Below is a compilation of Dr Thomas Stuttaford’s Q&As on the subject of Bipolar disorder covering all aspects of the illness beginning with basic information and moving on to advice on specific symptoms, medications and treatments.

(Dr Stuttaford’s replies cannot apply to individual cases and should be taken in a general context. Please consult your GP if you suffer from any health or special conditions.)

What are the common treatments (and their side effects) available for people suffering bipolar disorder? T. Pratt, Houston, Texas

The most common treatment for bipolar disorder is lithium. In the acute phase, when the patient may be very agitated, it is usually combined with an antipsychotic tranquilliser until the patient has settled down. Haloperidol is the drug which is often used. Once the patient has quietened down lithium by itself is usually enough, but it needs very careful control because its possible toxic level is close to its therapeutic level. Furthermore, if an inadequate dose is given it is ineffective. This means that blood levels need to be checked very carefully, with the blood being taken at the precise time after the last dose so that the serum lithium level can be carefully controlled.

Lithium interacts with diuretics, anti-inflammatory agents (like Brufen), and all the other rheumatic drugs. Some of the anti-epileptic drugs, some of the antipsychotics – antipsychotics are not usually used with it without special care - some antidepressants, particularly the trycyclic antidepressants, and some antibiotics.

It can cause nausea, diarrhoea, shakes, unsteady gait; it can affect the level of the thyroid production in the body; it may induce obsessive thirst and hence frequent urination. Correct control will remove most of these possibilities.

Other forms of bipolar disorder will respond to atypical antipsychotics or anti-epileptic drugs; in other cases the patient may get along well if the occasional depressed episode is treated with antidepressants and the hypomania treated with tranquillisers and sleeping pills. Bipolar disorder needs bespoke medical tailoring, rather than a treatment taken off the peg, so it is quite impossible to pontificate about it. Find yourself a good primary physician whom you trust and a psychiatrist in whom you have confidence.

If a person who has suffered with manic depression for several years recovers, what are the chances of manic depression returning? Bob Sixpence, Luton

Bipolar disorder, as one would expect from its name, varies in its severity. Before effective drug treatment was available, or in those patients who don’t cooperate with their treatment, a third became chronically so disturbed that they were unable to resume normal activities. Even now, when most people take their treatment regularly, some may be left with residual symptoms so that they find it difficult to live a normal social, or professional life. Cognitive therapy has helped many of these people to slot into life again.

My partner is suffering from severe manic depression. He has been prescribed drugs and we are waiting for them to take effect. How can I support him and lift his spirits when he feels so down? He has also suffered from ME for the past five years and consequently cannot work so this does not help. Any suggestions? Arnavaz Sethna, India

The good news is that your partner has now been given a firm diagnosis for which there is treatment. The medication he receives will undoubtedly help his condition and lessen his symptoms. Unfortunately treating bipolar disorder has to be individualised, no one regime can be guaranteed to help everybody. Some degree of trial and error is almost inevitable and hence the need to attend a psychiatrist who is interested in the condition.

A number of patients who have been diagnosed with ME later are found to have an affective disorder, or some bipolar disorder. It is very common for people with bipolar disorder, even in its early stages or if it is not severe, to be unable to hold down a job. When hypomanic, or manic, their behaviour may be a trial to colleagues, when depressed life can seem hopeless and pointless, and at no times more pointless than when carrying out uninteresting work.