Bipolar disorder is a mood disorder that affects an estimated 5.7 million adults in the U.S. each year. While the symptoms can be disruptive and overwhelming, treatment is available. From psychotherapy and medication to brain stimulation and self-management techniques, here’s everything you need to know about how to treat bipolar disorder.
What is Bipolar Disorder?
Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings. From emotional highs (mania or hypomania) to lows (depression), these mood swings can affect a person’s energy, thinking, sleep, behavior, and the ability to function in everyday life. Some episodes last days, while others can stretch into weeks or months.
There are several types of bipolar disorder, including:
- Bipolar I
- Bipolar II
- Cyclothymia
- Rapid cycling bipolar
- Bipolar with mixed features
- Bipolar with seasonal pattern
- Unspecified bipolar
Each one presents differently, but all of them involve some combination of elevated and depressed mood states. Knowing what type of bipolar disorder you have can help you find the right treatment and support.
Types of Medications for Bipolar Disorder
Medications are often used to treat bipolar disorder. While treatment won’t be the same for everyone, the right medication(s) can help stabilize your mood, reduce the risk of relapse, and improve your day-to-day life. It may take time and patience to find what works best for you, but a psychiatrist can help guide you through the process.
Lithium
Due to its efficacy in reducing the frequency and intensity of mood episodes, as well as its ability to lower the risk of suicide, lithium has been considered the gold standard for treating bipolar disorder for years. Per a recent meta-analysis that reviewed several studies on lithium:
- Around two-thirds of individuals experienced an improvement in symptoms
- More than 50% achieved full remission
Antipsychotics
Certain atypical antipsychotic medications are FDA-approved to treat bipolar mania, depression, or both. These medications help regulate brain chemicals that influence mood and behavior and are often used alone or along with mood stabilizers. Common antipsychotics for bipolar disorder include:
- Aripiprazole (Abilify)
- Cariprazine (Vraylar)
- Clozapine (Clozaril)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
Studies show that antipsychotics lead to better response and remission rates compared to placebo.
Mood Stabilizers
Mood stabilizers help prevent manic and depressive episodes by balancing brain activity. They are usually prescribed as long-term maintenance treatment. Types of mood stabilizers include:
- Valproic acid
- Lamotrigine
- Carbamazepine
Research has found that low to moderate doses of mood stabilizers are tied to a reduced risk of relapse in bipolar disorder.
Psychotherapy Options for Bipolar Disorder
While medication can help individuals manage symptoms of bipolar, psychotherapy can help them understand their condition, recognize early warning signs, improve relationships, and learn healthy coping skills. Sessions may be one-on-one or done in a group setting by a licensed mental health provider.
Cognitive Behavioral Therapy (CBT)
CBT is one of the most widely used therapies for bipolar disorder, and is especially beneficial during depressive episodes. It helps people challenge unhelpful thought patterns, manage guilt or shame related to past manic behavior, and work through feelings of isolation or loss. CBT focuses on:
- Recognizing early signs of mood changes
- Challenging automatic negative thoughts like “I’ll never get better”
- Learning coping skills to manage stress and conflict
- Improving awareness of emotions, behaviors, and physical cues tied to manic or depressive episodes
Dialectical Behavior Therapy (DBT)
For those who struggle with intense emotions or unstable relationships, DBT may be another option to consider. It teaches skills to regulate mood and maintain stability, such as:
- Mindfulness
- Distress tolerance
- Emotion regulation
- Interpersonal effectiveness
- Self-management and problem solving
DBT helps individuals feel more in control of their emotional responses and build more supportive relationships.
Interpersonal and Social Rhythm Therapy (IPSRT)
IPSRT is specifically designed for people with bipolar disorder. It focuses on stabilizing daily routines (e.g., sleeping, eating, and social interaction) because irregular rhythms can trigger mood episodes. Treatment includes:
- Identifying and tracking daily routines (social rhythms)
- Reducing the impact of stress and interpersonal conflict
- Exploring how past mood episodes affected behavior and relationships
- Working with a therapist to build consistency and address major life role changes (e.g., becoming a parent)
Each week, patients track and review their routines with their therapist to build structure and prevent relapse. Research shows IPSRT is effective in improving symptoms and reducing emotional instability in those with bipolar disorder.
Brain Stimulation Therapies
If a person doesn’t respond to medication or therapy alone, brain stimulation therapies may be able to provide relief. These treatments target specific areas of the brain to help regulate mood and improve symptoms.
Transcranial Magnetic Stimulation (TMS)
TMS is a noninvasive treatment that uses magnetic pulses to stimulate nerve cells in the brain. A coil is placed on the scalp to deliver these pulses. In a recent study, 87% of people with bipolar depression responded to repetitive TMS (rTMS), and 74% reached remission.
Common side effects are usually mild and temporary, and they may include:
- Scalp discomfort or pain
- Headaches
- Facial twitching or tingling
- Lightheadedness
Rare but serious side effects:
- Seizures
- Mania
- Temporary hearing problems if ear protection isn’t used
Electroconvulsive Therapy (ECT)
ECT is used in cases of severe bipolar disorder, especially when symptoms are life-threatening or unresponsive to other treatments. During ECT, controlled electrical currents are passed through the brain while the patient is under anesthesia. This causes a brief seizure, which can reset brain chemistry and quickly improve mood symptoms.
Self-Management Strategies
Medication and therapy are a big part of treating bipolar disorder, but they can’t work without effort on your part. Here are ways you can support your treatment:
- Use a journal or mood tracker to notice your patterns over time.
- Identify situations, thoughts, or habits that trigger mood swings.
- Follow a daily routine that can especially help you during periods of instability.
- Aim for 7-9 hours of sleep each night.
- Eat balanced meals.
- Stay active for improved mood and reduced anxiety.
- Surround yourself with people who understand your condition and can offer encouragement during tough times.
- Create a crisis plan so you know what to do and who to call if symptoms escalate.
When to Seek Emergency Help
Sometimes the symptoms of bipolar disorder can become dangerous. If you’re experiencing an extreme manic episode, hallucinations, or delusions, you may need emergency hospitalization to ensure your safety and the safety of those around you. If you’re having thoughts of suicide or self-harm, call 911 or reach out to the Suicide and Crisis Lifeline at 988.
How We Can Help Treat Your Bipolar Disorder
At Cura Behavioral Health, we understand that everyone’s experience with bipolar disorder is different. Whether you need medication management, transcranial magnetic stimulation, or psychotherapy, our team is here to create a personalized treatment plan that fits your needs and supports sobriety that lasts. Contact us today to learn more about your options.
Sources:
- Bipolar Disorder Statistics – Depression and Bipolar Support Alliance
- Comparing measurements of lithium treatment efficacy in people with bipolar disorder: systematic review and meta-analysis – British Journal of Psychiatry
- Effect of antipsychotics and mood stabilisers on metabolism in bipolar disorder: a network meta-analysis of randomised-controlled trials – eClinicalMedicine
- Dosing levels of antipsychotics and mood stabilizers in bipolar disorder: A Nationwide cohort study on relapse risk and treatment safety – Acta Psychiatrica Scandinavica
- Efficacy of the interpersonal and social rhythm therapy (IPSRT) in patients with bipolar disorder: results from a real-world, controlled trial – Annals of General Psychiatry
- A Pilot Study of High-Frequency Transcranial Magnetic Stimulation for Bipolar Depression – The Journal of Clinical Psychiatry
