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Long-Term Treatment of Bipolar Disorder
While most medical concern relates to the recognition and management of manic or depressed episodes, the major issue for the person with bipolar disorder is long-term stability. Poorly-controlled bipolar disorder indicates either the inherent severity of the condition or poor compliance with medication. It is hard to accept such a diagnosis and, for younger people the prospect of taking preventative medication for long periods is very unappealing. Another factor in non-compliance with medication reflects the seductiveness of the experience of mania. Both unpleasant side-effects of medication or 'denial' of the illness represent further reasons for non compliance. Side-effects are often easily remediable, although lowering the dose too far can lead to a loss of treatment efficacy.
Most people who have had one manic episode will go on to have further illness. Thus, ongoing treatment is necessary to prevent relapse. For those who have had previous manic episodes, the benefit of ongoing treatment are evident in a reduction in severity and frequency of illness.
Conclusions
Bipolar disorder is an illness which can require long-term medication. There are choices between medications as to the one (or combination) that is the best for the individual. The 'pattern' of mood swings may take a while to establish itself, but the person with bipolar disorder, with the help of skilled medical management, is able to lead a stable and productive life.
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