New research indicates that people with serious mental illness — which include schizophrenia, bipolar disorder, and major clinical depression — die, on average, 25 years earlier than the general population. Sixty percent of premature deaths in persons with schizophrenia are due to medical conditions such as cardiovascular, pulmonary and infectious disease.
Unfortunately, people with serious mental illness also suffer from a high prevalence of modifiable risk factors, in particular obesity and tobacco use. Compounding this problem, people with serious mental illness have poorer access to established monitoring and treatment guidelines for physical health conditions.
Our nation?s healthcare system tends to be fragmented, with increased reliance on specialists who address very focused aspects of the health/illness continuum.
Fragmentation is most notable in the separation between the treatment for mental and physical illnesses. This separation is an artifact of how services have been funded historically, with the preponderance of funding for mental illness treatment coming from states and directed toward state psychiatric facilities that were often — literally and figuratively — far away from the mainstream of medical delivery.
What Can Be Done to Address this Tragedy?
There are solutions to this epidemic of premature death and morbidity among persons with mental illness. Policy makers can provide the policies, resources, and leadership to close this gap. We will have accomplished this goal when we can say that:
- Adequate funding is available to allow every provider of public mental health services to assess the physical health status as well as mental status of clients served in the public mental health system.
- States are learning from and following the examples of states such as Missouri and Louisiana, which are implementing primary care medical home initiatives with explicit mechanisms and financing integrated treatment between the mental health and primary care providers for coordination of services.
- State legislatures can create the policy infrastructure through statute or regulation to ensure that there is a strong working partnership between community mental health and community health provider organizations. These policies can define roles for these organizations, establish referral protocols, or allow for the cross-placement and reimbursement of clinical staff.
Disease Management: Another Promising Approach
Usual medical care often fails to meet the needs of chronically ill patients, even in managed, integrated delivery systems. The medical literature suggests strategies to improve outcomes in these patients. Effective interventions tend to fall into one of five areas: the use of evidence-based, planned care; reorganization of practice systems and provider roles; improved patient self-management support; increased access to expertise; and greater availability of clinical information. The challenge is to organize these components into an integrated system of chronic illness care. One approach to meeting these goals is through the creation of disease management programs.
Disease management (DM) is an approach to care coordination for individuals with chronic or persistent medical conditions for two important reasons: improved quality of care and decreased cost. Quality is improved because treatment is coordinated across the spectrum of care for individuals with these conditions using evidence-based practice guidelines and education on illness self-management. States have also been able to reduce costs through this approach.
The Centers for Medicaid and Medicare Services (CMS) issued a letter to state Medicaid directors encouraging the adoption of DM. Currently, DM is now widely used in states for asthma, diabetes, hypertension and other persistent medical conditions, and increasingly for enrollees with serious mental illnesses.
Washington State Example
On June 28, CMS approved a state plan amendment (SPA) for Washington State that uses the Benchmark Plan option to offer regular Medicaid State plan services plus disease management (DM) services to adult Medicaid recipients with complex medical needs. The benchmark State plan option provides States with the opportunity to offer an alternative benefit package to beneficiaries without regard to comparability of services, a traditional Medicaid requirement.
Medicaid recipients statewide will be identified by a contractor based on claims history, referred by a provider, or may be self-referred. Eligible recipients include those who are diagnosed with certain chronic medical conditions, including: diabetes, heart failure, coronary artery disease, cerebrovascular disease, renal failure, and chronic pain associated with musculoskeletal conditions and other chronic illnesses, including co-morbid depression and/or anxiety.
In addition to the traditional State Medicaid plan services, individuals enrolled in the DM program will receive assistance in locating a primary care provider (”Medical Home”) and additional benefits tailored to specific health needs, including:
- Condition-specific education;
- Access to a nurse call line;
- Regularly scheduled telephonic health care management and support; and
- Care coordination, including feedback to the primary care physician.
