In general, bipolar treatment includes psychotherapy (sometimes called talk therapy) and mood-stabilizing medication. In addition, it’s important to avoid drugs and alcohol because they can trigger or worsen mood symptoms. It’s also helpful to get enough sleep, and to maintain healthy eating and exercise routines. Many people with bipolar disorder have co-occurring conditions, such as attention deficit hyperactivity disorder, depression or substance abuse problems. These conditions must be treated, too, if the person with bipolar disorder is to improve.
The first step in getting bipolar treatment is a mental health evaluation. Your doctor may perform this or refer you to a mental health specialist, such as a psychiatrist or psychologist. The psychiatrist will use a tool such as the Diagnostic and Statistical Manual of Mental Disorders to determine whether you have bipolar disorder. The psychologist will evaluate your thoughts, feelings and behaviors to assess your overall mental health.
If your psychiatrist determines that you have bipolar disorder, a treatment plan will be developed. Medications are the most common form of bipolar treatment. They are typically prescribed to help manage both the highs and lows of mood, but they do not prevent the onset of mania or hypomania. You will likely need to take these medications for life, even during periods when you don’t have any symptoms.
Your healthcare team will likely recommend other treatments, too, to help you live as normally as possible with bipolar disorder. These can include lifestyle changes, support groups and psychotherapy. It’s important to be honest with your healthcare provider about your symptoms and experiences. In some cases, the stigma surrounding mental illness can make it difficult for you to admit that you have a problem. This can lead to misdiagnosis. For example, a manic episode with hallucinations might be mistaken for schizophrenia.
Keeping track of your moods can help you and your doctor notice triggers, see how well your treatment is working, and spot any changes in sleeping or eating patterns. A good tool is a mood diary, such as the ones available from Bipolar UK (see Useful contacts).
For some children and teens with bipolar disorder, psychotherapy can be an important part of their treatment. It can teach coping skills, address family issues, and help children and teens develop social relationships. Psychotherapy can also be used to treat co-occurring conditions, such as anxiety or ADHD.
Sometimes, electroconvulsive therapy (ECT) is used to help reduce mania and depression when other treatments fail. During this procedure, electrical currents are passed through the brain, intentionally triggering a brief seizure. Some people have success using transcranial magnetic stimulation (TMS) to treat depressive and mania symptoms that do not respond to antidepressants or other medications.
For some adults with rapid-cycling bipolar disorder, ketamine treatment is being used as an alternative to ECT. Ketamine is an anesthetic, but it works rapidly to improve mood and decrease agitation and suicidal thoughts in some people with severe, difficult-to-treat mania and depression.