The biggest reason people stop medication is they don’t like taking pills. Some people just forget. Others start doing well so they say, “I don’t need it anymore”. Side effects that are uncomfortable are another big problem. Dry mouth, constipation, nausea, and dizziness can occur with a lot of medications. People stop medications because they don’t believe that they are sick or that the medication will help. Individuals are in denial about illness. Lately I’m seeing people stop medication because it’s too expensive. Sometimes people stop medication because they like the manic state and don’t want anything to stop.

One patient told me he wanted to use alcohol and didn’t want to take his medication with alcohol. I think that makes sense.

How do we keep people on medication? First education is the key. Educating them on the risks of the mental illness. Psychiatric illness can be damaging to the brain. Untreated mental illness results in breakup of relationships, loss of jobs, legal problems and problems in marriages.

Going off medications may result in withdrawal syndromes. Stopping medications can make a lot of things worse. Depressive disorders, anxiety disorders and psychiatric disorders become worse. Untreated mental illness may predispose people to addiction and self medication with drugs of abuse. (more…)

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The first step is identifying the illness.  Depression is more that just feeling sad for a few days.  Depression means weeks of being so sad, you start having trouble working or going to school.  You start having problems in relationships.  Problems develop in just taking care of you.

People with depression have two types of symptoms.  The first type is psychological.  The second type is physical.  Psychological symptoms are sadness, lack of desire for fun, hopelessness helplessness, despair, worthlessness, guilt, thoughts of death and dying.  The physical symptoms are changes in appetite and changes in weight.  Problems with sleeping develop.  Usually individuals wake from sleep easily.  Problems with concentration and cognition develop.  Individuals become agitated or irritable.  Problems dealing with stressors and making decisions.

That’s enough about symptoms.  Once you see you or a loved one has depression help is crucial.  See a mental health professional.  Things can be done right away if you are depressed.  One important thing is to start exercising everyday.  Stop drinking alcohol or using non prescribed sleep aids.  Start eating a healthy diet.  That means lean meats, fresh chicken, fruits, vegetables and nuts.  No sugar, salt or complex carbs.  Complex carbs are anything from a bakery.  You know cakes, cookies, candies, breads and processed foods.  That’s what individuals can do for themselves.  Then it might be helpful to see a psychotherapist.  That’s where you sit and talk to someone.  Seeing a psychiatrist is also helpful. (more…)

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The treatment depends on what state the individual is in and how severe.  Manic patients have a wide range of symptoms.  The severely agitated and psychiatric manic patient needs hospitalization and treatment with antipsychotics, like Risperdal, Seroquel, Geodon, and Zyprexa.  The less severe forms of mania respond to Depakote, Lamictal, Trileptal, Lithium, Abilify, Topamax and Zonegran.  The key here is to put someone on a medication which they can live with.  Most Bipolar patients require a lifetime of treatment.

What happens if they are depressed with a known history of mania?  You have to pre-treat with a mood stabilizer which I mentioned above and then use an anti-depressant.  Anti-depressant medications I like to use are Wellbutrin, Lexapro, Zoloft and Prozac.

(Note, some mood stabilizers like Abilify, Lamictal, Seroquel, and Zyprexa may be enough to treat both depression and mania.) (more…)

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