Manic depression, otherwise known as bipolar disorder, is a complicated mental health condition. Sufferers cycle back and forth between mania and depression. During a manic phase, sufferers experience increased energy, a decreased need for sleep and the inability to sit still or concentrate. They tend to be impulsive and sometimes reckless, and seek out intense thrills. During a depressive phase, the mood reverses. Sufferers experience lack of energy or motivation, an increased need for sleep and an inability to become excited about activities they enjoy. Bipolar disorder does not always require hospitalization, but inpatient treatment is available if needed.

Reasons for Hospitalization

Involuntary commitment is a common reason for those with manic depression to enter a facility. Although state laws vary, in most jurisdictions sufferers can only be hospitalized against their will if they pose an imminent threat to themselves or others. Manic depression can lead to thoughts of suicide or even homicide. Involuntary commitment is usually brief and focused on quickly stabilizing the patient's moods. Voluntary hospitalization may be sought by those who feel their condition is out of control, often at the suggestion of a psychiatrist or therapist. Insurance plans vary in their requirements for coverage, but those with good insurance may be able to stay for several days or weeks. A major advantage of voluntary hospitalization is that the patient is able to leave daily stressors behind and focus solely on learning to manage her condition.

Medications

Bipolar disorder is most commonly treated with medications. Lithium is the oldest and most common mood stabilizer. Other mood stabilizers include anticonvulsant medications and calcium channel blockers. Anti-psychotic and anti-anxiety drugs may be prescribed during a manic episode to increase the effectiveness of mood stabilizers. Hospitalization is not generally required to treat manic depression with medications. However, some of the drugs are very potent and require close screening and frequent blood tests. During severe phases of mania or depression, hospitalization allows doctors to closely monitor drug reactions. Patients who are experiencing extreme symptoms may have trouble complying with doctors' orders and keeping appointments on an outpatient basis.

Behavioral and Talk Therapy

Most inpatient facilities run frequent psycho-educational groups designed to help patients learn to manage their own conditions. Group and individual therapy are also common. These treatments are also performed on an outpatient basis, but during a hospitalization they generally take up most of the day. Therapy usually focuses on working through personal issues and learning new coping skills.

Electroconvulsive Therapy

Electroconvulsive therapy, also known as ECT or shock therapy, is a highly controversial treatment for manic depression. Modern ECT utilizes sedation and muscle relaxants to avoid the pain and possible injuries of older shock treatment, but reported side effects, including memory loss and cardiac risks, ensure that the treatment is generally a last resort. ECT is beneficial for some patients who are unable or unwilling to take medications or suffer from extreme symptoms that do not respond to other treatments. ECT can be administered on an outpatient basis for many patients, but some doctors prefer that ECT recipients, particularly those with complicated medical histories, be hospitalized for the duration of treatment.

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Bipolar Disorder: What You Should Know