The mainstay of medication therapy for bipolar disorder is a mood stabilizing agent such as depakote (valproic acid) or lithium. That is the foundation of medical therapy.
Once the patient is tolerating one of those medication, if further medical therapy may be of benefit there are many other medications which can be added, but the specific one chosen may depend on the patient's other medical conditions and their psychiatric symptoms, i.e. if they remain depressed or of elevated mood.
The best therapy combines both medication and behavioral therapy. For example while undergoing medication treatment with a psychiatrist, also seeing a psychologist who can spend time discussing life and how the patient manages with their symptoms and can form coping strategies to help "naturally" mitigate their symptoms.
Additionally, some supplements are thought to help the patient with mood disorders, though taking any "natural" substance to treat a condition should be considered medical therapy. For example there are some reports, though varying in outcome, that fish oil supplementation can help with symptoms. Other studies more recently have shown that folate supplementation can help stabilize a patient's mood, however with regard to folate, the over the counter formulation does not cross the barrier between the blood supply and the brain and there is a prescription form of folate called L-methylfolate that has shown benefit and can cross that barrier.
So, between initiating medical therapy with a mood stabilizing agent, seeking both psychiatric (MD) and psychologic (PhD) counseling, "natural supplementation" under the approval of your physician, and self-education by reading quality sources about the condition (not just forums online which can be quite misleading) you can have the best impact on your life.
Also making sure to get quality sleep, setting a regimen so that you get to sleep at an appropriate and consistent time, avoiding substances such as nicotine and caffeine which can trigger changes in mood, getting exercise and eating a balanced diet.
If you have side effects with one medication there are always second line agents such as lamictal (which may not be as effective, but has a much less likely occurrence of side effects)
However valproic acid or lithium are the go-to mood stabilizers. Antipsychotics may help some patients but are generally added after the patient has been on a mood stabilizer for a while.
Yes as far as medication goes, a mood stabilizer such as depakote (valproic acid) or lithium is most highly recommended
There are other options, but generally patients end up being on one of those two. They have the most concrete evidence behind their effectiveness.
And in addition to medication, taking a holistic approach as well (not just popping a pill) will far and away give the best outcome to this life-long condition
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Yes. That is the place to start and reassess after you have been on in for a while to determine if adding another medication on top would help "tweak" your symptoms so that you feel as well as possible
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i have been on a moodstabiliser in the past (epilim) and i've not been able to function properly. it seems to only make me more depressed
That is where additional medications come in. After the mood is stabilized other medications such as one from the class of atypical antipsychotics (seroquel etc for example) can help reduce the depression.
Traditional SSRI medications are not recommended for depression in patients with bipolar as they can destabilize them into an episode of mania.
But the key is a mood stabilizer and then adding on a medication such as a lamictal, a SNRI or atypical antispychotic (a class of newer antipsychotic medications) to further improve symptoms
the more medications i take the more horrible side effects i would suffer from
If you are against taking medications, then still seeing a psychiatrist but going a more natural approach with supplementation such as folate and fish oil as I mentioned as well as regular psychologic counseling may be the best alternative fit for you, though not all medications give patients side effects. Just because you had ones with a certain medication does not mean you will have them with another.
Medications are not one size fits all