bipolar disorder

bipolar disorder

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Understanding NICE guidance
Information for people who use NHS services
Bipolar disorder
This booklet is about the care and treatment of people with bipolar
disorder in the NHS in England and Wales. It explains guidance (advice)
NICE `clinical from NICE (the National Institute for Health and Clinical Excellence). It is
guidelines' advise written for adults, children and adolescents with bipolar disorder but it
the NHS on caring may also be useful for their families or carers or for anyone with an
for people with interest in the condition.
specific conditions The booklet aims to help you understand the care and treatment options
or diseases and the that should be available in the NHS. It does not describe bipolar disorder or
the tests or treatments for it in detail. A member of your healthcare team
treatments they
should discuss these with you. There are examples of questions you could
should receive. ask throughout this booklet to help you with this. Some sources of further
information and support are on page 25. Medical terms printed in bold
type are explained on pages 26­27.
Information about NICE clinical guideline 38
Issue date: July 2006

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Your care 3
Bipolar disorder 4
What should happen when I am first diagnosed? 4
What support can I expect from healthcare professionals? 5
Who can I expect to treat me? 6
What treatments are helpful for people with bipolar disorder? 6
Can I expect treatment in the long-term? 12
How do I stay healthy? 18
Will I be offered any further support? 18
Special issues for women who are pregnant or planning a 19
Special issues for children and young people with…read more

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Your care
Your treatment and care should take into account your personal needs
and preferences, and you have the right to be fully informed and to make
decisions in partnership with your healthcare team. To help with this, your
healthcare team should give you information you can understand and that
is relevant to your circumstances. All healthcare professionals should treat
you with respect, sensitivity and understanding and explain bipolar disorder
and the treatments for it simply and clearly.…read more

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Bipolar disorder
People with bipolar disorder have periods (or `episodes') of what is called
`mania' and periods of `depression'. For this reason, it was once known
as `manic depression'. It can affect people of any age, from children to
older adults (people over 65).
During a manic episode, people usually have feelings of elation (extreme
happiness or feeling `high'), or irritability, or both. They may also feel over-
confident, sleep less than usual, and be driven to take unnecessary risks.…read more

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Questions you could ask healthcare professionals
about bipolar disorder
· What makes you think I have bipolar disorder?
· What do you think causes bipolar disorder?
· Are all of my symptoms caused by bipolar disorder?
· How might bipolar disorder affect my everyday life and what
might it mean for my physical health?
· How can I recognise the early warning signs of an episode of
mania or depression?
What support can I expect from healthcare
Good information, informed consent and mutual
support…read more

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Who can I expect to treat me?
Most people with bipolar disorder receive most of their treatment from a
psychiatrist and other specialist mental health professionals, although your
GP will also play an important part in your treatment.
If your GP is or has been responsible for your treatment for bipolar
disorder, you may be offered an appointment with a psychiatrist or other
specialist if you move to a new practice.…read more

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If you are a woman at an age where you could get pregnant, your doctor
should talk to you about the risks involved and about contraception (see
the section 'Special issues for women who are pregnant or planning
a pregnancy', page 19).
If you have had a manic episode or severe depression, your healthcare
professional should meet with you again within 1 week of your first
assessment.…read more

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Treatments for episodes of mania or hypomania
If you are taking an antidepressant at the time that a manic episode
starts, your doctor should stop the medication.
The main drugs used to treat mania are summarised in the tables below.
If you are not already taking a drug for mania
Medicines you may What you need to know
be offered
An antipsychotic (such as Can be particularly helpful if symptoms are
olanzapine, quetiapine and severe or your behaviour is disturbed.…read more

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Healthcare professionals may give you advice about coping with manic
feelings. This may include avoiding situations that make you over-excited;
doing things that help you to feel calm; and getting into a good routine,
especially making sure you regularly get enough sleep.
Treatments for depression
If you develop depression when you are already taking medication for
mania, your doctor should first check that you are taking the right dose of
medication and change it if necessary.…read more

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What you should know about antidepressants
If you are offered an antidepressant, you should be given full information
about it, including how long it takes to work, the importance of taking
the medication as advised, any side effects and advice on what to do if
you have them. You and your doctor should be able to discuss any
worries you have.
Your doctor should see you regularly, particularly when you first start
taking an SSRI.…read more


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