My nephew is a patient of bipolar disorder (Psy. Disease) his mood is very ups and down and he is not able to sleep in the night and feeling tired whole day. He is taking some any depression medicine but not getting benefit. Please suggest if he can modify his lifestyle and lead a normal life.

Dr. Saul PereiraPsychologist46yrs exp

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He must meet with a counselor and continue both therapies for a long time. The counselor will draw up a timetable for him to follow and you can help by making sure he complies with the treatment requirements. If you do not take care of this situation now, it can become too difficult to handle later on. There are certain adaptations that will suit you during the elation phase and there are certain behaviors that are required during the depressed phases. In the meantime, you can do certain things that will give you benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. You need to particularly look at your levels of anger both for its reasonableness and to express it in an appropriate manner. I suspect that much of this anger may have origins in early childhood that you may never be aware of now. Talk to your parents and explore that angle. This information will help the counselor too. Also, you will need to check whether there is any genetic factor involved. You must exercise regularly, eat healthily and sleep normally too. If your motivation and cooperation are good much can be achieved. You must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times you will be inclined to have grandiose notions and confidently believe that you can do without the medication. This will set you back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. Bipolar is characterized by two extreme poles i.e. feeling very high (mania) and suddenly feeling very low (depression). You can ask the doctor for the symptoms he noticed in you for a personal understanding. 

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