Bipolar disorder (BD) is a mood disorder, characterized by alternating episodes of low mood or depression and unnaturally elevated mood or mania along with changes in levels of energy and activity. Treatment of bipolar disorder is readily available, but recovery can be a time-consuming process.
The main treatment for bipolar disorder involves medication, psychotherapy, or electroconvulsive therapy. Read on to know in detail about how is bipolar disorder treated.
Medical Treatment Of Bipolar Disorder
Medicinal treatment of bipolar disorder is primarily aimed at stabilizing mood, and managing anxiety and sleep issues. There are different types of medication available and a psychiatrist usually prescribes one based on the individual’s symptoms and case history.
Typically, medications in the treatment of bipolar disorder are found to be most effective when administered in combination with psychotherapy.
I. Mood stabilizers
In psychopharmacology, mood stabilizers comprise the most effective treatment for bipolar disorder. Research 1 Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. Lancet (London, England), 381(9878), 1672–1682. https://doi.org/10.1016/S0140-6736(13)60857-0 attests to their efficacy in the treatment of manic episodes and depressive symptoms. Commonly prescribed mood stabilizers in the treatment of bipolar disorder include:
- Lithium
- Valproic acid
- Carbamazepine
II. Anti-seizure medication
Anti-seizure or anticonvulsant medication 2 Subbarao, B. S., Silverman, A., & Eapen, B. C. (2022). Seizure Medications. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482269/ is prescribed to people with bipolar disorder if they experience a rapid mood cycle. Some commonly prescribed drugs in this category include:
- Carbamazepine
- Gabapentin
- Lamotrigine
III. Antipsychotic medication
Antipsychotic medications are used for brief or long-term treatment of bipolar disorder to control psychotic symptoms experienced by BD patients such as hallucinations, delusions, or mania symptoms. Commonly used antipsychotic medication 3 Ertugrul, A., & Meltzer, H. Y. (2003). Antipsychotic drugs in bipolar disorder. The international journal of neuropsychopharmacology, 6(3), 277–284. https://doi.org/10.1017/S1461145703003560 for treating bipolar disorder involves:
- Aripiprazole
- Asenapine
- Cariprazine
- Clozapine
- Lumateperone
- Lurasidone
- Olanzapine
- Quetiapine
- Risperidone
- Ziprasidone
IV. Antidepressants
For the treatment of bipolar disorder, psychiatrists mostly prescribe 4 Cascade, E. F., Reites, J., Kalali, A. H., & Ghaemi, N. (2007). Antidepressants in bipolar disorder. Psychiatry [Edgmont (Pa. : Township)], 4(3), 56–58. antidepressants in combination with a mood stabilizer. Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and bupropion are commonly consumed in first-line therapy for bipolar disorder.
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V. Benzodiazepine
Benzodiazepines are sometimes used as adjuncts to mood stabilizers or antipsychotic drugs for the pharmacological treatment of patients with bipolar disorder. However, the prescription of benzodiazepines is always kept at a bare minimum and their use 5 Bobo, W. V., Reilly-Harrington, N. A., Ketter, T. A., Brody, B. D., Kinrys, G., Kemp, D. E., Shelton, R. C., McElroy, S. L., Sylvia, L. G., Kocsis, J. H., McInnis, M. G., Friedman, E. S., Singh, V., Tohen, M., Bowden, C. L., Deckersbach, T., Calabrese, J. R., Thase, M. E., Nierenberg, A. A., Rabideau, D. J., … Kamali, M. (2014). Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: results from the Bipolar CHOICE trial. Journal of affective disorders, 161, 30–35. https://doi.org/10.1016/j.jad.2014.02.046 appears to be a marker for a more severe course of illness.
Psychotherapy Treatment Of Bipolar Disorder
Bipolar disorder treatment without medication can also be quite effective. Evidence shows that psychotherapy can enable people suffering from bipolar disorder to identify mood symptoms early for mania and develop coping strategies for depression.
