Prior to about 1950 people with severe depression, or mania, had little recourse. There was little that physicians or psychiatrists could do other than institutionalize the patient, administer potent anti psychotic medications. ECT (electro convulsive therapy) was also common but administered at that time using inhumane methods. Psychoanalysis did little to help the patients in the midst of severe symptoms.
Most patients, once institutionalized, were there for a lifetime. Patients who were able to go home were in and out of hospital frequently as their condition was not controlled.
Then in 1970 a "magic" pill called lithium was discovered. Suddenly patients with mania were getting well and going home! Later, lithium also proved effective in preventing both manic and depressive episodes of bipolar disorder.
Medical journals and papers touted lithium as a new wonder drug that would treat all phases of bipolar disorder (manic depression) with only mild, tolerable side effects for most, if not all, patients.
Can you just imagine the exhilaration of that time? I mean, this was a disorder that was centuries old and a cure had been found? Now in the year 2000 we look back and see how optimistic, yet naïve they were.
Now
"We've come a long way baby" is the first thought that comes to my mind. The second is "but we still have a long way to go."
Since the discovery of lithium, research has been ongoing in both the study of bipolar disorder itself, and various methods of treatment.
We have learned that bipolar disorder is a lifetime mental illness. The cause is unknown at this time although it is expected that it is genetic (there is certainly a genetic component that is traceable in families affected). Two thirds of individuals affected with bipolar disorder have a family history of it. Bipolar Disorder is a biological disorder affecting the neurological functioning of hormones in the brain.
New medications have been discovered. Mood stabilizers, which act like lithium to control mania, and stabilize mood (including tegretol, depakote, depakene, lamictal, neurontin, topamax, are now on the market). Even newer ones are being researched. Mexiletine is one of these and is for use for treatment-resistant bipolar disorder.
Entire new classes of antidepressant medications have joined early antidepressants including the MAOI's and tricyclics. "Talking" therapies have advanced and many people with bipolar disorder benefit from cognitive therapy, supportive therapy and others.
Other therapies including ECT, alternative therapies etc have advanced.
With all of these advances one would think that there would be much improvement in the life of a person with bipolar disorder today. According to Dr. Michael Gitlin, Clinical Professor of Psychiatry at UCLA School of Medicine and Director of the Affective Disorders Clinic at the Neuropsychiatry this is not true. Quoting from Dr Gitlin's paper at http://www.mhsource.com/hy/j62.html
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