Q: My cousin is under treatment for bipolar disorder. She is in the Mania stage. She says she wants to start her own Company and give salary to the employees when she is hardly 19 years old. She also has a lot of chat friends who have distracted her. She has undertaken 6 ECT and is still saying the same words that she wants to chat on the net. Is the treatment right or is something else required?

A:Treatment for bipolar disorder includes medication (pharmacological treatment), supportive psychotherapy and occasionally ECT. Electroconvulsive therapy is not always the 1st line of treatment as most patients exhibit acute response to mood stabilizers. However, it is often a preferred form of treatment for severe depression or manic delirium (such as in this case where she is exhibiting symptoms such as delusions). ECT is mostly used when medication doesn't work or is unsafe and often recommendations are made by the doctor to undergo up to 3 treatments a week. She may feel the need to apply her heightened energy to an outlet and there may be a drive for pleasurable activity, such as in this case it may be chatting on the Internet. You could discuss this with a psychiatrist along with methods to reduce external stimuli in this stage. As bipolar disorders are generally recurrent, maintenance treatment is also recommended.