Bipolar disorder is treated with three main classes of medication: mood stabilizers, antipsychotics, and, while their safety and effectiveness for the condition are sometimes controversial,antidepressants.Typically, treatment entails a combination of at least one mood-stabilizing drug and/or atypical antipsychotic, plus psychotherapy
Treatment of bipolar disorder
Treatment for bipolar disorder has two main aims:
- to deal with symptoms when they occur
- to stop symptoms from coming back.
- medications for mania, hypomania and depression
- medication to stop symptoms returning
- psychological treatments (talking therapies).
In some circumstances, electroconvulsive therapy (ECT) might be recommended.
You and your health-care team will work together to find the treatment that works best for you.
Most people with bipolar disorder will need medication to control symptoms.
Psychological treatments can help you deal with depression, live well with bipolar disorder, and control stress (which can set off mania).
Treatments for mania
If you have mania, you need urgent care from a doctor – even if you feel great.
You will need medication, and you may need to go to hospital. Severe mania is a medical emergency.
Medications for mania include:
- short-term sedatives to calm you down when the symptoms are at their worst.
- antipsychotic medications, such as aripiprazole, asenapine, haloperidol, olanzapine, quetiapine, risperidone and ziprasidone
- mood-stabilising medications such as lithium, sodium valproate and carbamazepine.
These treatments can also be used to treat hypomania.
ECT is occasionally used to control some types of severe mania. It is a safe and effective treatment.
Treatments for bipolar depression
A combination of medication and a psychological treatment (talking therapy) is the best treatment for bipolar depression.
Medications for treating bipolar depression include:
- antipsychotic medications, such as quetiapine
- mood-stabilising medications, such as lithium
- a combination of an antidepressant medication and a mood stabiliser.
Antidepressants can sometimes set off mania. People with bipolar depression should only have antidepressants in combination with medications that prevent this happening (mood stabilisers).
ECT is sometimes used for people with severe bipolar depression.
Psychological treatment for bipolar disorder
Psychological treatment aims to help you learn skills to:
- cope with having bipolar disorder
- have fewer episodes of mania or depression
- recognise the signs of mania or depression early, so you can get treatment
- improve your quality of life.
Treatments are provided by trained therapists (e.g. psychiatrists, other doctors, or psychologists).
Psychological treatments that are effective for bipolar disorder include:
- cognitive behavioural therapy (CBT) – a type of psychological treatment that asks you to challenge unhelpful thoughts.
- psychoeducation – a program to help you become an expert in managing your own illness
- family-focused therapy – helps whole families learn to communicate and solve problems better, to reduce stress on the person with bipolar disorder
- interpersonal and social rhythm therapy – aims to reduce stress, improve relationships, and set up a pattern of regular sleep.
Medication for bipolar disorder
Getting the most out of your bipolar disorder medication
- Take every dose of your medication at the time recommended to you by your psychiatrist.
- When starting a medication, give it time to start working properly.
- Don’t change your medication without talking to your psychiatrist.
- If you have symptoms that you think could be a side effect of medications, tell your doctor as soon as possible.