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Bipolar Disorder Treatment - Hospitalization and Electroconvulsive Therapy

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D.

Medications are the primary means of treatment for bipolar disorder, but they are by no means the only useful bipolar disorder treatments that exist. A range of other medical and non-medical treatments complement bipolar medications. These often include hospitalization, electroconvulsive therapy, and various forms of psychotherapy.

Bipolar Disorder Treatment - Hospitalization

front building doors Most patients with bipolar disorder do not require extended inpatient psychiatric hospitalizations. However, short-term hospitalizations can be necessary for situations such as:

  • severe mood episodes
  • suicidal attempts
  • untreated bipolar symptoms
  • bipolar medication adjustments

More severe cases of bipolar disorder are more likely to require more frequent intermittent hospitalizations.

Hospitalization is among the more expensive bipolar treatment options available. Because of this, it is generally used only when no other treatment options will prove sufficient to ensure patient safety.

During their time in the hospital, patients are diagnosed (if their diagnosis is not already clear), and started on bipolar medication. Alternative psychiatric treatments such as electroconvulsive therapy may also be administered if they are indicated, and patients agree to receive them. Hospital treatment may include regular group therapy sessions, scheduled eating, sleeping and recreational periods, and occasional interviews with doctors and nurses. As soon as symptoms start to turn around, and there is no imminent risk of suicide, patients are discharged back to their homes and regularly scheduled supportive care. When outside supports are not adequate such as when there is no treating psychiatrist, or no psychotherapist, or housing is not adequate, the hospital may aid with coordination of care to resolve these issues.

Bipolar Disorder Treatment - Electroconvulsive Therapy (ECT)

One of the more successful non-medical therapies available to bipolar patients is Electroconvulsive Therapy (ECT). This is often referred to as "shock therapy." It involves passing an electric current through the brain to create an artificial seizure. ECT is typically used for people with severe depression that has not responded to other treatments and/or for people requiring non-medication treatment of depression.

The ECT procedure takes about 10 or 15 minutes, with an additional 30-45 minutes for preparation and recovery. It can be performed either during a hospital stay or as an outpatient procedure. ECT requires brief general anesthesia (i.e., the person is asleep during the procedure). Prior to the procedure, patients are given muscle relaxants to prevent damage from convulsions, which occur during the seizure. An electrode (or electrodes) is placed on the side or the front of the person's forehead. Then a short, controlled electrical current is passed through the brain.

Most patients receive 6 to 12 ECT treatments over the course of several weeks. Usually, treatment is administered two to three times a week until symptoms improve. Then, maintenance treatments will be administered at less frequent intervals. Though the procedure has the side effect of causing temporary short term-memory loss and concentration problems, it can work very well when other treatments fail.

Historically, ECT was thought of as a barbaric, inhumane treatment. This is not at all the case today. The modern method is well-researched and regulated. It is quite safe and provides very fast relief from forms of depression that will not otherwise respond to treatment. Because there are no body effects, it may be the safest treatment option for pregnant women or nursing mothers suffering from depression. It is not clear exactly how ECT helps people with depression. Many neurochemical and neuron aspects of brain functioning are altered during and after seizure activity. It is thought that when ECT is administered on a regular basis, these changes build upon one another, somehow reducing depression. In addition, ECT increases neuron growth in the brain, which may lead to relief from depressive symptoms.

 

Reader Comments

zonegran - - Dec 26th 2010

why have i not heard of anyone on zonegran for bipolar? i am. its supposed to be the new lithium replacement. i lose weight instead of gain it.

