Navigating Bipolar Disorder: An Overview Of Bipolar Therapy And Treatment Options

Bipolar disorder (previously known as manic depression) impacts more than 2% of adults in the United States. This mental illness includes periods of extreme highs (called a manic or hypomanic episode) and lows (referred to as bipolar depression), and these mood shifts can make it difficult to function and complete responsibilities day-to-day. Although bipolar disorder and related disorders can make life more challenging, individuals may learn to successfully control symptoms with a combination of psychotherapy and medication. Below, learn more about bipolar disorder, including its types, symptoms, and causes. Then, explore some of the most effective treatment options. 

What is bipolar disorder?

Bipolar disorder is a mental health condition in which a person experiences unusual shifts in mood, activity levels, concentration, or energy. People with this disorder go through intense mood swings, experiencing extreme periods of feeling up (i.e., elated and energized) to feeling down (e.g., sad or hopeless). These periods are known as mania and depression, respectively. 

Types of bipolar disorder

There are three types of bipolar disorder that someone might experience, including: 

• Bipolar I disorder: To be diagnosed with bipolar I disorder, a person must experience at least one manic episode that lasts seven days or longer or severe manic symptoms that require immediate medical attention. A person with this subset of the disorder often experiences depression as well. However, depression is not required for this diagnosis. 

• Bipolar II disorder: A person experiencing bipolar II disorder will experience a pattern of hypomanic episodes and depressive episodes. They do not experience manic episodes. 

• Cyclothymic disorder: This type of bipolar disorder occurs when someone experiences hypomanic and depressive symptoms that are not severe or long-lasting enough to qualify as a hypomanic episode or a depressive episode.

Symptoms

Warning signs and symptoms of bipolar disorder can vary based on whether a person is experiencing a period of mania or depression. Symptoms exhibited during a depressive episode can include:

• Trouble concentrating or remembering information 

• Loss of interest in daily activities

• Worthlessness or hopelessness

• Persistent sadness 

Symptoms exhibited during a manic episode may include:

• Feeling extremely happy or energetic

• An inflated sense of self-importance 

• Fast speech

• Irritability

• Making risky or out-of-character decisions

• Psychosis (in some cases) 

Consider that each individual may have a unique experience when living with bipolar disorder. They may have different symptoms than those listed above. Moreover, the severity of symptoms can vary from person to person. 

Contributing factors

Several factors can increase an individual’s chance of developing bipolar disorder. Still, just because someone has one or more of these contributing factors does not mean they will develop the condition. Some of these risk factors include: 

• Genetics

• Brain structure

• Substance misuse

• High-stress situations

• Other mental health conditions

Traditional bipolar therapy and treatment options

Bipolar disorder often requires lifelong treatment. A comprehensive bipolar treatment plan consists of therapy and medication to help individuals manage disruptive symptoms. With treatment, those with this condition may lead healthy, productive lives. Treatments may include but are not limited to the following.  

Psychotherapy

Although medication is often used by doctors to treat bipolar disorder, psychotherapy is another effective option, whether by itself or in conjunction with medication. Specifically, psychotherapy can assist individuals in developing coping skills. The therapist may teach them more about the condition and how they can adapt their lifestyle to manage it. Psychotherapy can be performed by a psychiatrist, psychiatric nurse practitioner, therapist, counselor, or social worker. 

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) is designed to help people with mental health challenges modify negative thoughts and behaviors and shape them into more productive ones. Cognitive-behavioral therapy involves educating people about their condition and helping them identify the cognitive distortions that lead to their symptoms. With CBT, those with bipolar disorder can learn to recognize the negative thoughts associated with periods of mania or depression and find ways to change their thinking patterns. Therapists can also use cognitive-behavioral therapy to teach their clients how to manage their sleep, stress, and anxiety.

Dialectical behavior therapy

Dialectical behavior therapy (DBT) is designed for individuals who experience intense emotions. Based on cognitive-behavioral therapy, this modality is a type of talk therapy that helps people manage and control their emotions. Research has shown that DBT can successfully decrease depressive and manic symptoms and improve emotional dysregulation.  

Interpersonal and social rhythm therapy 

Interpersonal and social rhythm therapy (IPSRT) was created to support people with mood disorders such as bipolar disorder. This type of therapy consists of three different stages. During the initial stage (usually the first few sessions), the therapist learns about the client’s current state and prior episodes, diving into the behaviors that occur during periods of mania and depression. The therapist and client may also work together to select an interpersonal problem area that they can then work together to improve. 

During the intermediate stage, the client may track and control their social rhythm and work with the therapist to learn how to manage changes in their rhythm more effectively. When clients reach the final stage, they can consult with their therapist to determine whether therapy should be concluded or if sessions should occur less often.

Family-focused therapy

Family-focused therapy (FFT) can be provided to children and adults with bipolar disorder as well as their immediate family. Treatment typically takes place during 21 sessions spread over nine months. Unlike some other therapy techniques, FFT does not often focus on decreasing manic or depressive symptoms. This type of therapy aims to educate family members about coping responses, communication, and problem-solving skills. 

