Bipolar Disorder Treatments

Bipolar disorder is a lifelong condition, so it requires lifelong treatment, even when the affected person feels fine. Treatment is usually guided by a psychiatrist or other mental health professional skilled in treating bipolar disorder. Treatment may include a combination of medication, therapy, and other treatments that may be necessary, such as rehabilitation from substance abuse. Hospitalization may be necessary if a person is behaving dangerously, feeling suicidal, or becoming completely detached from reality (experiencing a psychotic break).

Psychiatrists typically recommend medications as initial treatment to balance moods and control symptoms as quickly as possible. Once symptoms are under control, maintenance treatment is needed to manage bipolar disorder in the long term. Maintenance treatment is very important; without it ,risk of relapse is higher, and there’s a greater chance that minor mood swings can turn into full-blown mania or depression.

Medication

There are a number of different drugs that are used to treat bipolar disorder, including mood stabilizers, antidepressants, and drugs that relieve anxiety. Depending on the type of bipolar disorder and the person’s individual symptoms, medical history, and overall health, he or she may be prescribed any one or a combination of these drugs. Some of the most commonly prescribed medications for bipolar disorder include:

Lithium

Lithium is a mood-stabilizing drug that has been used since the 1970s. It can help control acute mania and can prevent the recurrence of periods of mania and depression.

Learn more about lithium.

Anticonvulsants

These drugs help to stabilize mood in patients with bipolar disorder. They have been approved for use in treating bipolar disorder since the mid-1990s. In 2009, the drug asenapine (Saphris) was approved in the treatment of bipolar disorder I and for alleviating symptoms in people who experience mixed episodes.

Learn more about anticonvulsants.

Antipsychotics

This class of drugs tends to be effective for people who do not have a positive response to anticonvulsants. Some examples of commonly prescribed antipsychotics are:

• olanzapine (Zyprexa)
• risperidone (Risperdal)
• quetiapine (Seroquel)

Learn more about antipsychotic drugs.

Antidepressants

This class of drugs is used to treat the depressive moods of bipolar disorder. However, because they can trigger manic episodes, antidepressants are usually prescribed in combination with a mood stabilizer to avoid onset of manic symptoms. Both medications should be taken, even during times of depression, to avoid the onset of manic symptoms.

Learn more about antidepressants.

Benzodiazepines

Benzodiazepines are medications with anxiety-relieving properties. Existing guidelines do recognize that anxiety has a negative impact on the course and outcome of bipolar disorder; however, there has been minimal research examining the treatment response of patients with both bipolar and anxiety disorders. Benzodiazepines should be carefully considered because they can lead to dependence and some formulas have been known to result in rebound anxiety that is difficult to manage.

Learn more about benzodiazepines.

Get more detailed information on drugs that treat bipolar disorder.

Psychotherapy

Psychotherapy is a vital part of bipolar disorder treatment, because it can give a patient the skills to identify and manage bipolar triggers, replace unhealthy behaviors with positive ones, manage problems in school or at work, and facilitate healthier relationships. Several types of therapy may be helpful.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a common form of individual therapy for bipolar disorder. In cognitive behavioral therapy, a therapist helps someone with bipolar disorder identify bipolar episode triggers and ways to manage them. CBT can also be helpful in identifying unhealthy beliefs and behaviors and replacing them with healthy ones. This type of therapy can also help you manage stress and cope with difficult situations.

Read more about CBT.

Psychoeducation

This type of counseling can help a person and his or her loved ones learn about bipolar disorder, understand the condition, and recognize warning signs of mood swings.

Family Therapy

In this type of therapy, a psychologist or other type of therapist provides counseling to the bipolar disorder patient together with his or her family members. It can help family members learn how to reduce stress, improve communication, resolve conflicts, and identify stressors that trigger bipolar symptoms.

Find out more about family therapy.

Group Therapy

This type of therapy provides a forum to communicate with and learn from others with bipolar disorder. A patient might be able to learn tips from other people with the same condition for managing stress, building better relationships, and coping better in school or at work.

Learn more about group therapy options.

Other Therapies

Interpersonal therapy is a type of therapy which helps a person identify and resolve problems in relationships. Another type, called social rhythm therapy, helps a person identify and resolve problems with his or her daily routine. Both of these have been shown to help some people with bipolar disorder.

Electroconvulsive Therapy

During electroconvulsive therapy (ECT), mild and controlled electric currents are delivered to the brain while the patient is under general anesthesia. Researchers do not fully understand how ECT works, but it is thought that the electric currents that are delivered to the brain cause changes in brain chemistry that stabilize mood. It is typically recommended for patients who have severe episodes of depression, feel suicidal, or who have not seen their symptoms improve despite other treatment. It is also recommended as an option for women with bipolar disorder who are pregnant and experiencing mania or depression but cannot take their medications. ECT should only be performed at centers with appropriate support staff and physicians skilled in its use.

Read more about ECT.

Hospitalization

Some people with bipolar disorder benefit greatly from psychiatric treatment at a hospital. In a hospital setting, a patient can get help stabilizing his or her mood in a calm and safe environment. Other options to consider are partial hospitalization or day treatment programs, which provide support and therapy or counseling until symptoms are under control.

Treatment Expectations

Although there is no cure for bipolar disorder, continuous treatment (not on and off) can effectively manage the condition, prevent its symptoms, and delay relapse. However, even with proper treatment, mood changes may continue to occur, especially if a person has a mental illness in addition to bipolar disorder. Treatment tends to be more effective when an individual with bipolar disorder and his or her family work closely with a doctor and communicate openly about their concerns and choices.