Treatment and Prevention
People with bipolar disorder will receive treatment to manage their current episodes as well as treatment on a long-term basis to prevent future episodes. Components of treatment include medications, education, and psychotherapy. Electroconvulsive therapy (ECT) is usually reserved for people who do not respond to treatment with medications for bipolar disorder.
Medications: Treatment for bipolar disorder must be customized to fit the individual because the patterns and severity of this disorder vary from one person to the next. Long-term medications are commonly used to treat bipolar disorder. Medications used to manage bipolar disorder are as follows:
Mood stabilizers: Most people with bipolar disorder are treated with medications called mood stabilizers (e.g., lithium*, divalproex or valproic acid, carbamazepine). These medications provide relief from current episodes, prevent them from recurring, and do not worsen depression or mania, or lead to increased cycling. Sometimes other medications normally used to treat people who have epilepsy are used to treat symptoms of bipolar disorder (e.g., gabapentin, lamotrigine, topiramate). Combination therapy with two mood stabilizers is sometimes recommended for people who do not respond to or develop resistance to the use of one medication. These medications need to be closely monitored by the doctor.
Antidepressants: These medications treat the symptoms of depression, and they work by altering the levels of certain chemicals in the brain in a way that elevates a person's mood. For people with bipolar disorder, antidepressants must be used together with a mood stabilizer medication to prevent cycling into a manic episode. Many types of antidepressants are available, working in different ways, and with different side effect profiles.
Other medications may be prescribed by the doctor for other problems associated with bipolar disorder such as medications for sleeping, anxiety, restlessness, or thought disturbances.
It is important for people with bipolar disorder to keep taking these medications in order for the drugs to work properly in managing this condition. Do not stop taking these medications or adjust the dose on your own, without speaking to your doctor or pharmacist first. Symptoms that recur after medications have been stopped are sometimes much harder to treat. Talk to your doctor and pharmacist if you have any questions about the medications you are taking and ask about possible side effects.
Education and counseling: Learning more about bipolar disorder and seeking counseling can help people and their families learn how to best manage the condition and prevent other complications from occurring.
Psychotherapy: Psychoeducation (or psychotherapy) is usually combined with medication to help people with bipolar disorder and their families understand and deal with the medical condition. Specific psychotherapies (cognitive behavioral, interpersonal, and problem-solving therapy can be as effective as antidepressants in treating the depressive episodes in bipolar disorder).
Other things that a person with bipolar disorder can do to help reduce symptoms include:
- learn to recognize early warning signs of a new mood episode
- try to get enough sleep, and go to bed at a regular hour each night
- exercise regularly
- avoid alcoholic beverages and street drugs
- reduce stress at work and in everyday life
- eat a well-balanced diet
- keep a diary to track your daily feelings, activities, sleep patterns, life events, and side effects of medications. This will help you and your doctor determine which treatment works best for you.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.