Diagnosis and management of bipolar disorders are complex, as symptoms vary widely from person to person. It can take time to find the right treatment for someone, and they may need to be on it for years before symptoms begin to improve.
Treatments for bipolar disorder include medications, psychotherapy and lifestyle management. They help stabilize mood and reduce the risk of relapse, which can be dangerous.
Diagnosis
Diagnosis is the process of determining the nature of a disease or disorder and distinguishing it from other possible conditions. It usually begins with a detailed history and physical exam by a doctor.
After asking questions about the symptoms, your family history, and any other mental illnesses you or your loved one has had, your doctor may refer you to a psychiatrist for an evaluation. Psychiatrists are doctors who specialize in mental health issues, and they can tell if bipolar disorder is the problem or if you have another illness that needs treatment.
Your GP can also diagnose you with bipolar disorder if they notice that your symptoms are making it hard for you to function normally. They will check your moods, look at your medical and family history, and ask you to keep a diary of how you feel each day.
Keeping a mood journal can help your GP understand your symptoms, and give you an idea of how well your medications are working. It can also help you identify triggers and monitor your treatment.
Medications
People with bipolar disorder often experience alternating mood episodes — highs (mania) and lows (depression). These symptoms can affect a person’s work, relationships and daily activities.
Some medications for bipolar disorder help control these mood shifts and other symptoms. Antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda), cariprazine (Vraylar) or asenapine (Saphris) can be prescribed alone or along with a mood stabilizer.
These medications can be used for long or short periods of time, and they need to be taken as prescribed by your doctor. They can help treat a range of other symptoms associated with bipolar disorder, such as anxiety and sleep problems.
Some medicines can also help reduce the risk of suicide in people with bipolar disorder. If the medication you are taking for your disorder does not work, your doctor may recommend other therapies, such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).
Psychotherapy
Psychotherapy, also called talk therapy, can help you manage your bipolar disorder. Often, psychotherapy is prescribed by your doctor as part of a treatment plan alongside medications.
Cognitive behavioral therapy (CBT) helps you identify unhealthy thought patterns and behaviors and replace them with healthy, positive ones. It can also teach you to recognize and change the triggers of your episodes and cope with stress.
Psychiatrists, psychologists, licensed professional counselors, licensed social workers, and psychiatric nurses are examples of mental health professionals who can provide psychotherapy. Find a therapist who has the right skills and experience to treat your specific needs.
NIMH clinical trials found that patients who received intensive psychotherapy while on medication were more likely to get well and stay well than those who didn’t receive such treatment. This type of therapy focused on self-care and stress regulation, and involved individual and family-focused approaches to CBT, psychoeducation, and interpersonal and social rhythm therapy.
Other treatments
There are many different treatments available for bipolar disorders. These include mood stabilisers, antipsychotics and antidepressants.
The best treatment for you depends on your symptoms and the severity of your disorder. Doctors typically treat bipolar disorder using a combination of medications and psychotherapy.
They’ll also teach you to manage your illness and prevent relapse. This includes a lifestyle approach, which can include eating well and getting enough sleep.
Your psychiatric care team will work together to come up with the right treatment plan for you. They may include a medical doctor who specializes in mental health conditions (psychiatrist), a psychologist, social worker and psychiatric nurse.
Family-focused therapy helps patients and their families understand their symptoms. It also teaches them to recognise warning signs of a manic or depressive episode.
Psychotherapy can help people with bipolar disorder adhere to their medication regimens. Poor adherence can be due to forgetfulness or a lack of understanding about bipolar disorder and treatment options.