bipolar-running - Misty - Dec 1st 2010

for me the article that was written above about "Running", really hit home for me.  I have been running all of my life. Acting on impulses if you will!  My daughter was in 5 different elementary schools in one year from florida to indiana to Tennessee.  I just thought I was trying to find my way.  I would move in brand new houses, apartments, love it and as soon as i got back on my feet again, I would do it again.  I had no idea why. I never had company because I didn't want anyone to know where I lived. I had friends but wouldn't let them et too close. I guess I was affraid that eventually they would start seeing a difference in me and figure out that I wasn't exactly normal.  I would think that I wanted to move to Florida and would pack right then and be on my way. Stay for a while, decide this isn't where I want to be and go back to Indiana. I hsve left, got to Florida, woke up the next morning and went back home. On my credit report I have 42 different addresses! Get my point?  I don't like people close to me, behind me, I hate it when people look at me. I barely sleep due to mind racing.  I have taken all different types of meds, all with awful side effects.  I am now on 600mg of Seroquel, Benzotropine, Valium.  I am going to ask my Dr. about electroconvulsive therapy. The side effects from that are pretty much memory loss.  With my past, I would mind to be honest. As far as my treatment nbow, I think my Dr. is just to the point where there is nothing more for her to do. I am going to suggest the ECT and see what she says. If she denies me the treatment I am going to find a DR. who will do it!!!!!! I am desperate at this point!

there is always a caring soul within reach - eros` - Jul 5th 2010

im 18 and i was diagnosed with bipolar disorder at 16 after several mental breakdowns and about a hundred cries for help... i have managed to push any and every good thing away from me including my family and close friends i stopped taking my meds and stopped going to therapy for some reason i dont quite understand at the moment but i know once i get back to myself and out of this place im in mentally i will understand it.

i think having the disorder and getting the whole idea of whats going on in your brain makes us experts. so being an expert on how the bipolar mind works i think this might help anyone who might need this as much as i did.

these feelings, these worthless no one cares or understands feelings, feelings of rebelion and repression are part of the disorder and its really hard to navagate them but the biggest one is stop running its the worst thing you can do during a manic episode take it from me i know i have been running for so long my feet are tired perverbially that is. but running when you have no specific direction and no set destination is so self destructive its ridiculous and if you just try to slow down and navigate your thoughts you realize there are people out there that care wether  you want them too or not and there are definately other people who feel the same way you do and when you find someone who does feel that way and just slow it down and have a conversation maybe get into there head and maybe say things you wouldnt normally say to people just inner thoughts they might give you the feedback you search for day in and even those restless nights and there are more people out there that have been where your at then you think an its in your best interest to seek help and if you have the courage to do it yourself and get out of this mental hell your in. more power to you and whentimes get hard my friend think about the times where your are yourself and just try so hard to work your way through and when that anger takes ahold of you just breathe and find a place in your mind to pick through what triggered your anger and usually how in theory its nothing to lose your cool over most of the time,(not always)then come right back to reality a deal with the situation at hand it takes a minute to get the hang of it but it helps so much  

and one more thing here is a quoute that has gotten me through my darkest hours. "We find comfort in those who agree with us--growth among those who don't."

             -eros`

someone always cares.... - - Nov 20th 2009

bipolar is a challenge to try and handle.  mood swings, anger, hate, love, friends, no one like me, i could go on..

i have been there, am there, never seem to leave there, but some days when i am my true self, it is a total joy to

be alive and appreciate all the superb things we have. on an average i was getting a day and a half once a month of being myself. then things would happen, my friends didn't know when i would (go off - like a bomb) so most of them stayed away a distance. i don't have many friends now, but that's ok because i know when i wrangle this monster and it will almost go away, then i will have many friends. they love us, they are just afraid of us and what we may do to ourselves or to them in a fit of anger. so we have to take control, no one else is going to do it. the doctor can only do so much, and they have seen much worse.  but our family who may not want us around in these episodes...would surely miss us if we were not around.  you have to endure and keep going to the end. think about a gift you may have and can share with others (when you're thinking right). it will work.

I reached out..no one cares - Jan - Apr 27th 2009

I went to a local hospital because I was at my wits end. Was prescibed a couple of meds, told to make appointments, sent home. No family,or friends,to turn to.At least, now,I have enough meds to end this misery, if God lets me go on, this time.

- Rosemary - Jan 5th 2008
I think that you guys should add more information, add more information about the new medications coming out to treat Bipolar Disorder......Well I still think it has good information..

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