Mais Samhoury Center
Dr Raghad Shnaigat is a psychiatrist and addiction-treatment specialist with the Jordanian Board in psychiatry. She practises at Mais Samhoury Center in Abdoun,…
Treatments
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Treatment for bipolar disorder is a long-term plan aimed at achieving mood stability, preventing episodes and reducing their severity and duration — not simply managing one episode when it appears. The condition itself involves alternating periods of elevated mood and energy, periods of depression, and periods of stability. The plan usually rests on four complementary pillars: a mood-stabilising medication plan set and titrated by a clinician; psychoeducation for you and your family about the nature of the condition and its early warning signs; disciplined regulation of sleep and daily rhythm, since disruption of these is among the strongest triggers of episodes; and psychotherapy that addresses the effect on work and relationships and builds skills for handling an episode before it grows. Accurate diagnosis is the foundation, because depressive episodes are usually what first drive a person to seek help, and the picture can be read as unipolar depression. For that reason the clinician asks carefully about any earlier period of increased activity and reduced need for sleep with impulsivity or unusual spending. This distinction matters in practice: some antidepressants used without a mood stabiliser can push mood towards the elevated side. A written crisis plan is an element that is often neglected. It is drawn up with your family while you are well, and it names your own individual early warning signs, who should be contacted, what you permit your family to do if your judgement becomes impaired, and where help should be sought. The limits deserve to be stated honestly. There is no treatment today that cures bipolar disorder permanently; the goal is long stability and a full life, not the complete absence of any mood variation. Psychotherapy alone is not sufficient during acute episodes. And two common myths need correcting: bipolar disorder is not simply day-to-day moodiness, and it is not schizophrenia — these are entirely different conditions.
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Procedure steps
- 1
Diagnosis and building an episode timeline
A timeline of your mood history is constructed: depressive episodes, periods of elevated activity, how long they lasted and what triggered them, with specific questions about reduced need for sleep, impulsivity and spending, plus family history. This is where bipolar disorder is distinguished from unipolar depression.
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Medical work-up before treatment
Physical examination is performed and tests are requested, typically including thyroid, kidney and liver function and a blood count, sometimes with an ECG, together with a review of everything you take and exclusion of any contribution from alcohol or stimulants. This baseline makes the medication plan safer and its monitoring possible.
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Treating the acute episode, safety first
During an acute episode, safety comes first: assessing suicide risk in depression and the risk of impulsive, damaging decisions during an elevated phase. The medication plan is adjusted more rapidly, and the level of care is decided between intensive outpatient follow-up and hospital admission when risk is high.
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Stabilisation and prevention
Once the episode settles, the most important phase begins: continuing the preventive plan, psychoeducation for you and your family, a mood chart recording sleep, mood and energy, fixed sleep and waking times, reducing alcohol and stimulants, and organising work pressures and travel so that your daily rhythm is not disrupted.
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Long-term follow-up and a crisis plan
Regular follow-up appointments are scheduled even during stable periods, along with whatever monitoring tests your plan requires. A crisis plan is written with your family naming your early warning signs, who to contact and what to do if your judgement becomes impaired, and it is reviewed yearly or after each episode.
Before the procedure
Come to the appointment with a written timeline: when the mood changes began, how long each period lasted, and what preceded them — travel, lost sleep, pressure or bereavement. Try to recall any period when you needed less sleep yet felt energetic, or spent money or made decisions that were out of character. Bring a full list of everything you take, including supplements, herbal products and energy products, plus previous reports and test results. Tell the clinician about any family history of mood disorder, about alcohol, substances and stimulants, and about pregnancy or plans to conceive, since this influences the choice of plan. If possible and with your consent, bring a relative who has observed your episodes from outside, as a family member's description of an elevated phase is often more accurate than the person's own.
After the procedure
Keep sleep and waking times as consistent as you can and record mood, sleep and energy on a simple chart — the cheapest and most accurate early warning tool available. Follow the medication plan as agreed along with any monitoring tests, avoid alcohol, stimulants and energy products, and discuss with your clinician before travel that disrupts your sleep schedule or before taking anything new prescribed elsewhere. **Seek help immediately if there is a clear reduction in the need for sleep alongside high activity and racing thoughts, unusual spending or decisions, irritability and aggression, intense suspiciousness or hearing voices, stopping eating and drinking, or a rapid decline in mood.** **If thoughts of harming yourself or of suicide arise, get urgent help straight away: call emergency services, go to the nearest emergency department, or tell someone you trust right now. Do not wait for your next appointment.** Most importantly, do not stop medication because you feel better — abrupt discontinuation is among the commonest causes of relapse, and any stopping must follow a gradual medical plan. Psychotherapy and medication are not rivals, and bipolar disorder in particular needs both.
Expected duration
The initial assessment usually takes 60 to 90 minutes; an acute episode needs review every one to two weeks until stability, then follow-up every one to three months during long-term prevention.
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Finding Bipolar disorder treatment services in Jordan
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