Just 60 years ago, there was hardly a way to treat mental disorders, with most severely ill persons detained in asylums, and the moderately ill trying to carry on normal lives. Lithium carbonate changed the face of bipolar treatment, offering a long-term medical treatment option that allowed many bipolar to live a normal life. Since then, there are over 100 medications worldwide that can be used to treat manic depression.
One of the main concerns voiced by some people is why psychotropic medications work differently depending on the person. After all, why should one drug work for someone and another work for someone else? They don’t give someone with an physical infection different drugs.
The problem with treating bipolar disorder is that it is not understood what biological mechanism actually causes the illness. A “chemical imbalance” is a notion spread by pharmaceutical companies, which you will not hear from your psychiatrist. There are likely many genetic and environmental factors that cause bipolar disorder, and until scientists understand the exact mechanisms of this illness, researchers will not be able to target a specific drug to manic depression.
There is also a theory that mental disorders are variably expressed. For example, if there are eight different genes determining bipolar disorder, having four of these switched on may cause cyclothymia, while having all eight switched on may cause schizoaffective disorder. This is a rather simplistic explanation, and there may be hundreds of different genes that cause manic depression.
Here are some reasons that psychiatrists prescribe different psychotropic drugs to different patients.
Symptoms
Symptoms vary depending on the patient. One person with bipolar disorder may suffer from more severe episodes of mania, while another may more frequently suffer from episodes of depression. One individual may suffer from insomnia, while another may have trouble staying awake.
Side Effects
The side effects of drugs vary depending on a person’s metabolism. While one drug may cause a person to gain weight, an individual with a faster metabolism may experience no weight gain whatsoever. Other medications may cause an individual to feel extremely tired all the time, while hardly affecting another person at all.
Drug Interactions
Some people with bipolar disorder take other medications for physical illnesses or have multiple mental conditions. The combination of certain psychotropic drugs and other medications can cause severe life threatening side effects. A psychiatrist has to take this into account when writing a prescription.
Different Drugs, Different Cures
One drug may be used to treat mania, while another drug may be used to treat depression. Some drugs can also cause side effects such as tremor, so additional drugs are prescribed to control the side effects of the first drug.
Effectiveness
Medications have varying effects depending on the mind and body of a person. As the causes of bipolar disorder are not known, these drugs cannot be laser targeted, resulting in a hit or miss strategy. What works for one person is not guaranteed to work for another when it comes to mental illness.
Keeping all of these factors in mind, it is important that a bipolar individual play an active part in their treatment. All of these reasons do not give psychiatrists a blank check to prescribe a veritable candy store of drugs. Generally speaking, it is best to find a treatment regimen comprised of the least amount of drugs possible, which will vary depending on the person. Some manic depressives may find that they need five drugs to live a normal life, while others may be able to get away with taking one drug every once in awhile.