Bipolar Disorder Treatment

Bipolar Disorder is often treated with a regimen of medication, psychotherapy, and lifestyle changes. The purpose of treatment is to enhance general functioning, manage symptoms, stabilize mood, and prevent relapses.

The main difference between Bipolar I Disorder and Bipolar II Disorder lies in the severity and duration of the manic or hypomanic episodes. As such, there are different treatment options for Bipolar 1 Disorder and Bipolar 2 Disorder.

Bipolar I Disorder Treatment

Individuals with bipolar I disorder experience manic episodes that typically last for at least one week. During these episodes, they may exhibit symptoms such as an elevated or irritable mood, increased energy, racing thoughts, decreased need for sleep, inflated self-esteem or grandiosity, impulsivity, and engaging in risky behaviors. The symptoms of mania significantly impair daily functioning and may require hospitalization in severe cases.

People with Bipolar I Disorder may also experience depressive episodes similar to those seen in Major Depressive Disorder. These episodes are characterized by persistent feelings of sadness, hopelessness, low energy, loss of interest in activities, changes in appetite or sleep patterns, difficulty concentrating, and thoughts of death or suicide.

To receive a diagnosis of Bipolar I Disorder, an individual must have experienced at least one manic episode. The depressive episodes may or may not occur, but they are not necessary for the diagnosis.

Medication treatment for Bipolar Disorder I often involves mood stabilizers as a primary intervention to manage manic episodes and stabilize mood. Lithium, valproate, and carbamazepine are commonly prescribed. Atypical antipsychotic medications may also be used during manic episodes.

There are multiple types of therapy available for people with Bipolar Disorder, from cognitive-behavioral therapy (CBT)  to Family Therapy.

Psychotherapy for this type of Bipolar Disorder is typically centered around addressing depressive symptoms, managing mood fluctuations, and improving overall emotional well-being. Educating the families of people with bipolar is paramount, helping them understand the person is not to blame for their symptoms.

Given the potential for more severe manic episodes and risk-taking behaviors, safety monitoring and interventions may be more intensive for bipolar I disorder. Hospitalization may be required in some cases to ensure the person’s safety.

Bipolar II Disorder Treatment

Individuals with Bipolar II Disorder experience depressive episodes similar to those in Bipolar I Disorder. These episodes are characterized by significant and persistent feelings of sadness, hopelessness, and other depressive symptoms. To receive a diagnosis of Bipolar II Disorder, an individual must have experienced at least one hypomanic episode and one major depressive episode. The presence of a full manic episode would lead to a diagnosis of Bipolar I Disorder instead.

Medication treatment for Bipolar II Disorder typically involves mood stabilizers to manage depressive episodes and prevent hypomanic episodes from escalating into full-blown mania. Commonly prescribed mood stabilizers include lithium, lamotrigine, and valproate.

Antidepressant medications may be prescribed with caution to manage depressive symptoms.

Psychotherapy, such as cognitive-behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), and family-focused therapy, can be beneficial for both Bipolar I and Bipolar II Disorder. These therapies can help individuals learn coping strategies, manage stress, improve medication adherence, and enhance communication and problem-solving skills. Psychoeducation is often a component of therapy to educate individuals about their condition and treatment options.

LifeStance Health mental health clinics offer different types of treatment options for Bipolar Disorder I and Bipolar Disorder II. We offer in-person and telehealth options. Find a clinic or provider near you.

Treatment for Rapid Cycling Bipolar Disorder

Rapid cycling bipolar disorder is a subtype of bipolar disorder characterized by frequent and distinct episodes of mood swings. In general, bipolar disorder involves periods of depression alternating with periods of mania or hypomania.

In rapid cycling bipolar disorder, an individual experiences four or more mood episodes within a 12-month period. These episodes can include manic, hypomanic, or depressive episodes, or a combination of them. The mood swings can occur rapidly, sometimes within a matter of days, weeks, or months, as opposed to the more typical pattern of longer intervals between episodes.

Medication management is one of the most effective treatments. Types of medication include:

• mood stabilizers
• atypical antipsychotics
• antidepressants

The depressive symptoms of rapid cycling bipolar disorder have not been effectively treated by antidepressants like fluoxetine (Prozac^®), paroxetine (Paxil^®), and sertraline (Zoloft^®), and they may even make fresh episodes more frequent over time. Therefore, many medical professionals advise against using antidepressants to bipolar patients who have rapid cycling (particularly over the long term).

Psychotherapy is often a part of the treatment plan, especially Interpersonal and social rhythm therapy (IPSRT) and Family-focused therapy. IPSRT targets a person’s circadian rhythms, or biological clock, in order to reduce symptoms of Bipolar Disorder. Family-focused therapy (FFT) involves a person’s family members and caregivers in an approach to managing Bipolar Disorder.

LifeStance Health mental health clinics offer treatment options for Bipolar Disorder I, Bipolar Disorder II, and Rapid-Cycling Bipolar Disorder. We offer in-person and telehealth options. Find a clinic or provider near you.

Many types of therapy are effective for bipolar disorder, and the most commonly used are:

Cognitive Behavioral Therapy (CBT)

CBT involves changing thinking patterns to help people face common triggers in constructive ways. Through role-playing, individuals will learn how to handle problematic situations in a non-stressful environment, equipping them with the tools to thrive in daily life. This therapy usually takes place in a one-on-one setting, with a therapist and patient, which works as a resource for finding healthy ways of dealing with life’s difficulties.

Interpersonal and Social Rhythm Therapy (IPSRT)

This form of therapy is rooted in the idea that changes in routine can trigger episodes in people with bipolar. It encourages them to set up a stable routine to support them, highlighting the fact that stress caused by interpersonal conflict can affect mood. IPSRT teaches people the essential skills needed to protect themselves against potentially triggering events and minimize the severity of future episodes.

Family-Focused Therapy (FFT)

Family-focused therapy is typically implemented following an episode, involving family members in treatment. By focusing on psychoeducation regarding bipolar disorder symptoms, communication enhancement training, and problem-solving skills training, family conflict may be reduced. As the symptoms of bipolar disorder often have a significant impact on the people a diagnosed person is close to, family therapy offers support for them as well. In the long term, FFT is highly successful at helping people manage their condition.

Psychoeducation Therapy

As its name suggests, psychoeducation therapy focuses on educating a person with bipolar on the root causes of their condition. Highlighting the biological causes of manic and depressive episodes will provide people with faith in the medications prescribed to counteract these symptoms. Additionally, education will empower people to identify their symptoms ahead of time and take preventative measures. This type of therapy usually takes place in a group setting.

The most effective treatment for Bipolar Disorder is psychotherapy alongside medication. Following the advice offered to you by your healthcare provider should involve a mood stabilizing medication as well as an extended period of therapy.

LifeStance Health mental health clinics offer all the types of psychotherapy that treat Bipolar Disorder along with medication management treatment. We offer in-person and telehealth options. Find a clinic or provider near you.

Typically, treatment for Bipolar Disorder is managed in an outpatient setting. Regular meetings between psychotherapist and patient can ensure the person is on the right track, with crisis help available when needed.

In some cases, in-patient treatment will be appropriate, supporting rapid recovery under observation. When someone is considered a danger to themselves or others, residential treatment is the preferred option to keep them safe during an episode. If you are having feelings of harming yourself or others, reach out to a medical professional or helpline to receive the support you need.