Linda Rosenberg
http://www.articlesbase.com/mental-health-articles/an-avoidable-tragedy-the-relationship-of-premature-death-and-serious-mental-illness-696271.html
If you have bipolar disorder, you will probably need medication. You may need it for the rest of your life. That can be hard to accept. Some people see medication as a crutch or a weakness; instead they want to get better on their own.
But you have to remember that bipolar disorder is a real medical illness. It’s not something you can cure with willpower. Taking bipolar disorder medication is just like taking medication for high blood pressure or heart disease.Medication can be like a pair of glasses. Bipolar disorder distorts your view of things; medication may allow you to see clearly again.
While your diagnosis of Bipolar Disorder may leave you feeling relieved on one hand because you finally know what is wrong, but more worried on the other, know that you are on the right path. Once your doctor or therapist has diagnosed your disorder, you can gain the knowledge you need to learn to deal with your disorder. Along with suggesting some lifestyle changes, your doctor may start you on a regimen of medicine to help control your symptoms.
There are several medicines available to help Bipolar Disorder, but in order for them to be effective, they must be taken exactly as your doctor prescribes. Here are some of the Bipolar medications your doctor may prescribe. The first medication used to treat Bipolar Disorder, and still prescribed today, is Lithium.
First used in the 1950’s, Lithium was not actually approved for use in Bipolar disorder until the 1970’s. Once your doctor prescribes Lithium, it will probably take about one week to start working and may take up to three weeks before you feel the full benefits. Along with its mood stabilizing abilities, Lithium users may also experience hair loss, thyroid problems and swelling. Your doctor may be able to prescribe medicines to help with the side effects of this Bipolar medicine.
Another type of Bipolar medicine often prescribed to help stabilize moods includes medicines originally formulated as anticonvulsants. These include drugs such as Depakote or Tegretol. Like Lithium, these drugs may also take up to three weeks to completely control your Bipolar symptoms.
Reported side effects include mild stomach cramps, hair loss, and sleepiness or grogginess during the day. The higher your medication dose, the more problems you may have with daytime sleepiness. Users of these medicines often report turning to coffee to help counteract this side effect.
A newer class of drugs now being used to treat the manic phase of Bipolar Disorder is called the psychotropic medicines. There are several drugs in this class that will help reduce chance of experiencing a manic phase and may even bring about a remission in your symptoms. The Bipolar medicine in this class offers a lower risk of weight gain as well as a lower risk of developing diabetes than some other treatments.
One note of caution about most Bipolar medications – they can be very dangerous to pregnant women. If you are a woman who wants to become pregnant or has just become pregnant, tell your doctor. He or she can help you to assess the risks to you and your baby and together you can decide how to progress with your treatment.
There are many types of Bipolar medicine on the market today. While some may produce desirable results in one patient, they may not help another. Some may find the side effects of one medicine intolerable while they do not affect another. Only by working together with your doctor and therapist you can find a medication that best suites you and best controls your symptoms.
Abhishek Agarwal
http://www.articlesbase.com/mental-health-articles/the-perfect-bipolar-medication-fishing-for-the-best-treatment-739511.html
If you have bipolar disorder, you will probably need medication. You may need it for the rest of your life. That can be hard to accept. Some people see medication as a crutch or a weakness; instead they want to get better on their own.
But you have to remember that bipolar disorder is a real medical illness. It’s not something you can cure with willpower. Taking bipolar disorder medication is just like taking medication for high blood pressure or heart disease.Medication can be like a pair of glasses. Bipolar disorder distorts your view of things; medication may allow you to see clearly again.
While your diagnosis of Bipolar Disorder may leave you feeling relieved on one hand because you finally know what is wrong, but more worried on the other, know that you are on the right path. Once your doctor or therapist has diagnosed your disorder, you can gain the knowledge you need to learn to deal with your disorder. Along with suggesting some lifestyle changes, your doctor may start you on a regimen of medicine to help control your symptoms.
There are several medicines available to help Bipolar Disorder, but in order for them to be effective, they must be taken exactly as your doctor prescribes. Here are some of the Bipolar medications your doctor may prescribe. The first medication used to treat Bipolar Disorder, and still prescribed today, is Lithium.
