What Types Of Bipolar Disorder Treatment Work Best?

Bipolar disorder is a serious mental health condition marked by mood changes, shifts in energy levels, and fluctuations in behavior. A combination of pharmaceutical medication and psychotherapy is often recommended to treat bipolar disorder. However, there are many medications and therapeutic modalities people use to cope with symptoms like hypomania, mania, and depression. Those living with this condition may want to know which treatment works best. Although the answer can be personal, a combination of medication, therapy, and support from friends and family may be the most common approach.

How do you diagnose bipolar disorder?

To begin the process of receiving care for bipolar disorder, an individual will typically need a diagnosis. Prior to providing a diagnosis, a healthcare professional may conduct a series of assessments, including a physical exam, blood tests, and screenings to evaluate the severity of mood symptoms and other concerns. In addition to evaluating an individual’s depressive and manic symptoms, a provider might ask about their sleep patterns, family medical history, and use of certain medications. 

Following their evaluation, the professional may compare the individual’s symptoms to the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V). There are three primary conditions in the category of “Bipolar and Other Disorders” in the DSM-V—bipolar I disorder, bipolar II disorder, and cyclothymic disorder—though other diagnoses may be provided in certain cases. 

For an individual to be diagnosed with bipolar I, they must have experienced at least one episode of mania. While a manic episode may precede or follow a period of major depression, a depressive episode is not necessary for a diagnosis. To be diagnosed with bipolar II, a person must have experienced at least one depressive and one hypomanic episode. Cyclothymia may be diagnosed if an individual experiences periods of mood symptoms that do not meet the criteria for a depressive, manic, or hypomanic episode. 

Is bipolar disorder curable?

Bipolar disorder is not curable, but it may be treatable and can respond well to treatment. A condition being "incurable" means no treatment option will undoubtedly and entirely eradicate the disorder and its symptoms. However, some people with this condition manage their symptoms and live healthily.

Bipolar disorder is not an indication of how successful one might be. For example, several famous people with bipolar disorder have had significant success. Proper treatment can help you manage your symptoms to the point where you experience them less often. Knowing which treatment works best for you can be a matter of trial and error. 

How do you treat bipolar disorder?

Given that bipolar disorder commonly persists throughout adulthood, lifelong treatment is often necessary. As with many mental health conditions, professionals often treat bipolar disorder with a combination of medication and psychotherapy. An individual’s treatment plan will typically depend on several factors, including their medical history, age, the type of bipolar disorder they’re experiencing, and the potential presence of other mental health conditions.

Treating bipolar disorder with medications

Prescription medications are often the recommended treatment for bipolar disorder. Medications can help individuals manage mania and depression. In some cases, they may eradicate manic episodes or cause them to be less severe. Consult a medical doctor before starting, changing, or stopping any medication. 

Mood stabilizers

One of the primary classes of medications prescribed for bipolar disorder, mood stabilizers stabilize a person's mood so that it is less susceptible to the changes sparked by mania or depression. 

One of the first mood stabilizer medications to be used successfully for bipolar disorder was lithium carbonate. In one review of the scientific literature on lithium, researchers found that lithium effectively prevented mania relapses in bipolar I disorder. However, it may also support depression. Lithium is used less often in modern psychology than in previous decades due to its side effects, which can include weight gain, cognitive impairment, and fatigue. 

In recent decades, doctors have turned to other pharmaceutical drugs for mood stabilization. Newer medications were designed as anticonvulsant medications for people with epilepsy and other seizure disorders but are often effective in treating bipolar disorder, as well. Valproic acid is an anticonvulsant that mental health professionals often prescribe as a mood-stabilizing medication.  

Antidepressants

Antidepressants may be used to treat the depressive episodes of bipolar II disorder. They may sometimes be used to treat bipolar I disorder. However, some antidepressants may worsen mania, which can be dangerous. For those who struggle more with depression than hypomania or mania, these medications might be used if other options aren't effective. 

