Treating Bipolar Disorders

Discover bipolar disorder treatment options and how to choose what works best for you in managing the condition.

Are you or a loved one living with bipolar disorder? If so, you know that the manic-depressive illness – which can cause major shifts in mood, energy, activity levels and other disruptive symptoms – can significantly impact job performance, relationships, and daily living. If not properly managed, symptoms can worsen.

Fortunately, people with bipolar disorder can still lead normal lives when effectively treated. Discover the options and how to choose what works best for you in managing the condition.

Types of Bipolar Disorder
Bipolar disorder symptoms can be divided into two emotional states -- the highs of mania and the lows of depression. In the manic stage, people may feel agitated, restless and have racing thoughts, while the depressive stage brings on feelings of extreme sadness. The frequency of mood shifts depends on the individual. Rapid cycling, a severe type of bipolar, is defined as at least four episodes per year. A small number of people may have episodes within a week or even the same day, while others only experience a few episodes in their lifetime. People with mixed bipolar disorder may feel mania and depression at the same time.

Manic symptoms may include:

  • Exaggerated optimism and self-confidence
  • Fast talking and racing thoughts
  • Grandiose ideas about one's self
  • Impulsive and reckless behavior (wild shopping sprees, irresponsible driving choices, engaging in risky sexual activity, abusing drugs, etc.)
  • Extreme agitation and irritability
  • Restlessness and little to no sleep
  • Psychotic behaviors (such as delusions or hallucinations)

Depressive symptoms may include:

  • Hopelessness and sadness
  • Fatigue and exhaustion
  • Nervousness
  • Irritability
  • Loss of interest in daily matters
  • Suicidal thoughts or actions

Main Treatment Options for Bipolar Disorder
While there is no cure for bipolar disorder, doctor-prescribed medication can go a long way in regulating symptoms. Here are some of the most common choices:

  1. Mood stabilizers. Mood stabilizers and anticonvulsants help control moods and are usually the go-to bipolar meds. Lithium and valproic acid are popular mood stabilizers. 
  2. Atypical antipsychotics. Antipsychotic medicines often help control acute mania, mixed episodes and acute bipolar depression. They are often paired with other bipolar medications.  
  3. Antidepressants. These medications can sometimes be effective in treating the depressive side of the disease. However, taking only antidepressants may sometimes lead to increased mania or hypomania, which is why doctors tend to prescribe antidepressants with mood-stabilizing meds as well.

While taking medication is key to treatment, counseling sessions with a psychiatrist or psychologist who is knowledgeable about treating bipolar can also help. Psychotherapy, also known as talk therapy, can offer guidance and support to patients and their families. The following are common forms of psychotherapy:

  • Cognitive behavioral therapy (CBT) teaches patients how to change negative or destructive thoughts, patterns and behaviors.
  • Family-focused therapy includes family members and enhances family coping strategies. 
  • Interpersonal and social rhythm therapy helps patients improve their daily routines, relationships and interactions.
  • Psychoeducation is typically done in a group setting. This type of therapy gives patients a more in-depth look into their illness and treatments, as well as how to manage symptoms before they turn into a full-blown illness.

Electroconvulsive Therapy (ECT)
When symptoms are severe and medication, along with psychotherapy, doesn’t help ease them to an acceptable degree, electroconvulsive therapy, formerly called “electric shock,” may be recommended. While this form of therapy has had a bad rap, the way in which it’s administered has improved over the years and can offer relief for patients with severe bipolar symptoms.  

Lifestyle factors
Living with a mental illness can make you feel like you're powerless against your condition. But certain lifestyle habits can help manage symptoms as well. For example, regular physical activity can help you fend off depression with the release of feel-good hormones called endorphins. It may also improve sleep and help curb weight gain – one possible side effect of bipolar meds. Writing or journaling can also be a constructive outlet during traumatizing experiences. It’s important to refrain from drinking or using illegal drugs; substance abuse is common among bipolar patients.

Guidelines for Getting the Right Treatment
Take medications as prescribed and tell your doctor about any side effects or symptoms you experience. Keeping track of your moods, treatment progress and sleep patterns can help doctors see if medication is working properly for you. Your doctor may switch or add medications if your symptoms worsen or become unbearable.

Be patient with your treatment plan. Medications don't all work the same for everyone. You may need to try several (sometimes more than one at a time) before you and your doctor determine what's working. Continue to work closely with your doctor for an overall treatment plan that is best for you. 

Medically reviewed in May 2018.

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