It can also motivate them to follow the treatment plan closely. Moreover, including family education in the treatment of bipolar disorder can improve communication among family members and help patients cope better.
I. Cognitive behavioral therapy
Cognitive-behavioral therapy (CBT) 6 Özdel, K., Kart, A., & Türkçapar, M. H. (2021). Cognitive Behavioral Therapy in Treatment of Bipolar Disorder. Noro psikiyatri arsivi, 58(Suppl 1), S66–S76. https://doi.org/10.29399/npa.27419 helps with the symptoms of depressive, dysphoric, and elevated mood episodes. It can also help a patient with bipolar disorder develop an enhanced adherence to drug treatment, as well as learn the skills to prevent future episodes. CBT also treats comorbid conditions associated with bipolar disorder like psychosis, eating and sleep disorders, etc.
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II. Interpersonal therapy
Interpersonal therapy (IPT) 7 Markowitz, J. C., & Weissman, M. M. (2004). Interpersonal psychotherapy: principles and applications. World psychiatry : official journal of the World Psychiatric Association (WPA), 3(3), 136–139. is a time-limited treatment that addresses patterns in social relationships and the capacity for intimacy in people with bipolar disorder. It also addresses mental health issues and interpersonal deficits related to grief, social acceptance, etc.
III. Dialectical behavioral therapy
Treatment of bipolar disorder can also involve dialectical behavior therapy (DBT) 8 DiRocco, A., Liu, L., & Burrets, M. (2020). Enhancing Dialectical Behavior Therapy for the Treatment of Bipolar Disorder. The Psychiatric quarterly, 91(3), 629–654. https://doi.org/10.1007/s11126-020-09709-6 which is an effective adjunct treatment that targets emotional dysfunction. It improves emotion regulation and residual mood symptoms in patients with bipolar disorder.
IV. Family-focused therapy
Family-focused therapy 9 Miklowitz, D. J., & Chung, B. (2016). Family-Focused Therapy for Bipolar Disorder: Reflections on 30 Years of Research. Family process, 55(3), 483–499. https://doi.org/10.1111/famp.12237 emphasizes the enhancement of skills linked to communication, problem-solving, and decision-making in people with bipolar disorder. It may be administered along with psychoeducation in the treatment of bipolar disorder.
Electroconvulsive therapy
Electroconvulsive therapy (ECT) is used for the treatment of bipolar disorder when other treatment options have proven ineffective. The process involves directing small doses of electrical currents through the brain to deliberately induce a brief seizure. This is done under general anesthesia to alter the balance of specific brain chemicals.
ECT can rapidly remedy bipolar disorder symptoms. This treatment approach is usually safe and controlled with minimum side effects and risks. In fact, about 80.2% 10 Popiolek, K., Bejerot, S., Brus, O., Hammar, Å., Landén, M., Lundberg, J., Nordanskog, P., & Nordenskjöld, A. (2019). Electroconvulsive therapy in bipolar depression – effectiveness and prognostic factors. Acta psychiatrica Scandinavica, 140(3), 196–204. https://doi.org/10.1111/acps.13075 of BD patients tend to show a positive response to electroconvulsive therapy.
Self-Help for Bipolar Disorder
In conjunction with bipolar disorder treatment and during recovery, several coping strategies can be practiced to manage the symptoms better.
Consider the following self-help tips to cope with bipolar disorder more effectively:
- Maintain a good sleep regime and try to get at least 7-8 hours of sleep every night.
- Take steps to prevent sleep disturbances (for example, turning your phone to silent, turning the lights off, etc.).
- Eat a healthy and balanced diet.
- Follow a routine for your daily tasks, such as eating, working, socializing, etc.
- Try to stay physically active.
- Practice relaxation techniques such as yoga, meditation, etc.
- Learn how to identify triggers and sudden mood swings.
- Seek support from family and friends.
- Do not hesitate to seek professional help and take your treatment seriously.
