Bipolar disorder: Treatment.

Extract: Acute mania is as close to a medical emergency as we have in psychiatry. A manic patient is likely, if not treated rapidly, to take actions that will endanger his marriage and his job, if not his (and potentially other people's) life. A manic patient driving at 110 miles an hour through the city may have just had a conversation with his family physician where he denied delusions or hallucinations; yet the result of poor judgment on the road can be life-threatening. The famous European psychiatrist Manfred Bleuler once wrote "I have seen many cases in which the patient has ruined the happiness, the social condition of himself and of his family for good as he had not been hospitalized at the right time." He went on to point out in his letter to me that the modern emphasis on keeping schizophrenic patients out of the hospital in order to reduce hospitalization and dependency (not to mention cost!) has unfortunately and unduly been generalized with respect to the care of the manic patient. Moreover, laws cherished by well-meaning human rights advocates to guarantee that human beings cannot be incarcerated unjustifiably have led to the increasingly cumbersome and difficult procedure of involuntary hospitalization.