How is bipolar disorder treated?

Ruth White, MPH
Social Work
Medication, psychotherapy and lifestyle changes are the three most common ways of treating bipolar disorder. Some people use alternate therapies like Chinese medicines or naturopathy. Medications include anti-depressants and mood stabilizers and anti-anxiety medications. Psychotherapies include Cognitive Behavioral Therapy. Lifestyle changes include regular exercise, reducing or eliminating mood influencers like caffeine and alcohol, and a healthy diet that includes Vitamin D and Omega 3s. Other behavior changes like reducing stress and sticking to a sleep routine because sleep is very important to moods.
Guidelines indicate that for treatment of bipolar disorder in adults, individuals need a combination of the following:
  • Maintenance Therapy: Medications such as lithium, lamotrigine, and olanzapine are currently recommended options for maintenance therapy;
  • Treatment of Mania: Atypical antipsychotics (e.g. olanzapine, risperidone, quetiapine), lithium, and valproate are all medications that are recommended for the treatment of mania;
  • Treatment of Depression: Most guidelines recommend an antidepressant only if in combination with a mood stabiliser (e.g. lithium, valproate) or antimanic agent for the treatment of Bipolar Depression since antidepressants alone may induce switching to mania or hypomania, mixed episodes, and rapid cycling. Current research is focused on finding better ways to treat this hard-to-treat phase of the disorder.
  • Overall Treatment of the Disorder: A comprehensive and coordinated approach, which includes both medication and psychotherapy, is recommended to provide optimal care for those with bipolar disorder.

Bipolar disorder treatment requires mood-stabilizing medication. Compliance with medication is one of the biggest challenges in treating bipolar disorder. says Tarique Perera, MD, a psychiatrist with Contemporary Care of Connecticut.

The main treatment options for bipolar disorder include a combination of medication and psychotherapy, as well as palliative care and family therapy. Watch psychologist Jeffrey Gardere, PhD, discuss these treatment options for bipolar disorder.

Treatment for bipolar disorder includes the following:
  • Medication. The main treatment for bipolar disorder is medication. Your doctor will probably recommend that you take a mood stabilizer (such as lithium) every day. A mood stabilizer can help prevent wild mood swings. Also, from time to time, you may need to take other medications to treat episodes of mania or depression that break through despite the mood stabilizer. Unlike unipolar (major) depression, with bipolar disorder it can be harmful to use an antidepressant alone -- this can make you less stable or even bring on a manic episode. What's the most important thing to remember? Keep taking your medication even after you start to feel better. Consistent treatment is the key to keeping symptoms at bay.
  • Counseling. Also called psychotherapy or "talk therapy," counseling can help you -- and your loved ones -- work out some of the problems caused by your illness. Support groups and advocacy groups can help too.
As you and your doctor begin to plan your treatment, keep in mind that it may take some time to find a good plan for you. Don't give up. You have many options for treatment. If your illness isn't controlled, you and your healthcare providers can try a new approach.
Ms. Julie A. Fast
Mental Health
This answer will focus the medication treatment of bipolar disorder. I focus on management in my other answers.

Bipolar disorder medication treatment depends on your diagnosis. The majority of people with bipolar have either Bipolar I (one) or Bipolar II (two). They each have a different medication treatment path.

Bipolar I and Bipolar II share the same symptoms of depression, anxiety, ADD symptoms and psychosis, etc.

The main difference is the mania.
  • Bipolar I has full blown mania. This mania can involve psychosis.
  • Bipolar II has a milder mania called hypomania with no psychosis.
There are four main medication categories used to treat bipolar disorder.
  • Mood stabilizers
  • Anti-psychotics
  • Anti-depressants
  • Anti-anxiety
If you have Bipolar I with full blown mania, your drug regime will focus on preventing mania. This means taking a mood stabilizer and/or an anti-psychotic. If there is psychosis with the mania, an anti-psychotic is essential.
If you have Bipolar II, the hypomania is milder, but still a very serious mood swing that has to be caught early so that you don’t make destructive decisions. It’s not essential that a person with Bipolar II always be on an anti-manic mood stabilizer, but it can help if the mood swings are regular.

Once the mania is discussed and addressed, depression treatment is added. The main problem with bipolar depression treatment is that the anti-depressants used for unipolar depression can cause mania for those with bipolar. Thus, anti-depressants can only be used with a mood stabilizer or anti-psychotic. (I should note that if a person is in a depressive mood swing, the depression will naturally be treated before a mania regime is decided.)

One popular drug used for bipolar depression in Bipolar I and II is the mood stabilizer Lamotrigine. It helps the depression without causing mania. It can also reduce rapid cycling, irritation, anger, anxiety and mild mania. Lithium can be used as well, though it can take a long time to work. Anti-psychotic companies are now advertising that their drugs can boost anti-depressant effectiveness. The jury is out on that one regarding bipolar depression.

Anti-anxiety drugs are used as needed for a variety of symptoms. The main being anxiety of course, but I use mine for sleep. Addiction can be a problem here, so be careful.

Wow. Now you can see why bipolar disorder is one of the most difficult illnesses to treat.
Donna Hill Howes, RN
Family Medicine
Doctors treat bipolar disorder with medications called mood stabilizers. The purpose of these drugs is to reduce and prevent manic episodes, which can lead to overly excited mood and reckless behavior. Mood stabilizers include lithium and certain drugs that are also used to prevent seizures, such as valproate, carbamazepine, and others. In some cases, doctors also prescribe certain types of antipsychotic medications, including aripiprazole, olanzapine, and others. Doctors may also give patients antidepressants to treat sadness and despair that can occur during low episodes. Many people with bipolar disorder also benefit from psychotherapy (talk therapy) with a mental-health professional, such as a psychiatrist or psychotherapist.
Keith Star
Medication is a part of the recommended treatment course for bipolar disorder. People with undiagnosed bipolar disorder may sometimes self-medicate with alcohol or drugs to relieve their symptoms.
Katherine Lee
Social Work
Bipolar is best treated with consistent use of psychotropic medications with psychotherapy such as cognitive behavior therapy, which concentrates on changing negative thought patterns and behavior. Psychoeducation is also helpful as it teaches a person about his/her illness and the importance of taking medications consistently. Family therapy also helps to improve communication and relationship between the client and his/her families.
Mona A. Schulz, MD
The medications you may be prescribed will vary depending upon whether you are given a diagnosis of bipolar I and bipolar II. In general, if you have bipolar I, you will not receive antidepressant or stimulant medications as both may push you into a "manic episode." Both bipolar I and bipolar II are treated with mood stabilizers medications Lithium (Eskalith), Carbamazepine (Tegretol), Valproic Acid (Depakote), Gabapentin (Neurontin), Lamotrigine (Lamictal), Topiramate (Topamax), Tiagabine (Gabatril), or their medication derivatives. And bipolar I and bipolar II irritability and depression are currently often treated with Aripiprazole (Abilify), Ziprasidone (Geodon), Quetiapine (Seroquel), and Olanzapine (Zyprexa) - but with all treatment, if your mood worsens or thoughts of death and suicide occur, you have to go to your physician or prescribing nurse-practitioner immediately. Finally, some patients with bipolar II may be treated with antidepressants, but this is done with great caution given that this class of medications may increase one's chance of having irritability and hypomania.

Various treatment options can help those with bipolar disorder. The most common approaches are medications and counseling. Treatment is often lifelong and must be continued even during periods when one's mood is stable. Uninterrupted treatment can help one lead a more predictable, stable emotional life and prevent problems at home, work, or school. It can also help prevent the condition from getting worse over time.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.