For older patients, supportive psychotherapy is indicated. It is important to give patients feedback about current symptoms, identify early symptoms of an episode, help solve problems, and repair relationships damaged by the illness. It is also important to teach patients how to control their symptoms better. For instance, because lack of sleep can precipitate an episode of mania, patients should take additional medication to stabilize their sleep when they are under stress and sleeping less. Changing the dose of a mood stabilizer during periods of stress is not as important as ensuring a good night's sleep.
Patients can also help themselves through self-help groups.
The National Depressive and Manic Depressive Association, for example, meets regularly in cities throughout the country and teaches patients how to live with their illness. Substance Abuse and Bipolar Illness Substance abuse is a problem in bipolar illness. Therefore, the use of alcohol and illicit drugs needs to be examined and monitored. When a patient is not doing well or not responding to treatment, the physician should suspect substance abuse. The others, especially those with chronic depression, are severely disabled.