For example, FFT may help clients and their family members better understand mood changes, which may help them recognize early warning signs of a hypomanic or depressive episode. Recognizing the early signs of hypomania may increase the likelihood of getting help early on and prevent a full-blown hypomanic episode. 

Psychodynamic therapy

In psychodynamic therapy, clients dive into the psychological roots of their condition. Studies have shown that this technique can lead to lasting change, even after therapy sessions have ended. 

Group therapy

Group therapy for bipolar disorder is facilitated by a psychologist or trained peer mental health counselor. The focus of this therapy may depend on the dynamic of the group. Some groups may educate and teach coping skills, while others become a safe harbor for people with bipolar disorder to connect with others experiencing the same struggles. The National Alliance for Mental Illness and Bipolar Support Alliance both offer group therapy. Online group therapy sessions and support groups may be available for those struggling to find in-person therapy options. 

Medication

The American Psychiatric Association identifies medication as the cornerstone of bipolar disorder treatment. People living with the condition are often prescribed a mood stabilizer. Other medications may include antipsychotics, antidepressants, or anti-anxiety medications. 

The type of medications a mental health professional prescribes may depend on the person's symptoms, symptom severity, and whether they are experiencing other mental disorders, like anxiety. Some prescription medications may cause unwanted interactions with other medications or supplements. To avoid potential health-related issues associated with medication interactions, speak with a doctor before starting a new prescription medication, over-the-counter medication, or supplement. A qualified healthcare professional can discuss with you the efficacy, side effects, and treatment duration of a specific medication. 

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

Alternative treatment options

Medicine and talking therapies are two common treatments for bipolar disorder, but other treatment options may help individuals manage the condition, such as the following.  

Lifestyle changes

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends several lifestyle changes to manage symptoms, including:  

• Follow a consistent sleep schedule to normalize sleep patterns by going to sleep and waking at the same time each day

• Adopt healthy eating habits to provide your body the nutrition it needs

• Consult your doctor before you take medications, whether prescribed or over-the-counter

• Avoid alcohol and substance use and seek help if you have a substance use problem

• Keep a mood journal to track how you feel each day and note any events that incited symptoms or changes in your experience

• Exercise regularly to improve your mood

• Maintain a supportive network of family and friends

Electroconvulsive therapy

During electroconvulsive therapy (ECT), patients are put under anesthesia and receive brief electrical currents to their scalp to cause short, controlled seizures. These seizures may modify brain pathways and improve symptoms in those living with bipolar disorder. 

Complementary and alternative medicine

Research is still looking into the efficacy of complementary and alternative medicine in treating mood disorders. Current studies have shown promising support for light therapy, St. John’s wort, and omega-3 fatty acids. If you’re interested in exploring other treatments or alternative medicine treatments for bipolar disorder, speak to your doctor about how to combine these options with more traditional treatments like medication and therapy. 

Challenges of bipolar disorder treatment

Undergoing treatment for bipolar disorder may include a few obstacles along the way. Knowing what might occur may help individuals prepare for these challenges and navigate them effectively.  

Misdiagnosis

A healthcare professional will make a diagnosis based on a physical exam, medical testing to rule out possible illnesses, and a mental health evaluation. While the diagnostic process for bipolar disorder is comprehensive, it is possible for people with bipolar disorder to be misdiagnosed. People with bipolar disorder can experience more depressive episodes than they do manic episodes and may only seek help when experiencing a depressive episode. As a result, they may be misdiagnosed with major depression, which can delay the start of appropriate treatment.

Difficulty in finding the right treatment approach

Mental health professionals use a trial-and-error approach to develop each client’s most effective treatment plan. Certain bipolar disorder medications may exacerbate symptoms or do nothing to improve them. In addition, medicine can take weeks or months to take effect. As a result, it can take six months or longer to settle on a mood-stabilizing medication that meets your specific needs. In addition, your doctor may adjust your dosage as your symptoms change or you experience physical changes such as weight loss or pregnancy. 

Finding the right psychotherapy approach may also take time. When looking for a therapist, you might want to find a therapist who specializes in bipolar disorder and follows an approach that suits your individual needs.

Importance of ongoing monitoring and adjustment

Bipolar disorder is a lifelong condition, and as such, it can be vital for people with this diagnosis to adhere to their treatment plan. When treatment is followed, individuals may more effectively avoid the extreme mood shifts associated with bipolar disorder. As a result, they may experience fuller and more productive lives. 

Online bipolar disorder treatment

While people with bipolar disorder can benefit from psychotherapy, symptoms can make it difficult to adhere to a therapy plan. During depressive episodes, a person may be unwilling or unable to leave their home to meet with a therapist. During a manic episode, they may not acknowledge that they even have a mood disorder since they feel so great.

Online therapy through a platform like BetterHelp can mitigate barriers by making treatment available anywhere at any time. Individuals can participate in therapy from their bed or couch, wherever is most comfortable. In addition, they can send a message to their therapist at any time of the day. Online therapy can make it easier and more convenient for those with mood disorders to get support and care without lengthy wait times. 

Research has shown that online therapy can be effective in reducing symptoms of mood disorders. A study published in 2023 confirmed that those participating in internet-based cognitive behavior therapy saw significant reductions in their symptoms of bipolar disorder. This result held true for all participants, whether they were taking medication or not.