Integrated Therapy for Depressive Episode of Bipolar Disorder: A Case Study Highlighting the OPD Based Treatment Strategy

Abstract

Bipolar Disorder (BD) is a recurrent and chronic disorder that is characterized by episodes of depression and elevated mood with intervening periods of normal mood. Bipolar accounts for approximately 2.4% of the Global population substantially affecting functionality, cognitive function and Quality of life. It is one of the leading causes of disability in young people and increases mortality, especially death by suicide by 29.2%. There is an increased mortality in patients with mood disorder by almost two times then general population. The management strategy includes pharmacological therapy, Electro Convulsive therapy (ECT) and non-pharmacological therapy. The case report highlights the OPD based integrated approach in the management of depressive episode of bipolar disorder. A 35-year-old female presented to OPD with complaints of sadness of mood, loss of interest in pleasurable activity, easy fatigability and difficulty sleeping from 3 to 4 month. The observations were made in the level of affective and behavioral domains of BD¹. In Ayurveda, the condition was diagnosed as Kaphaja Unmada (Kapha predominant depression) with Pittanubandha (association of Pitta) based on the clinical symptoms. Outdoor Patient Department (OPD) based integrated management strategy includes Shamana Aushadhi and Brain Polarizer therapy. Psychological supportive measures such as Satvavajaya Chikitsa (psychotherapy) and Yoga therapy were also sought under the supervision of Manasa roga (psychiatric disorder) experts. The depressive status of the patient was assessed using the Hamilton Depression Rating Scale (HAM D), World Health Organization Quality of Life – BREF (WHO QoL BREF) Questionnaire. The OPD based integrated management demonstrated substantial positive effect in the scales along with considerable symptomatic relief.