For About and By Caregivers

Bipolar Disorder: Keeping Tabs On Medications

By Jennifer Bradley, Staff Writer


The cornerstone of managing bipolar disorder (also known as manic depression) is medication management. It is also one of the most challenging tasks a caregiver can take on. Reaching a stabilization of the highs and lows that come with bipolar disorder takes time and patience. It also requires a strong relationship between caregiver and loved one, and the same bond with trusted medical professionals.

Are they on or off their meds?

A question a caregiver for someone with bipolar disorder most likely will ask themselves often is ďAre they on or off their meds?Ē Finding the right combination is the first hurdle to overcome, and the second is maintaining medications after the sense of normalcy returns. Many people living with bipolar disorder struggle more once they feel they can cope normally, forgetting the previous bouts of mania and depression.

Even if a loved one is on a committed treatment plan, side effects or other bipolar symptoms may worsen. A caregiver should take action immediately if they notice any mood changes or other issues. Point out your concerns to your loved one first and then alert the physician. A swift intervention is key to preventing an episode of relapse from flaring out of control. Once developed fully, a bipolar relapse can be dangerous as well as have long-term effects both physically and emotionally.

Warning signs of a mania relapse include: sleeping less, elevated mood, restlessness, speaking rapidly, increase in activity level, and irritability or aggression.

Depression symptoms include: fatigue and lethargy, sleeping more, trouble concentrating, loss of interest in activities, withdrawing from others and change in appetite.

Helping a loved one understand that medication most likely will be a long-term commitment is critical to a successful plan. Whether through therapy or other complementary treatments, a loved one can develop an acceptance of their condition, as well as what it takes to maintain it. Any caregiver who has been through relapse after relapse will confirm that the benefits of treatment outweigh the negatives, especially for a loved one with bipolar disorder.

Managing medication mishaps

Emphasizing the importance of medication and taking a direct role in ensuring all are being taken as directed often falls on a caregiver. People living with bipolar disorder, if off their medication, will not always be upfront and honest about it.

A caregiver must have a keen awareness of that personís baseline behavior, as well as triggers for relapse. Whether stress, substance abuse, seasonal changes, or positive medication reactions, each person will have their unique circumstances that promote symptoms of the disease. The less often a caregiver has to ask ďAre you off your meds?Ē the better everyone will be.

A caregiver should encourage a loved one to speak to their doctors about any side effects that might be bothering them. These can come on if a medication dose is too high or too low, and a small change may resolve the issue. The biggest mistake would be to stop the medication completely unless ordered by their physician, which someone with bipolar disorder may very likely do if not monitored closely. It often takes several tries to find the right balance, and a caregiver will need to bear the ups and downs along with the person receiving treatment during this time.

The Depression and Bipolar Support Alliance offers these tips for managing bipolar disorder medications:

  1. Use a daily reminder/medication saver system to ensure a loved one is taking all the necessary medications.

  2. Throw away old medications or ones no longer being taken.

  3. Realize that all medications work best when a loved one is making other healthy choices. Medication alone wonít fix a bad diet, lack of exercise, or abusive or chaotic lifestyle.

  4. A loved one should reduce the use of alcohol if applicable. It is a depressant and makes recovery even more challenging, while interfering with a medicationís intent.

Managing medications for a loved one with bipolar disorder requires a level of trust, education, the fostering of personal responsibility and sense of hope from all involved. When a caregiver and loved one work together, the outcome is much more likely to be a normal, healthy and happy life.

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