Although bipolar disorder is viewed as a long-term, often chronic condition, there are a variety of effective treatments available. People with bipolar disorder often seek out treatment according to what part of the cycle they’re in. When a person with bipolar disorder is in a manic or hypomanic phase, they may believe they have no further need of medications and stop taking them. When in a depressive phase, they often return to treatment.
Medication is nearly always a part of the recommended treatment course for bipolar disorder. People with undiagnosed bipolar disorder will sometimes self-medicate with alcohol or drugs to try and relieve their symptoms. However, such solutions rarely provide the type of long-term relief most people desire.
The types of treatment that are commonly prescribed for bipolar disorder include:
- Mood stabilizers
Older medications, such as lithium, which are reliable and well-tolerated by most. Once the first-line treatment for bipolar disorder, they have largely been supplanted by atypical antipsychotics. - Atypical antipsychotics
Newer, more expensive medications for bipolar disorder that may provide greater symptom relief, but also have greater side effects. - Psychotherapy & Self-Help Strategies
Psychotherapy and self-help strategies can keep someone with bipolar disorder stabilized and prevent relapse. - Other treatment strategies
Other treatments for bipolar disorder may include prescribing a combination of medications for bipolar, including antidepressants for bipolar.
Treatment for bipolar disorder can be divided into three general categories. Acute treatment focuses on suppressing current symptoms and continues until remission, which occurs when the symptoms are diminished for a period of time. Continuation treatment prevents a return of symptoms from the same manic or depressive episode. Maintenance treatment prevents a recurrence of symptoms. The risks of long-term medication use must be weighed against the risk of getting sick again (relapse).
Who Treats Bipolar Disorder?
A wide range of mental health professionals help treat bipolar disorder. Medications are usually prescribed by a psychiatrist (or generally should be — a general practitioner or family physician doesn’t have the extensive background and experience in prescribing these medications on a long-term basis). Psychotherapy to help learn better ways of coping and unlearn unhelpful thinking and patterns of behavior is usually provided by a psychologist or licensed clinical social worker. Usually for an initial diagnosis, it is recommended that you consult a psychologist or psychiatrist.
People who are experiencing life-threatening symptoms, such as life-endangering impulsive behavior (e.g., substance abuse, promiscuity or aggressiveness) or psychotic symptoms (e.g., hallucinations or delusions), as well as anyone who is severely suicidal, should be evaluated by a physician. Depending on the level of potential harm to self or others, they should go to an emergency room. Doctors there often will refer them to a psychiatrist for further treatment. In some cases, hospitalization in a psychiatric facility is a standard approach.
Prognosis for Bipolar Disorder
With appropriate treatment, the outlook for someone with bipolar disorder is favorable. Most people respond to a medication and or combination of medications. Approximately 50 percent of people will respond to lithium alone. An additional 20 to 30 percent will respond to another medication or combination of medications. Ten to 20 percent will have chronic (unresolved) mood symptoms despite treatment. Approximately 10 percent of bipolar patients will be very difficult to treat and have frequent episodes with little response to treatment.
On average, a person is free of symptoms for about five years between the first and second episodes. As time goes on, the interval between episodes may shorten, especially in cases in which treatment is discontinued too soon. It is estimated that a person with bipolar disorder will have an average of eight to nine mood episodes during his or her lifetime.
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