Dr Houston advises a reader with bipolar disorder on ways of managing their condition.

Dear Doctor

I have been diagnosed recently with bipolar |disorder. I feel very well now though and don’t see the need to continue taking my medication

BIPOLAR disorder can cause deep mood swings from manic behaviour to depression. The intensity of the mood swings can vary from mild to severe and may last for weeks or months. Bipolar disorder (also known as manic-depression) doesn't get better on its own.

Despite the mood extremes, people with this illness often don't recognise how greatly it affects their lives, and those of their family and friends.

You may not see any problem during a ‘high’ or manic phase and enjoy the feelings of euphoria, extreme optimism and cycles of being more productive. But the emotional crashes that follow can leave you depressed, worn out or suicidal and sufferers are prone to alcohol or substance abuse problems.

Lifelong

As well as the mental health trauma you experience, you may make decisions that can land you in financial or legal trouble. Bipolar disorder is a long-term condition that requires lifelong treatment, even during periods when you feel better.

Because the condition can affect so many areas of your life, your treatment is usually guided by a psychiatrist, psychiatric nurses, psychologists and social workers.

Medications are an essential part of bipolar treatment and are vital for reducing the frequency and severity of manic and depressive episodes. They help allow you to live a more balanced and enjoyable life.

Numerous medications are available to treat bipolar disorder — mood stabilisers such as lithium, anti-seizure medications, anti-depressants and atypical anti-psychotic medications. If one doesn't work well for you, there are many others to explore.

Your doctor may advise combining certain medications for maximum effect. It may take several weeks after first starting medication to notice an improvement.

Psychotherapy is another important part of bipolar disorder treatment. Several types of therapy, including cognitive behavioural therapy and |family or group therapy, may be of help.

Support

Coping with bipolar disorder can be difficult. Medications can have unwanted side effects, and you may feel angry or resentful about having a serious condition that requires lifelong treatment. During periods when you feel better, you may be tempted to stop treatment.

Don't stop taking your medication or skip therapy sessions. Be honest with how you are feeling with your doctors. Join a support group, which will help you reach out to others facing similar problems. Recovery can take time.

Stay motivated by keeping your recovery goals in mind. Explore healthy ways to channel your energy, such as sports, hobbies and

- Dr Niamh Houston