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Managing Bipolar Disorder

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Bipolar Disorder Treatment: A Guide

Medically Reviewed By Nicole Washington, DO, MPH

There are various treatment options for bipolar disorder. Typically these include medication, therapy, or a combination of treatments. Bipolar disorder is a mental health condition that involves extreme mood shifts. Often, people with bipolar disorder experience extreme highs and lows referred to as manic and depressive episodes. These episodes can last Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source for several weeks.

Bipolar disorder, a lifelong condition, is manageable. This article explains the treatment options for bipolar disorder.

How do you treat bipolar disorder?

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Treatments Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source for bipolar disorder include medication, psychotherapy, or a combination of treatments.

Treatment focuses on managing your symptoms. Still, even with treatment, you may experience episodes of mania or depression.

Each person with bipolar disorder may have a different treatment plan. Work with your doctor and mental health professional to find the most effective treatment. This may mean trying various treatments until you find what you are most comfortable with and also gives you the most effective results.

What is bipolar disorder?

Bipolar disorder is a mental health condition that involves shifting moods, thoughts, behaviors, and energy levels. These changes are more severe than usual ups and downs. Often, they involve episodes of mania, depression, or both.

According to the National Alliance on Mental Illness, anyone can experience bipolar disorder.

Manic episodes can involve:

  • excitability
  • irritability
  • feeling unusually active or wired
  • feeling unusually important or powerful

Depressive episodes can include:

  • low energy
  • sadness
  • despair
  • suicidal thoughts or attempts

If someone you know is at immediate risk of harming themselves or others, or at risk of suicide: 

  • Ask, “Are you considering suicide?” even if it is tough.
  • Listen without judgment.
  • Call 911 or your local emergency number. 
  • Stay with them until emergency services arrive.
  • Try to remove any weapons, medications, or other potentially harmful items.

If you or someone you know is having suicidal thoughts, contact the National Suicide Prevention Lifeline:

  • Call 988 
  • Chat with the lifeline

This service is available 24-7.

What are the 3 types of bipolar disorder?

There are three types of bipolar disorder:

  1. Bipolar I disorder: A person experiences at least one manic episode lasting about 1 week. Typically, depressive episodes also occur and last for at least 2 weeks.
  2. Bipolar II disorder: A person experiences one hypomania episode lasting at least 4 days and one depressive episode lasting about 2 weeks. These episodes of hypomania are generally less severe than the full manic episodes of bipolar I disorder.
  3. Cyclothymic disorder: A person may experience recurrent symptoms of hypomania and depression, but these symptoms are not as intense and do not last long enough to qualify as hypomanic or depressive episodes.

What are the symptoms of bipolar disorder?

The symptoms of bipolar disorder are unique to every person living with the condition. The following table details the differences between the symptoms of manic episodes and depressive episodes.

Manic episodes Depressive episodes
Feeling high, elated, excitedFeeling excessively sad or down
Being more active than usual, feeling wiredFeeling low on energy
Having racing thoughts, unable to still the mindUnable to focus or concentrate
Talking an unusual amount, sometimes at high speedsDifficulty with talking or having a conversation, talking very slowly
Having a high interest in activities such as eating or sex Lacking interest in any activity
Feeling like you can do many things at onceLacking desire or energy for even simple tasks
Feeling highly important, talented, famous, or powerful Feeling worthless, hopeless, in despair

Read more about bipolar disorder.

What medications treat bipolar disorder?

Medications to help manage symptoms of bipolar disorder include Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source :

  • mood stabilizers, such as lithium or sodium valproate
  • second-generation, or atypical, antipsychotics
  • antidepressant medications
  • medications for sleep or anxiety

Mood stabilizers, such as lithium, can prevent mood-related episodes and reduce their severity. This may decrease the risk of suicide, as well.

Antidepressant medications can help manage depressive episodes. However, mood stabilizers are needed with them because antidepressants alone can trigger a manic episode.

It is important that you continue taking your prescribed medications, even during periods of stability. Stopping mood stabilizers, for example, may increase the risk of mood episodes, hospitalization, and suicide.

Read more about medications for bipolar disorder.

Treating bipolar disorder with lithium

Lithium is commonly used Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to treat bipolar disorder.

