Bipolar disorder is a lifelong mental health disorder. Proper treatment — often through a combination of medications and mental health counseling — can keep symptoms in check, allowing you to enjoy a long, happy and productive life.

From the community: “I'm bipolar 1, also obsessive compulsive, and agoraphobic. I can tell you that cognitive behavioral therapy and medication has made such a huge difference in my outlook and actions. I only longer get irritable and so angry, or depressed. I had to want to get better though. I had to want to change. I had to work to be happy. I had to have the support of family who also kept me accountable. I'm now happier than I've ever been, but how I wish I had gotten to this point so much sooner. It's taken five years just to find the right combination of medications for me because I'm rapid cycling and treatment resistent. I'll keep you and your family in my prayers. Unfortunately there are no easy answers, it can take up to six weeks for some medications to take full effect and he may need increases in dose. I take two antipsychotics which help with the mania ando irritability, two mood stabilizers, and a low dose antidepressant.” – Inspire member  

What is bipolar disorder?

Bipolar disorder is a mood disorder that causes you to fluctuate between periods of mania (high energy), depression (low energy), and normal moods. There are different types of bipolar disorder. Some people experience hypomanic symptoms that aren’t as intense as full-blown mania. Many people who develop bipolar disorder have a family history of the disorder. For others, the condition occurs for no known reason. 

Do you need treatment for bipolar disorder?

Without proper treatment, there’s a risk of suicide from severe depression or life-endangering reckless behaviors during manic episodes. People with untreated bipolar disorder are also more at risk for serious issues like:

• financial or legal difficulties

• poor work or school performance 

• relationship struggles

• substance use disorders 

Who treats bipolar disorder?

Managing the symptoms of a mental disorder like bipolar disorder often requires a team approach. You’ll need support from family and friends, as well as healthcare experts like:

• psychiatrist

• primary care physician (PCP)

• neurologist

• psychologist

• licensed clinical social worker

How do you treat bipolar disorder?

Treatment for bipolar disorder depends on many factors like the disorder type and your symptoms. Most people benefit from combining one or more of these treatments:

• medications

• psychotherapy

• brain stimulation therapies

Medications 

Medications help control bipolar disorder symptoms. You may need to take more than one medication to manage all symptoms. Your doctor will choose the best medicines based on the type of bipolar disorder and your symptoms. 

Medications for bipolar disorder include: 

• Mood stabilizers: These medications prevent extreme high and low emotional states.

• Antidepressants: These medications lower the risk of extreme depression. In some instances, taking antidepressants can bring on a manic episode. To prevent this, you may take this drug along with a mood stabilizer or antipsychotic.

• Antipsychotics: Your doctor may prescribe an antipsychotic if you experience psychosis (delusions or hallucinations) or mood stabilizers don’t fully control symptoms.

From the community: “How many times do you have to go through meds to see which one works for you? I have been on Abilify (2 mgs) and I couldn't stand the side effects (severe agitiation), I was then put on Depakote (1000 mgs) but that just made me even MORE depressed, now they have me on lithium 300mgs in the morning and 450 in the evening, but I have noticed that I am getting a slight case of the shakes. If this continues, I think I will go in to see what else can be done, but I was reading that the shakes are temporary, and that they will improve within a couple of weeks of taking Lithium. Just wondered, how many meds are you taking and does it work for you?” – Inspire member

Psychotherapy 

Psychotherapy, or talk therapy, can help you address and change your behaviors and thought processes. You also learn strategies to better regulate your emotions. Psychotherapy for bipolar disorder is most effective when you also take medications.

Types of psychotherapy that are helpful for people with bipolar disorder include:

• Cognitive behavioral therapy (CBT) to replace unhealthy behaviors and thoughts with healthy ones and learn ways to cope with stressful or upsetting situations.

• Family therapy to improve communication and relationships with loved ones and provide a safe place for all to share their feelings. 

• Interpersonal and social rhythm therapy (ISRT) to regulate moods through the implementation of consistent routines for sleep, eating, and physical activity.

• Psychoeducation to help you and your loved ones better understand bipolar disorder and its symptoms, as well as develop strategies to help you stick to your treatment plan. 

Brain stimulation therapies

People who don’t respond to treatments for severe manic or depressive episodes have an increased risk of suicide and other life-threatening issues. They may benefit from brain stimulation therapies. These treatments bring on chemical changes in the brain to improve your emotional state. 

Types of brain stimulation therapies for bipolar disorder include:

• Electroconvulsive therapy (ECT): This treatment delivers a mild electric current to your brain. You may undergo three ECT sessions per week for several weeks.

• Transcranial magnetic stimulation (TMS): This treatment uses magnetic waves to stimulate brain changes and treat severe depression. You may get transcranial magnetic stimulation (TMS) five days a week for four to six weeks.

From the community: “I'm on "maintainance" electroconvulsive therapy and it helps but the effect seems to wear off. I'm also on meds, clomipromine and quetiapine. Does anyone have experience with ECT? I would really like to stop getting it but I'm afraid nothing else will work.” – Inspire member 

What steps can help you manage bipolar disorder?

In addition to medications and mental health counseling, these actions can help you manage a lifelong mental disorder:

• adopt healthy sleep habits like no phones in the bedroom, and stick to a sleep schedule

• be physically active and try to maintain a healthy weight

• connect with others who understand your struggles by joining an in-person or online support group like Mental Health America’s online support group on Inspire 

• don’t drink alcohol or use recreational drugs

• keep a daily mood journal to capture your thoughts and behaviors, and identify triggers of mood swings

• learn better ways to cope with stress like meditation, yoga, or listening to music

What is the prognosis for someone with bipolar disorder?

People with bipolar disorder will always need to treat the condition. Some studies suggest that having bipolar disorder decreases one’s life expectancy by 8 to 12 years. Suicide claims the lives of 1 in 5 people with bipolar disorder. And approximately 6 out of 10 people misuse alcohol or drugs. A good support network, along with the right mental health care, can help you avoid these life-threatening issues.

SOURCES

• Kessing VL, et al. Life expectancy in bipolar disorder. Bipolar Disorders. April 2015.

• Bipolar disorder. Cleveland Clinic. April 2022.

• Electroconvulsive therapy (ECT). Cleveland Clinic. April 2022.

• Transcranial magnetic stimulation (TMS). Cleveland Clinic. June 2018.

• Bipolar disorder: Diagnosis and treatment. Mayo Clinic. February 2021.

• Bipolar disorder: Overview. Mayo Clinic. February 2021.

• Bipolar disorder. MedlinePlus. September 2021.

• Bipolar disorder. Mental Health America.

• Bipolar disorder. National Alliance on Mental Illness. August 2017.

• Bipolar disorder. National Institute of Mental Health. October 2018.

• Brain stimulation therapies. National Institute of Mental Health. June 2016.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.