What Are Treatment Options for Bipolar Disorder?
There is no cure for BD but, with proper therapy, people with this disease can lead stable and productive lives. Bipolar disorder will not get better without medical treatment. The most complete treatment plan for bipolar disorders include both mood-stabilizing medication(s) and psychotherapy.
Self-Care at Home
Bipolar disorder is a serious condition, and most people will need to stay on prescription mood stabilizers through their lives. Self-treatment of BD without medical treatment is not recommended and could be risky as there are likely to be more serious mood episodes. However, in addition to medications and appointments with doctors, there are many ways that a person with bipolar disorder can take care of themselves, and involvement of family and friends can be a vital support in maintaining good mental health. Regular routines, particularly around sleep and social activity, are critical for improving stability. Avoiding the use of excessive alcohol and non-prescribed drugs and medications can also improve health and avoid triggers for episodes. Supporting this type of healthy lifestyle changes in your loved one with bipolar disorder, as well as encouraging them to take their prescriptions regularly, can improve their mental and physical health.
Optimal treatment of bipolar disorder includes both (1) medications to stabilize mood episodes and prevent future episodes and (2) specific types of psychotherapy (talk therapy) with a licensed therapist. However, therapy is more successful with strong support from family and loved ones.
There is no test to determine which medication is best for an individual with bipolar disorder. Because of this, a number of medications may need to be tried before the right combination is found. Also, medications usually take weeks to have their full effect, so it is important to stay on the medications long enough (and to work with your doctor) to make sure they are working. While medication adjustments are being made, support from their friends and family can encourage the person with bipolar disorder hold on to hope while they are recovering from a mood episode.
In addition to medications, interventional treatments can also be very effective. Electroconvulsive therapy (ECT) is a procedure performed in a hospital setting that can be extremely effective for treating both depressive and manic episodes in bipolar disorder. In ECT, an electrical pulse is used to cause a seizure in a controlled way. It is thought that the seizure causes the release of large amounts of neurotransmitters that trigger plastic changes in the brain circuits involved in mood regulation. Many people misunderstand ECT based on inaccurate portrayals in movies and on TV. However, modern ECT is very safe and humane, and with qualified psychiatrists and anesthesiologists performing the procedure, it is tolerated with very few risks or side effects. ECT is a critical option for pregnant women for whom medications may be unsafe and for patients who are not getting better with medications.
During a severe episode of mania or depression, the person with BD may be at risk of suicide or other dangerous behavior. Psychiatric hospitalization may be required during those times to protect the person and others. In the hospital, medical staff can more quickly start and adjust medications to treat symptoms and stabilize mood. While in the hospital, group and individual therapy sessions can provide education about self-care and bipolar disorder, as well as strategies to avoid suicidal acts, maintain sobriety, and physical health. Not all episodes are serious enough to require hospitalization. Many people can be treated as outpatients.