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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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Although it is early in the diagnosis and treatment with medications

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Although it is early in the diagnosis and treatment with medications I am already wondering about shock treatments for son's bipolar disorder. I would be very nervous in regards XXXXX XXXXX but I wonder how much success people have with this as far as long term relief from manic and depressive episodes. As I understand it you need to continue treatment permanently and I don't know if health care plans cover it. I must admit from looking at my son right now I am feeling extemely worried and hopeless.

Hi! I believe I can be of help with this issue.

First, I want you to not be either too eager to opt for ECT (electroconvulsive therapy) right away or to be afraid of it either. You are clearly a loving and caring parent so you are already trying to consider options. That can be a good idea with Bipolar Disorder (BD). However, ECT is a second line treatment option. That means that it is considered only when medications are not doing the job. I would urge you to consider psychotherapy with a psychologist or psychotherapist who is experienced in BD to complement the medications. Therapy geared toward BD can be very effective. At the end of my answer I'll address this a little more.

ECT is an accepted and approved treatment for depressive symptoms and for bipolar disorder symptoms. And it has helped many people. The course of treatment is only 12 treatments maximum. Usually somewhere between 6-12. There is no "permanent" ECT treatment. It is a course of treatments up to 12 maximum. So, if anyone tells you differently, they are not correct, okay?

There are side effects of ECT that can occur. How often they occur is a matter of debate. The primary complaint is memory loss. This is what I hear the most in terms of complaints. I can't tell you what percentage of patients have this problem. Physicians who administer ECT can't say either, because there are no definitive studies.

But the side effect is something you have to consider and discuss with his doctor before agreeing to the treatment. Here are both the Mayo Clinic's entry and Harvard Medical School's. They are both pretty fair though they tend to downplay side effects:

There are two types of ECT, unilateral and bilateral. Bilateral has more side effects associated with it. Different doctors have their opinions about the efficacy of each. So keep this in your files to discuss this also with his doctor if ECT is considered. Here is the page on it:

I think it is a matter of your own benefit vs. risk calculation. ECT today is not what the old movies portrayed. If the doctors decide it is the right treatment to pursue, the above sites will help you to get informed and make a decision.

Now for psychotherapy:

Your son will need to be working with someone who is using a CBT therapy that is modified especially for BD. In my practice, I use the resources with people with BD from Mary Ellen Copeland. I have found her work easy for people to use and easy to keep with him . The biggest problem is forgetting to keep to the plan when times are good and then something happens! Copeland also had BD and was hospitalized. She's a therapist and developed a BD treatment protocol called Wellness Recovery Action Plan (WRAP). First let me cite one of her books for you.

The Depression Workbook: A Guide for Living with Depression and Manic Depression by Mary Ellen Copeland. Amazon:

Now here's a YouTube search I've put together on the WRAP program. I want you to look at the videos and see what you think:

The video with Mary Ellen is a bit strong but worthwhile. Here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful look at the listing and see if they list BD or mood disorders as something they work with and perhaps if they accept a sliding fee if he needs the financial help though insurance should cover it.

Good Therapy is a non profit directory. Same idea as the one above:


Okay, I wish you the very best!

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