Antipsychotics

Antipsychotics may treat the delusions and hallucinations that can happen during a manic episode. When depression or mania don't go away with other medications, adding an atypical antipsychotic medication may offer relief. In addition, these antipsychotic medications can be added to an antidepressant as an antimanic agent to prevent mania.

Treating bipolar disorder with psychotherapy

Many modalities of psychotherapy have been used for bipolar treatment. There is evidence that administering talk therapy alongside the use of prescriptions drugs can be more effective than treatment through medication alone. Therapy can help an individual with bipolar disorder identify potential sources of their symptoms, develop coping skills, and process challenging emotions. 

There are over 400 therapeutic modalities available for therapists to practice, so what works for you may not be what works for someone else. For those who don't like traditional talk therapy modalities, expressive treatments like music therapy or art therapy may be beneficial. Below are a few options for people living with this condition. 

Psychoeducation

Psychoeducation involves learning about the symptoms and diagnostic criteria of bipolar disorder and how you might be affected. After an initial diagnosis, your therapist may offer psychoeducation to help you learn what to expect and why following a treatment plan can be essential. 

Cognitive behavioral therapy (CBT) 

Cognitive-behavioral therapy (CBT) is often considered the "gold standard" of psychotherapy for many mental illnesses. It helps clients explore the negative or unrealistic thoughts and beliefs behind unwanted behaviors. Once the root of these behaviors or attitudes is located, you can work to overwrite them with healthier ones. 

This technique can help you improve your behavior and mood. If you have bipolar disorder, CBT may help you identify inciting events that tend to bring on a bipolar episode for you. You can also use CBT to manage stress and cope with situations exacerbating your bipolar disorder symptoms.

Family-focused therapy

Family-focused therapy is a type of intervention that can prevent relapses in bipolar disorder. This type of therapy builds support and improves communication within a family unit. During sessions, the family learns more about bipolar disorder and how to help the person diagnosed by recognizing warning signs.

Interpersonal and social rhythm therapy

Interpersonal and social rhythm therapy (IPSRT) is a therapy proven successful in helping people with bipolar disorder prevent relapses. IPSRT may enable you to stabilize daily rhythms, like sleeping, waking, exercising, and mealtimes. Because these rhythms can be erratic during an episode, some people with bipolar disorder abandon their regular schedules out of fear of losing consistency again. Getting back on track with these daily habits can improve mood and potentially prevent mood swings.

Alternative options for symptom management

In addition to the primary treatment methods outlined above, healthy lifestyle changes—such as maintaining a healthy diet, exercising, and getting plenty of sleep—can help an individual control symptoms of bipolar disorder. Light therapy is another complementary modality that has been shown to alleviate certain symptoms of bipolar disorder. Though light therapy—which works by exposing an individual to a bright light source in the morning—can reduce depressive symptoms, it may worsen mood symptoms that arise during manic episodes. 

Brain stimulation therapies, which work by activating certain regions of the brain through electrical currents, have also been shown to treat depression and mania effectively. Electroconvulsive therapy and transcranial magnetic stimulation are two brain stimulation therapies that may be utilized for bipolar disorder.  

How online therapy can help 

Regardless of what type of therapy you pursue, there are several ways to receive treatment. Some people experience barriers to in-person therapy, such as financial insecurity or inaccessibility. In these cases, online therapy through a platform like BetterHelp may be beneficial. 

Online therapy can help save you time and money by allowing you to avoid commuting, gas costs, and parking costs. In addition, you can choose between phone, video, or live chat sessions depending on your treatment goals. 

In some cases, online therapy options may be a more approachable way to receive professional support. One recent review of over a dozen studies on online cognitive-behavioral therapy found it to be a more cost-effective option for clients than in-person therapy, all while successfully treating mental health symptoms related to depression. Another study found that 95% of people with bipolar disorder achieved an improved quality of life after partaking in online therapy.