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Expert Q&A

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Can I heal from bipolar?

Asked by Brad, Seattle, Washington

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I have suffered from bipolar depression for five years. I am taking medication and worked with a specialist for three years. My question is, can one ever grow out of or heal from this affliction?

Expert Bio Picture

Mental Health Expert Dr. Charles Raison Psychiatrist,
Emory University Medical School

Expert Answer:

One of the strange things about mental health questions is that the answer is almost yes. Can one recover from bipolar disorder? Yes. But this is very different from what is perhaps a more important question which is: How likely is it that bipolar disorder will completely go away once a person has it? Here the evidence is a good deal more sobering. On average, bipolar disorder is like most other modern medical illnesses, meaning that it doesn't tend to go completely away even with treatment.

Have you ever thought about this before? If not, take a moment to consider this. Pick any major modern disease -- I'll give you a list: cancer, heart disease, diabetes, HIV, dementia, autoimmune disorders. For most of these conditions, doctors can control symptoms but cannot eradicate the underlying disease process. The exception is cancer, but even with cancer no one would say that once someone has had a serious cancer that they are the same person with the same life expectancy as someone who has never had cancer -- at least not until a number of years of completely disease-free survival had passed.

For reasons too complicated to explain here, mood disorders like bipolar disorder share many of the same disease pathways as other modern illnesses, and because of this clinicians are frequently able to manage the condition very well but seldom cure. This is one of the reasons that major depression and bipolar disorder are such painful and devastating conditions and why it is so important to treat them aggressively.

Because it is not possible to know in advance who will recover from bipolar disorder and who will be part of the larger group of people who will struggle with the illness across their lifetimes, the smartest course of action is to treat the condition as effectively as possible. The goal should always be to have as few depressive or manic episodes as possible, because each episode increases the likelihood of having more episodes in the future. Plus, each episode appears to be bad for the brain and to increase the risk of getting other medical illnesses. Preventing depressive or manic episodes is usually best achieved by staying consistently on medications -- the specific medications are a matter for each patient and his or her doctor. It is also important to commit to leading a balanced and healthy, with manageable levels of stress, regular sleep and wake times, avoidance of drug and alcohol abuse and a healthy diet. In this last regard, a diet high in a nutrient called omega-3 fatty acid may be especially helpful in keeping moods stable.

So what is the take-home point? It is this: The best way to recover from bipolar order is to treat it as thoroughly and for as long a time as possible, which is exactly the best way to live an optimal life even if the condition never fully goes away.

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