Treatment for bipolar disorder is not a one-size-fits-all prescription, but rather a unique strategy designed for your symptoms and the way you respond to treatment. What you do have in common with others managing bipolar disorder is that you’ll gain the most benefit from starting treatment early and continuing to get treatment over the course of your life.
The most effective treatment approaches include mood stabilizers, atypical antipsychotics, antidepressants, talk therapy, and better lifestyle habits.
Mood stabilizers are the first line of treatment for most people with bipolar disorder. The two most common examples are lithium (Lithobid) and valproic acid (Depakote). These drugs will usually control both mania and depression, but they may have side effects such as:
Lithium can alter thyroid hormone levels in some people. If you have abnormal thyroid function, be sure to have your thyroid hormone levels checked regularly to avoid dangerously high or low thyroid levels. To get the most benefits with the fewest side effects, work with your doctor to find the right drug and dosage.
If a mood stabilizer does not relieve your symptoms, or if you have hallucinations (hearing, seeing, or believing things that are not real), your doctor may add an atypical antipsychotic to your treatment regimen. Common examples include olanzapine (Zyprexa) and aripiprazole (Abilify). Side effects of these drugs usually go away within a few days. Your doctor can help you manage side effects. They include:
Mood stabilizers usually treat depression and mania, but sometimes depression lingers. Your doctor may add an antidepressant medication like bupropion (Wellbutrin) or paroxetine (Paxil) to get depression under control. You almost always take antidepressants aong with a mood stabilizer to prevent triggering manic symptoms. Side effects are usually mild but can include:
Pregnancy and Bipolar Treatment
If you are pregnant or may become pregnant, finding the right drug treatment can be tricky. Most medications used to treat bipolar disorder can cross over to your baby in the womb, or through breast milk. Talk with your medical team about the safest medications during pregnancy.
Talk Therapy and Better Lifestyle Habits
Talk therapy with a therapist experienced in treating bipolar disorder may be an important part of your treatment. Talk therapy teaches you techniques for coping with your symptoms on a daily basis. Types of therapy that have proved particularly helpful with bipolar disorder are:
Cognitive behavioral therapy: you learn how to change harmful thoughts and behaviors
Psycho-education group therapy: you learn to recognize signs of a relapse
Family-focused therapy: you and your family learn how to cope with your disease
Interpersonal and social rhythm therapy: you learn how to improve your relationships and daily routines
You can help yourself by staying in treatment and letting all members of your medical team know how you’re doing. Create a healthy daily schedule for yourself that includes the three components of good health: nutritious meals that you eat at the same times every day, regular exercise (daily if possible), and restful sleep every night. Avoid unhealthy habits like smoking and drinking, and never try to self-medicate with illegal drugs.
Charting your daily habits will help you stick to your schedule. Note all symptoms, reactions to medications, and any triggers that cause a change in mood. Bring this information with you to doctor and therapy appointments, so that your medical providers can check your progress and adjust your treatment as needed.
Other Medical Options
If your symptoms are very severe, or if your treatment plan isn’t working, your doctor may suggest shock therapy. Known as electroconvulsive therapy (ECT), this treatment can be safe and effective for relieving both depression and mania. Side effects, such as confusion and memory loss, are usually temporary.
To find the right treatment for bipolar disorder, learn as much as you can about your disease and work closely with your doctor, psychiatrist, psychologist, and other mental health experts.
Medications called mood stabilizers are the mainstays of treatment, but there are many other drug options.
Since the disease is unpredictable, you may need to use several different treatments, and your treatment may change over time.
Psychotherapy and self-help strategies are important additions to drug treatment.