What Types Of Bipolar Disorder Treatment Work Best?

Bipolar disorder is a lifelong, 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 in the treatment of bipolar disorder, and there are many medications and therapeutic modalities people use to cope with symptoms of hypomania, mania, and depression. Those living with this mental health condition may want to know which treatment works best long-term. Although the answer varies by individual, a combination of medication, therapy, and support from friends and family is an effective approach for many.

How do you diagnose bipolar disorder?

To begin receiving care for bipolar disorder, an individual may first need a diagnosis. Before providing a diagnosis, a healthcare professional may conduct a series of assessments, including a physical exam, blood tests, questionnaires, or other 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 or substances.

Following their evaluation, the health care professional may compare the individual’s symptoms to the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The DSM-5 lists three primary conditions in the category of “Bipolar and Other Disorders”—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 disorder, 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 disorder, a person must have experienced one or more depressive episodes and one or more hypomanic episodes. 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 is treatable and often responds well to talk therapies, medications, lifestyle changes, and even electroconvulsive therapy (ECT). A condition being "incurable" means no treatment option will undoubtedly and entirely eradicate the disorder and its symptoms. However, many people with bipolar disorder manage their symptoms well and lead healthy, fulfilling lives.

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 is often a matter of trial and error. 

How do you treat bipolar disorder?

Given that bipolar disorder commonly persists throughout adulthood, lifelong treatment is typically 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, like anxiety disorders, depressive disorders, or neurodevelopmental disorders including attention deficit hyperactivity disorder (ADHD).

Treating bipolar disorder with medications

Prescription medications are often the recommended treatment for bipolar disorder. Medications can help individuals manage mania, depression, or both, and it’s not uncommon to take more than one medication at a time. Consult a medical doctor before starting, changing, or stopping any medication. 

The BetterHelp platform is not intended to provide 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.

Mood stabilizers

Mood stabilizers are one of the primary classes of medications prescribed for bipolar disorder. These medications stabilize a person's mood so that they are less susceptible to the changes sparked by mania and depression. 

In recent decades, doctors have turned more to modern pharmaceutical medications for mood stabilization. Several newer medications were originally designed as anticonvulsant medications for people with epilepsy and other seizure disorders but have proven effective in treating bipolar disorder, as well. 

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 can nudge someone’s mood too far in the opposite direction, worsening or causing manic episodes. However, for those who struggle more with depression than hypomania or mania and whose depression hasn’t responded well to other options, antidepressants might be recommended.

Antipsychotics

Antipsychotics 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 prescription medications 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 your bipolar depression may not be what works for someone else’s. 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 therapeutic options for people living with this mental illness.

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 an essential facet of your treatment.

Cognitive behavioral therapy (CBT) 

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

This technique may help you improve your behavior and mood. If you have bipolar disorder, CBT may help you identify inciting events that tend to bring on mood swings or other symptoms for you. You can also use CBT to manage stress and cope with circumstances that exacerbate your bipolar disorder symptoms.

Family-focused therapy

Family-focused therapy is a type of intervention that builds support and improves communication within a family unit. This modality may prevent relapses in bipolar disorder. During sessions, the family learns more about bipolar disorder and how to help the person diagnosed by recognizing warning signs that their loved one may benefit from urgent, additional care.

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 or episodes.

Alternative options for symptom management

In addition to the primary treatment methods outlined above, healthy lifestyle changes—such as eating nutritious meals, regularly exercising, and getting plenty of sleep—can help an individual control the symptoms of bipolar disorder. Light therapy is another complementary modality that has been shown to alleviate some symptoms of bipolar disorder. You may recognize it as a treatment for seasonal affective disorder. It works by exposing an individual to a bright light source in the morning and can reduce depressive symptoms. However, similar to antidepressant medications, it may also 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 are currently utilized for bipolar disorder. Resources such as the National Institute of Mental Health can provide more information on such treatments.

How online therapy can help 

Regardless of the type of therapy you choose, 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 long commutes, gas costs, parking fees, and more. In addition, you receive the flexibility to choose between phone, video, or live chat sessions depending on your treatment goals and what’s most comfortable for you. 

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.