Portfolio
News and Feature Stories

INTELLIGENCER JOURNAL (Lancaster, Pa.)
Cover, Business Monday

Bi-Polar Illness: The symptoms, the stigma, the treatment, the hope  (Part two in a series) - Continued

Treatment
Brettschneider explained that typical treatment for bi-polar disorder begins with a mood stabilizer that, like insulin for diabetes, an individual must take for the rest of his or her life.  Doctors do not have a cure at the moment, so it is a long-term treatment, but an effective one.

Other medications may be prescribed.  And many different forms of psychotherapy exist to help individuals with mood disorders.  Many patients do well with a combination of therapy and medications. 

For severely depressed individuals, such as those who have completely stopped eating and are literally starving to death, doctors also offer electroconvulsive therapy (ECT), which can work in cases where medications do not.  The benefits of ECT are widely recognized throughout the health care community because, indeed, this therapy often saves lives. 

Today it is used with both anesthesia and muscle relaxers.  In contrast to how this therapy has been portrayed in Hollywood movies, ECT is very safe in a controlled setting, Brettschneider said.

"About half of the patients receiving ECT in this day and age are not even hospitalized.  They come in from home and receive treatment in the morning.  They are watched for a few hours to make sure that they are okay.  And then they go home around lunchtime.

"I think the future looks promising," Brettschneider said.  "Many researchers here at Penn State, and across the country, are working on new medications and new approaches to treat mood disorders."

If you have been in treatment, but you have not gotten well, Brettschneider urges you not to give up.  Many individuals need to try different medicines before the right combination is found.  Meet with your doctor again, he suggests, to discuss other options.

"It is important to point out that even individuals who have mild to moderate symptoms may have considerable difficulty maintaining a job or going to school because of bi-polar illness.  There are things that employers can do to help. 

"For example, one of the most important things for individuals with bi-polar disorder is to establish a fairly regular sleep cycle.  For that reason, shift work is very difficult.

"If employees could work a regular routine schedule that doesn't change much, they can then adjust their home life and sleep cycle to that schedule. 

"Those who must change from one shift to another just never do as well, irrespective of whether they are taking their medicine or not."

According to Brettschneider, it is also important for folks suffering from general depression and bi-polar disorder to be given time to regularly attend visits with family doctors, psychiatrists, and their therapist. 

It is a difficult thing to argue with CEOs and legislatures, he said, but most studies support the idea that it is much better to invest money to treating people, than to not treating them. 

The economic impact of bi-polar disorder was addressed recently in a global study published in a European journal, which indicated that the economic impact of bi-polar disorder worldwide was a whopping $45 billion a year in total. 

"Only $7 billion of that amount, however, was associated with the direct costs of medications and out-patient treatment," Brettschneider said.  "Most of the amount represented indirect costs, such as lost productivity, lost jobs, and time on disability."

The Maryland Psychiatric Society actually runs a business forum two times a year during which they get leaders together to try to keep arguing this point.  In most cases, if companies invest in having good access to mental health treatment as part of their regular health benefits, it usually pays more dividends than what is lost from the lack of productivity from depressed employees.

"Bi-polar disorders and four other mental health disorders, including unipolar depression and alcoholism, rank among the top ten causes of disability world wide.  The sheer numbers of people affected is extraordinary.  There really are a lot of folks seriously affected by these issues.

"Treating the disorder is a good investment for employers, if that person then becomes more productive."

Stigma