First used in the 1950’s, Lithium was not actually approved for use in Bipolar disorder until the 1970’s. Once your doctor prescribes Lithium, it will probably take about one week to start working and may take up to three weeks before you feel the full benefits. Along with its mood stabilizing abilities, Lithium users may also experience hair loss, thyroid problems and swelling. Your doctor may be able to prescribe medicines to help with the side effects of this Bipolar medicine.
Another type of Bipolar medicine often prescribed to help stabilize moods includes medicines originally formulated as anticonvulsants. These include drugs such as Depakote or Tegretol. Like Lithium, these drugs may also take up to three weeks to completely control your Bipolar symptoms.
Reported side effects include mild stomach cramps, hair loss, and sleepiness or grogginess during the day. The higher your medication dose, the more problems you may have with daytime sleepiness. Users of these medicines often report turning to coffee to help counteract this side effect.
A newer class of drugs now being used to treat the manic phase of Bipolar Disorder is called the psychotropic medicines. There are several drugs in this class that will help reduce chance of experiencing a manic phase and may even bring about a remission in your symptoms. The Bipolar medicine in this class offers a lower risk of weight gain as well as a lower risk of developing diabetes than some other treatments.
One note of caution about most Bipolar medications – they can be very dangerous to pregnant women. If you are a woman who wants to become pregnant or has just become pregnant, tell your doctor. He or she can help you to assess the risks to you and your baby and together you can decide how to progress with your treatment.
There are many types of Bipolar medicine on the market today. While some may produce desirable results in one patient, they may not help another. Some may find the side effects of one medicine intolerable while they do not affect another. Only by working together with your doctor and therapist you can find a medication that best suites you and best controls your symptoms.
Abhishek Agarwal
http://www.articlesbase.com/mental-health-articles/the-perfect-bipolar-medication-fishing-for-the-best-treatment-739511.html
If you have bipolar disorder, you will probably need medication. You may need it for the rest of your life. That can be hard to accept. Some people see medication as a crutch or a weakness; instead they want to get better on their own.
But you have to remember that bipolar disorder is a real medical illness. It’s not something you can cure with willpower. Taking bipolar disorder medication is just like taking medication for high blood pressure or heart disease.Medication can be like a pair of glasses. Bipolar disorder distorts your view of things; medication may allow you to see clearly again.
While your diagnosis of Bipolar Disorder may leave you feeling relieved on one hand because you finally know what is wrong, but more worried on the other, know that you are on the right path. Once your doctor or therapist has diagnosed your disorder, you can gain the knowledge you need to learn to deal with your disorder. Along with suggesting some lifestyle changes, your doctor may start you on a regimen of medicine to help control your symptoms.
There are several medicines available to help Bipolar Disorder, but in order for them to be effective, they must be taken exactly as your doctor prescribes. Here are some of the Bipolar medications your doctor may prescribe. The first medication used to treat Bipolar Disorder, and still prescribed today, is Lithium.
First used in the 1950’s, Lithium was not actually approved for use in Bipolar disorder until the 1970’s. Once your doctor prescribes Lithium, it will probably take about one week to start working and may take up to three weeks before you feel the full benefits. Along with its mood stabilizing abilities, Lithium users may also experience hair loss, thyroid problems and swelling. Your doctor may be able to prescribe medicines to help with the side effects of this Bipolar medicine.
Another type of Bipolar medicine often prescribed to help stabilize moods includes medicines originally formulated as anticonvulsants. These include drugs such as Depakote or Tegretol. Like Lithium, these drugs may also take up to three weeks to completely control your Bipolar symptoms.
Reported side effects include mild stomach cramps, hair loss, and sleepiness or grogginess during the day. The higher your medication dose, the more problems you may have with daytime sleepiness. Users of these medicines often report turning to coffee to help counteract this side effect.
