Manic-depression or bipolar disorder (BD) is a multi-facetted illness with an inevitably complex treatment. Particularly complex situations include treatment-resistant mania and depression, mixed states, rapid cycling, co-morbid anxiety, drug misuse, pregnancy and the postnatal phase, and managing long-term side effects and non-compliance.
The presentation summarizes the current status of our knowledge and practice concerning diagnosis and treatment. While the prototypic clinical picture concerns the ‘classic’ BD, today mixed episodes with incomplete recovery and significant psychosocial impairment are more frequent. The clinical picture of these mixed episodes is highly variable, eludes contemporary classification systems and possibly includes a constellation of mental syndromes currently classified elsewhere.
The treatment includes the careful combination of lithium, antiepileptics, antipsychotics including atypicals and older drugs and antidepressants, but not all of the agents falling into these broad categories are effective for the treatment of BD. Knowing the evidence is the necessary first step but it is unlikely the end of the road. Clinical optimization of treatment is necessary especially for refractory chronically depressed patients.
This post was submitted by Dr John Cookson.
As a teacher I am interested in learning and understanding more about preventative and supportive care for children/students at risk of developing Bipolar Disorders.
I also seek to better understand familial risk factors(parents with clinically diagnosed BD) co-morbid familial risk factors: substance abuse, unemployment, low socio-economic status, and environmental stressors such as abuse and trauma.
I am seeking specialist advice on current best practice. of course involving non-pharmacological treatments which can improve children\’s resilience and increase protective factors suitable for educational settings. Focussing on early childhood settings that is Early Intervention.
I am interested in empirical efficiacy of:
• specific nutritional therapies e.g. utility of fish oils- omega,
•role of improving nutrition
•use of increased fitness programs,
• hydration improving /controlling levels throughout day
•cognitive-behavioural therapies- Learned optimism -programs you recommend suitable for use in classroom
•effective relaxation techniques
My background is Psychology and Anthropology B.A.(Adelaide Uni) Education:-Dip Ed. & Masters of Special Education, Grad Dip in Neuroscience(Flinders Uni,2009, Australia) Cert. in Mental Health for Teaching Professional(Monash-ongoing) 25 years practice as early years(5-8) teacher in mainstream settings. I understand Multi-variate analysis of variance(Audit Prof. John Keeves- Flinders, Australia)
My personal focus of interest children/students with learning difficulties/disabilities and co-morbid presentations of anxiety, depression, aggressive/impulsive externalising behaviours which interfere with their ability to succeed academically, socialise and enjoy life. Interaction of trauma and abuse and resultant changes in neurological chemistry, observable sensitivity to noise/ stress/ threat factors.
I have obviously only a sketchy grasp of factors and possible interactions but with your scaffolding and support hope to contribute to improved practice in educational settings in a small way in my sphere of influence.
In anticipation and with grateful thanks yours sincerely jane m. calvett