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Mental illness is finally losing some of its stigma. This is welcomed by support groups, family members and many people who suffer from bipolar disorder. With the increasing awareness of conditions like bipolar disorder, treatments are becoming more effective. A good treatment plan can take a patient from suicide attempts to living a normal life, they can be that life-changing.
Before the treatments for bipolar disorder are discussed, it is important address the different kinds of bipolar disorders as most people believe there is just one.
Bipolar I Disorder
Previously known as manic depression, bipolar I swings between hyper (mania) and hypo (depressive) states. Sometimes they can swing from one to the other over a matter of hours, other times over days, weeks or even months. Severe cases of bipolar I can see several swings between hyper and hypo in a week, making the living of a normal life next to impossible. A manic depressive faces a shorter life span and a higher level of disease than the average person.
Hyper States (Mania)
Mania is a state of excitement, energy and in many cases, motivation. Focus on single tasks at the expense of things like cleaning, eating or social interaction are common. Incessant talking, obsessive behaviour, irrationality, dangerous, pleasure seeking behaviour, delusions and hallucinations can all manifest themselves in a manic phase. This can make working, maintaining social ties and a healthy lifestyle very difficult for sufferers.
Hypo States (Depression)
In bipolar disorders, hypo states can range from a lack of motivation and energy, anxiety, fear, irrational beliefs; to suicide ideation, self-harm and suicide attempts. Most people with bipolar I can swing into a hypo state with no exterior cause, though certain triggers, like substance abuse, trauma or emotionally salient events can cause a downwards spiral, or a hypomanic episode.
Unfortunately, both hypo and hyper states in bipolar disorders can lead to self-destructive and harmful behaviour, with some patients being institutionalized for their own safety and the safety of others. The suicide rate for bipolar disorder is substantially higher than for the average population, and treatment is only effective 50% of the time.
Bipolar II Disorder
Bipolar II disorder is a less severe type of bipolar I disorder. It is also known as hypomania. Bipolar II has periods of depression and elation, much like bipolar I, but it is less intense and usually over a longer period. Treatment is usually effective and bipolar II is regarded as more of an aspect of personality than as a severe disorder like bipolar I.
A major depressive disorder, or unipolar depression, is much like the depressive states of bipolar but without the mania or elation. Sufferers go from feeling fine to depressed without hard swings upwards.
Bipolar disorder can be treated with talking therapies and drugs, as well as lifestyle changes such as improved diet, treatment of substance abuse issues, and improving fitness. Unfortunately, many treatments use very strong drugs that can have severe side effects for the patient, making them intolerable for some recipients. This presents a problem for the treatment of bipolar.
Mood stabilizers such as SSRIs and antipsychotics are commonly used in the treatment of bipolar, but often the combination of medications can make work and normal life very difficult. The side effects of some of these drugs can make some areas of work impossible, can interrupt sleep, diet, and social functioning to a degree that they are not worth taking. Most people respond positively to the drugs, but they cannot be used over very long periods without causing severe changes to a person’s personality and bodily health.
Medical Cannabis for People with Bipolar Disorder
A hopeful area of research is opening up for bipolar disorder; the use of medical cannabis. Until relatively recently, all parts of the cannabis plant were illegal in most of the world. This included the non-psychoactive cannabinoids like cannabidiol (CBD). The prohibition of the plant lead to a scientific vacuum in which very little work was done on the safety and efficacy of cannabis for treating mental disorders.
Cannabis has been used for thousands of years for food, clothing and for its medicinal qualities. Not only is it a largely enjoyable drug to imbibe, it appears to have mood stabilizing and antipsychotic effects. These were noted by early indigenous peoples and it spread around the world with traders, who found ready markets for its medicinal uses.
By the 1920’s, it was a commonly used drug in many areas of the world. It was made illegal for reasons that remain debated but include the wood pulp industry wanting to muscle hemp paper out of the US market, the temperance movement applying its stringent moral code to all narcotics, and total misinformation. It was equated with cocaine, regardless of its safety record (abundantly clear even then).
Since then, most countries have followed the USA in making it illegal. Only recently has the utterly ineffectual nature of its prohibition been debated nationally and decriminalization begun. So far, there have been small-scale studies into the effects of cannabis on mental disorders, but none on a large enough scale to be representative. This is a problem for those wanting to make a decision regarding cannabis use and bipolar disorder.
One small study found “that for some bipolar patients, marijuana may result in partial alleviation of clinical symptoms. Moreover, this improvement is not at the expense of additional cognitive impairment.” This was based on a sample of less than 20 bipolar patients, so is hardly representative. However, it does point the scientific world in the direction of cannabis as a potential treatment for bipolar disorders.
Treatments for medical conditions have to pass stringent tests before they can be approved by the regulatory bodies that make those decisions, namely the FDA. Currently, the data is not much better than anecdotal, and while there are more studies in the pipeline due to the legalization of cannabis at a state level in the USA, there is currently no data that would allow a clinician to prescribe cannabis to a patient with bipolar disorders like they would an SSRI, for example.
As there is so little data, the patient must make educated guesses as to the efficacy of treatment with medical cannabis. Cannabis is not hard to obtain but is of varying quality in countries that prohibit it. Where it is legal, medical marijuana dispensaries can provide consistent quality and quantities of cannabis that can make for consistent treatment.
When the dose of a drug varies, it is difficult to get reliable and effective treatment. This, combined with the legal risk of possessing an illegal drug, makes cannabis treatment for bipolar a less than ideal avenue to take. This site cannot recommend doing anything illegal. Moreover, any use of cannabis should only be done in direct consultation with a doctor and at their recommendation.
Cannabidiol is licensed in some countries where the rest of the cannabis plant is still illegal. This means it is a more hopeful potential treatment. The lack of psychoactivity, low toxicity and the proven safety record of CBD make it an ideal drug to try when others are failing. Once again, it should only be used in consultation with the physician who is treating bipolar, but it is a relatively safe bet for bipolar sufferers.
There is no hard evidence to prove that medical cannabis can work with bipolar disorder. What is known is far from the entire picture, and the effectiveness has yet to be proven. This does not mean that a bipolar sufferer should not take cannabis. It has a high tolerability, is inexpensive, can be ingested in a number of ways and has a very good relative safety record.
With bipolar disorders, it can be very difficult in either a manic or depressive state to get help or to even realize that it is happening. Spotting the signs and symptoms of bipolar can be hard. This is one reason that having friends and family members who can recognize the changes in your behaviour and deal with them appropriately is very helpful.
If you are feeling suicidal or have suicidal thoughts, please call the national suicide prevention lifeline on 1-800-273-talk 8255. It is free, strictly confidential and will not appear on your phone bill. There are volunteers who are trained to listen and have dealt with similar conditions to yours. Please do not take a chance with your health, give the number a call.