A newer class of drugs now being used to treat the manic phase of Bipolar Disorder is called the psychotropic medicines. There are several drugs in this class that will help reduce chance of experiencing a manic phase and may even bring about a remission in your symptoms. The Bipolar medicine in this class offers a lower risk of weight gain as well as a lower risk of developing diabetes than some other treatments.
One note of caution about most Bipolar medications – they can be very dangerous to pregnant women. If you are a woman who wants to become pregnant or has just become pregnant, tell your doctor. He or she can help you to assess the risks to you and your baby and together you can decide how to progress with your treatment.
There are many types of Bipolar medicine on the market today. While some may produce desirable results in one patient, they may not help another. Some may find the side effects of one medicine intolerable while they do not affect another. Only by working together with your doctor and therapist you can find a medication that best suites you and best controls your symptoms.
Abhishek Agarwal
http://www.articlesbase.com/mental-health-articles/the-perfect-bipolar-medication-fishing-for-the-best-treatment-739511.html
It’s not uncommon to see a person who suffers from bipolar disorder go undiagnosed for close to eight years. Though proper treatments are available, they are still going undiagnosed or are getting inadequate treatment.
When the illness is left untreated, it can cause an assortment of trouble in the person’s life. It is important they be diagnosed soon as symptoms start so treatment can get started.
There are numerous treatments for bipolar disorder and while some may fail, others are very triumphant in controlling the illness.
Sometimes patients tend to give up on medicines because they feel it’s just not working. This can be dangerous because any lapse from taking the medication can cause a relapse in episodes. Compliance is another factor in the dealing of the disease.
Treatment Stages – Acute and Preventive
In the Acute stage, the idea is to end current depression, hypomanic, mixed mood swings and manic. Preventative measures calls for a continuation in the therapeutic process to handling future episodes.
Medication, psychotherapy and education are all forms of treatment. Medication therapy is important for all of the patients during both stages.
Patients and families can find relief in more than usual bipolar disorder symptoms during psychotherapy sessions.
Because this disease is complex, families and patients need to be aware of what its symptoms are and how it can be managed. Education of this disease is important so people know what to expect.
Despite which treatment the patient, family and physician chooses, the main goal is to decrease the amount of episodes the bipolar person has…prevent it from cycling from each mood stage. It would be beneficial to have the mood disruptions decrease in intensity as well as frequency. This would also help the patient while they are in between episodes.
During talk therapy before medication or other treatment is prescribed, the physician must first identify what caused the initial outburst. The, the doctor will assess for other problems such as emotional or medical that could hinder the patient’s treatment and recovery.
Treatments available
There are several medications that can be used to help bipolar patients in their daily lives.
1. Mood Stabilizers – this is the core of bipolar medicinal treatment. They are efficient in acute stages of depression and even psychotic mania. It can also be used as a maintenance drug. The most commonly prescribed drugs in this area are Lithium and Valporate. The drugs act as a stimulate.
2. Atypical Antipsychotic- this is a mood stabilizer that can also be prescribed for schizophrenia. There are five kinds of medication offered in this treatment. They are: Olanzapine, risperidone, quetiapine, ziprasidone and ariprazol can be used for bipolar mania and mixed episodes. However, only Quetiapine is only allowed for mixed episodes.
The best thing about the drugs is that they can be used alone or combined with other drugs to help ward of the symptoms of the disease.
3. Antiseizure medications – this is typically given to patients who have rapid bipolar cycling with mixed episodes of mania, depression and those who have suffered from substance abuse. Three antiseizure medicines given are: carbamazepine, lamotrigine and oxcarbazepine.
4. Electroconvulsive therapy – ordered on patients who suffer from acute emotional stages.
5. Sleep Management and Psychotherapy – used with medications for bipolar disorder.
There are side effects with the medication like anything else. Some of these can include: weight gain, high cholesterol, diabetes. A diet should be followed and education on dietary intake is necessary. This can help in the reduction of these effects.
With friends and family behind the loved one, then it is possible for the patient to live a “normal” life.
Abhishek Agarwal
http://www.articlesbase.com/mental-health-articles/treating-bipolar-disorder-5-effective-drugs-that-help-739515.html
