How to Treat Bipolar II With OCD
Bipolar disorder is often called manic depression due to the periods of depression and mania that characterize the disease. However, if the periods of mania are not severe enough to impair your social and occupational life, they are termed "hypomania," and a diagnosis of bipolar II disorder is given. Obsessive compulsive disorder (OCD) was linked to bipolar II disorder in 2004 when it was found that 53 percent of OCD sufferers had symptoms of hypomania and 30 percent received a diagnosis of bipolar II disorder. Treating the combination of disorders can be tricky, though.
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Bipolar disorder is best treated with medication, though that can be trying due to the cycling between extreme moods. It is difficult to determine what medications tend to have the most beneficial effects on the disease as a whole, because studies tend to be small and limited in their subjects. The use of antidepressants tends to be suspect for this disorder because it runs the risk of pushing the patient into the manic or hypomanic phase of their cycle if not dosed appropriately. Medication requires careful monitoring by psychiatric staff to ensure that it is not worsening the disorder.
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Cognitive-behavioral therapy tends to be the treatment of choice for OCD. It is possible to treat it with medication, but behavior therapy tends to provide the best results. There are two components to this type of therapy. The first is exposure and response prevention. A common example of this relates to compulsive hand-washers. The therapist may force the patient to touch a public door knob, and then restrict them from washing their hands immediately thereafter. As the patient sits with the anxiety, the urge to wash will slowly fade and give them a sense of control over their own actions. This aspect of the therapy can actually remove compulsive behaviors entirely. The second part of the behavioral treatment is cognitive therapy, which focuses on the disastrous thoughts and increased sense of responsibility felt by OCD sufferers. The major target of this aspect of therapy is to teach the patient ways to respond to their obsessive thoughts without their previously obsessive behaviors.
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Treating bipolar II disorder when combined with obsessive compulsive disorder requires a delicate balancing of treatment options. It should be noted that the antidepressants most commonly used in treating OCD can actually worsen the symptoms of bipolar II disorder. Similarly, the antipsychotics typically used in treating bipolar disorder have been known to worsen the symptoms of OCD. It is important that you see your psychiatrist or doctor frequently if treating both conditions, because medications require frequent adjustment and your doctor may want to try a variety of options to find what will work best together for your particular condition.
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Tips & Warnings
Please consult your psychiatrist or physician before making any changes to your treatment.
