stress and alert­ing a sup­port net­work of fam­ily and friends.

‘‘ Vol­un­teers kept a diary sys­tem which is a hand-held record that al­lows them to have Con­tin­ued inside — Page 17

Pic­ture: Stu­art Mcevoy

Road to re­cov­ery: Med­i­ca­tion alone is not a long-term an­swer to bipo­lar dis­or­der, says Jenny Howell

Newspapers in English

Newspapers from Australia

© PressReader. All rights reserved.