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Standard of Practice for Treating Bipolar Disorder

by Heather Webb

Overview

Bipolar disorder is a mental illness that causes extreme shifts in mood, activity levels, energy and the ability to do everyday tasks, according to the National Institute of Mental Health (NIMH). Also known as manic-depressive disorder, bipolar disorder has no cure, but it can be managed effectively with treatment. Bipolar disorder usually starts in the late teen or early adult years and is a lifelong disorder, but proper treatment allows people to lead full lives.
Mood Stabilizers

According to the NIMH, mood-stabilizing medications are the first choice of treatment for bipolar disorder. Mood stabilizers are prescribed to control symptoms of bipolar disorder and prevent recurrent manic and depressive episodes. Lithium, valproic acid, divalproex sodium, lamotrigine, gabapentin, topiramate and oxcarbazepine are mood stabilizers often prescribed for bipolar disorder. All of these medications, with the exception of lithium, are anticonvulsants, used to treat seizures, but they also help manage moods. Anticonvulsants have been linked to suicidal thoughts, so anyone with bipolar disorder should be monitored closely until the effect of the medication is known.

Atypical Psychotic and Antidepressant Medications

Atypical psychotic medications, such as olanzapine, aripiprazole, quetiapine and risperidone, are used to treat manic or mixed episodes (manic and depressive symptoms at the same time), according to NIMH. Antidepressant medications, such as fluoxetine, paroxetine, sertraline and bupropion, often are taken with mood stabilizers to control bipolar depression symptoms. If taken alone, antidepressants can cause a person to experience mania or hypomania or develop rapid cycling symptoms (having four or more episodes of mania, depression, hypomania or mixed symptoms in a year). For many people, however, treating bipolar disorder with antidepressants and mood stabilizers are no more effective than treating with mood stabilizers alone.
Psychotherapy

Medications for bipolar disorder often are combined with psychotherapy. According to the Mayo Clinic, there are three types of psychotherapy: cognitive behavioral therapy, group therapy and family therapy. Cognitive behavioral therapy focuses on identifying unhealthy, negative thoughts and behaviors and replacing them with healthy, positive ones. During cognitive behavioral therapy, you explore what triggers your symptoms, as well as develop coping strategies for stress and upsetting situations. Group therapy with others who have bipolar disorder provides a forum of communication between people in similar situations. Family therapy focuses on identifying and coping with stress within the family and involves you and your family members. According to the NIMH, interpersonal and social rhythm therapy helps people with bipolar disorder develop better relationship skills and manage their disorder with daily routines. Psychoeducation is another option of treatment, educating people with bipolar disorder, as well as their family members and caregivers, about the disorder and its treatments. Psychoeducation teaches people about the early signs of relapse so they can seek early treatment, preventing a full-blown episode.