- Consider supplements like fish oil, Rhodiola Rosea, Perforate St. John’s worts, etc.
- Try maintaining a daily journal and write down your thoughts, feelings, triggers, and symptoms.
- Pursue any hobbies and interests that make you happy.
- Avoid consumption of excessive amounts of caffeine or nicotine.
- Avoid alcohol and recreational drugs.
Takeaway
Bipolar disorder can be a debilitating condition. But early identification and appropriate treatment of bipolar disorder can enable one to fully recover from the condition. As bipolar disorder can affect each person differently, the right treatment plan must be devised, according to each patient’s unique symptoms.
Moreover, the recovery time may also vary for each individual—depending on the symptoms severity, comorbid conditions, treatment compliance, and lifestyle. Nonetheless, patience, hope, and discipline throughout and after the treatment process can lead to improved symptoms and full recovery.
At a Glance
- Bipolar disorder can be a crippling mental health disorder affecting your life, well-being, and relationships.
- Treatment of bipolar disorder primarily involves psychotherapy and medication.
- Bipolar disorder treatment also includes self-help coping strategies like herbal remedies, journaling, exercising, etc.
- Having patience and discipline throughout and after the treatment process can lead to improvement in symptoms and a full recovery.
Frequently Asked Questions (FAQs)
1. What is the most frequently used psychopharmacological treatment for bipolar disorder?
Mood-stabilizing medication, such as lithium (to control manic or hypomanic episodes) is most frequently used in the pharmacological treatment of bipolar disorder.
2. Can bipolar disorder be managed without medication?
Yes. Counseling and therapy are one of the most effective treatments for bipolar disorder. A range of lifestyle changes can also help people manage and cope better. However, in case of severe condition, hospitalization and continuous pharmacotherapy are mandatory to improve the symptoms and quality of life.
3. What is the best way to manage bipolar disorder?
Treatment of bipolar disorder can be best managed with a combination of medication and psychotherapy along with self care strategies.
4. Is genetic counseling an option for bipolar disorder treatment?
Genetic counseling is still a heated debate when it comes to bipolar disorder treatment and its efficacy is largely disputed 11 Patch, C., & Middleton, A. (2018). Genetic counselling in the era of genomic medicine. British medical bulletin, 126(1), 27–36. https://doi.org/10.1093/bmb/ldy008 . But, it can be useful for families affected by a family history of bipolar disorder or other major illnesses like depression. It can also help fight the stigmatization of mental illnesses.
5. How to get rid of bipolar disorder naturally?
Some natural remedies to manage the symptoms of bipolar disorder include herbs and supplements 12 Bauer, M., Glenn, T., Conell, J., Rasgon, N., Marsh, W., Sagduyu, K., Munoz, R., Lewitzka, U., Bauer, R., Pilhatsch, M., Monteith, S., & Whybrow, P. C. (2015). Common use of dietary supplements for bipolar disorder: a naturalistic, self-reported study. International journal of bipolar disorders, 3(1), 29. https://doi.org/10.1186/s40345-015-0029-x with omega-3 13 Sarris, J., Mischoulon, D., & Schweitzer, I. (2012). Omega-3 for bipolar disorder: meta-analyses of use in mania and bipolar depression. The Journal of clinical psychiatry, 73(1), 81–86. https://doi.org/10.4088/JCP.10r06710 , magnesium 14 Phelan, D., Molero, P., Martínez-González, M. A., & Molendijk, M. (2018). Magnesium and mood disorders: systematic review and meta-analysis. BJPsych open, 4(4), 167–179. https://doi.org/10.1192/bjo.2018.22 , vitamins 15 Lakhan, S. E., & Vieira, K. F. (2008). Nutritional therapies for mental disorders. Nutrition journal, 7, 2. https://doi.org/10.1186/1475-2891-7-2 , etc. However, it is best to consult a professional before adopting any of these treatment options.