Lithium can help:

  • help with severe mood shifts
  • prevent recurrence
  • may reduce the risk of suicide during episodes

Side effects of lithium include:

  • restlessness
  • dry mouth
  • digestive issues
  • thyroid issues
  • kidney issues

What psychological therapies treat bipolar disorder?

Psychotherapy, also known as “talk therapy,” can help you identify emotions, thoughts, and behaviors that may trigger mood episodes.

Types of psychotherapy include:

  • cognitive behavioral therapy: identifying negative or false beliefs and restructuring them
  • interpersonal therapy: improving interpersonal skills
  • psychodynamic therapy: recognizing negative patterns of behaviors and feelings, particularly from the past
  • psychoanalysis: an intense version of psychodynamic therapy
  • supportive therapy: building self-esteem, reducing anxiety, and strengthening coping mechanisms

Psychotherapy can h Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source e Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source l Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source p Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source w Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source i Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source t Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source h Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source :

  • identifying automatic patterns of thinking that may be harmful, including a low opinion of self
  • examining thoughts to understand how they influence behavior and actions
  • changing self-defeating patterns
  • finding strategies to solve problems
  • finding ways to cope with stress or stressful situations
  • offering guidance for social interactions with others
  • offering guidance on communicating with others
  • providing emotional support
  • providing supportive counseling
  • creating a safety plan for those who have suicidal thoughts

Read more about psychotherapy.

What are other treatments for bipolar disorder?

A combination of medication and therapies can help people living with bipolar disorder manage symptoms and mood episodes. Other treatment options can also include:

  • Electroconvulsive therapy (ECT): This is a brain stimulation procedure. Electrical currents pass through electrodes on the head and through the brain, causing a seizure. Doctors use Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source ECT for severe depression, bipolar disorder, schizophrenia, or if a patient is suicidal or unresponsive to the outside world.
  • Transcranial magnetic stimulation (TMS): This is similar to ECT but uses magnetic waves instead of an electrical stimulus. TMS can be less effective than ECT, but there are fewer risks of memory loss. More research is needed on the benefits of TMS.
  • Self-care management: This involves making lifestyle changes, including regular exercise and a healthy and balanced diet. Self-care management also means understanding the condition and recognizing the early signs of an episode.

How do doctors diagnose bipolar disorder?

Extreme shifts in mood and energy levels are the main symptoms of bipolar disorder. Doctors will first rule out other medical conditions that can cause mood changes. A stroke, brain tumor, or overactive or underactive thyroid can also cause these changes.

Your doctor may order:

  • imaging tests
  • brain scans
  • blood tests

Doctors do not use brain tests to diagnose bipolar disorder.

Your doctor will ask about your symptoms. A diagnosis of bipolar disorder is based on markers such as Trusted Source National Institute of Neurological Disorders and Stroke Governmental authority Go to source :

  • severity of the manic or depressive episodes
  • length of an episode
  • frequency of an episode
  • frequency of symptoms

Questions a doctor may ask include:

  • What kind of moods do you experience?
  • When did these moods first begin?
  • How long do the moods last?
  • Do you have psychiatric or medical problems?
  • Do you have a family history of mental illness?
  • What medications are you taking?
  • Do you use illegal drugs or drink alcohol?
  • Do you ever have suicidal thoughts or thoughts about self-harm?

A doctor or psychiatrist may assess your symptoms and determine a diagnosis using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition Text Revision (DSM-5-TR).

Other frequently asked questions

Here are questions people also ask about bipolar disorder. They have been reviewed by Nicole Washington, DO, MPH.

What is the most common treatment for bipolar disorder?

The primary treatments for bipolar disorder include mood stabilizers, such as lithium, antipsychotics, and psychotherapy.

Is bipolar disorder easily treated?

Although bipolar disorder is a lifelong condition, you can treat and manage symptoms with medications and therapy.

What are the warning signs of bipolar disorder?

The main signs of bipolar disorder are severe mood shifts, ranging from high mania to depression. If you experience such shifts, particularly extreme ones, contact your doctor.

Summary

People with bipolar disorder experience extreme changes in mood and energy levels. This may include episodes of mania and depression. Living with bipolar disorder involves managing the symptoms and mood episodes.

Treatments such as medications and psychotherapy can help manage symptoms. Working closely with a doctor and mental health professional can help you create the best treatment plan for you.

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Medical Reviewer: Nicole Washington, DO, MPH
Last Review Date: 2022 Nov 16
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