The main treatments for bipolar disorder include medications and counseling (psychotherapy) to manage symptoms, and may also include educational and support groups, mood stabilizers. Antipsychotic medications are sometimes prescribed to treat episodes of mania. They can also be used as long-term mood stabilizers. Quetiapine can also be used for long-term bipolar depression.
Pioneering lithium and chlorpromazine trials were conducted in the 1970s and were followed by a focus on antiepileptics (e.g., valproate and carbamazepine) in the 1980s and 1990s. There are few trials that directly evaluate the comparative efficacy of different second-generation antipsychotics, but a meta-analysis of mixed treatments compared 13 drugs studied in 68 randomized controlled trials (16,073 participants). Antipsychotic drugs appear to be better than anticonvulsants and lithium in the treatment of manic episodes. Olanzapine, risperidone and haloperidol appear to have the best profile of currently available agents (Figure).
The best treatment for bipolar disorders is a combination of medications and psychotherapy tailored to the individual. While bipolar illness can't be cured, a consistent treatment plan can help you lead an active and healthy life. Lithium is one of the most commonly prescribed and studied drugs to treat bipolar disorder. Lithium is a natural salt and will reduce symptoms of mania within two weeks of starting treatment, but it may take weeks or months before manic symptoms are fully controlled.
Because of this, healthcare providers often prescribe other medications, such as antipsychotics or antidepressants, to help control symptoms. Therapy is essential to treat bipolar disorder and the problems it has caused in your life. By working with a therapist, you can learn to cope with difficult or uncomfortable feelings, repair your relationships, manage stress, and regulate your mood. And that, for many people with bipolar disorder, a stable and consistent routine often allows creativity to flow.
The defining sign of bipolar I disorder is a manic episode that lasts at least a week, while people with bipolar II disorder or cyclothymia experience hypomanic episodes. If you're thinking about going the natural route, it's important to talk to your doctor, as bipolar disorder is a progressive disease and symptoms can seriously worsen if not treated with FDA-approved medications or therapies. If you have been diagnosed with bipolar disorder, you and your doctor will work together to find the right medication or combination of medications for your needs. Long-term treatment with antidepressants in bipolar disorder tends to be recommended only when the initial response is clear and there are no current or emerging signs of mania or hypomania.
Research shows that antidepressants are not particularly effective in treating bipolar depression. Lithium, introduced by John Cade in 1949, remains the best-established long-term treatment for bipolar disorder. However, the Royal College of Paediatrics and Child Health states that other medications for bipolar disorder may be prescribed to children if recommended by their doctor. With these mixed results, additional clinical trials are needed to better clarify the role that marijuana could play in the treatment of bipolar disorder.
If you have been diagnosed with bipolar disorder, you will need to see your health care team regularly throughout your life to make sure your treatment is working well for you. Because people with cyclothymia have a higher risk of developing full-blown bipolar disorder, it's a condition that needs to be managed and treated. Episodes of depression are treated slightly differently in bipolar disorder, since taking antidepressants alone can cause a relapse. Identifying a new mental health condition, Disruptive Mood Dysregulation Disorder (DMDD), could affect how bipolar disorder is diagnosed in children.
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