About 5.7 million adult Americans or about 2.6% of the U.S. population is affected by bipolar disorder [1]. It is a medical condition that causes a person to cycle through periods of depression and elevated mood. Formerly known as manic-depressive illness or manic depression, it causes intense shifts in mood, energy levels, and behavior.
The condition is manageable with medications, talk therapy, lifestyle changes, and other treatments. Read on to learn more about it and how it can be treated.
What Is Bipolar Disorder?
Bipolar disorder typically consists of three states [2]:
- A high state, called mania
- A low state, called depression
- A well state, during which many people feel normal and function well
All people experience emotional ups and downs, but the mood swings for people with bipolar disorder are often more extreme. Bipolar 1 is marked by having at least one manic episode. Bipolar 2 has a milder form of mania called hypomania, plus a depressive episode. Cyclothymia has hypomania and depression over two years, but not as severely as the other types.
There are several types of bipolar disorder as defined by the Diagnostic and Statistical Manual DSM-5 as shown below [3]:
| Type | Characteristics |
| Bipolar 1 | • At least one manic episode in your life for at least a week with or without ever experiencing a depressive episode. • Manic episode is characterized by: • Abnormally elevated, expansive, or irritable mood • Increased goal-directed activity or energy • At least 3 (or 4 if only irritable) of the following: • Inflated self-esteem or grandiosity • Decreased need for sleep • More talkative than usual • Flight of ideas or racing thoughts • Distractibility • Increase in goal-directed activity or psychomotor agitation • Excessive involvement in risky activities • Symptoms cause significant impairment or require hospitalization • May have hypomanic or major depressive episodes, but not required for diagnosis |
| Bipolar 2 | • At least one hypomanic episode (lasting at least 4 consecutive days) • At least one major depressive episode • No history of manic episodes • Symptoms cause clinically significant distress or impairment |
| Cyclothymia | • Hypomanic and depressive symptoms over at least 2 years • Symptoms don’t meet full criteria for bipolar I or II • No more than 2 months without symptoms |
| Other Factors | • Rapid cycling: 4 or more mood episodes in 12 months • Mixed features: concurrent symptoms of opposite mood polarity • With anxious distress, melancholic features, or atypical features |
How Is Bipolar Disorder Treated?
Bipolar disorder treatment typically involves a combination of medication and psychotherapy. The main goals are to stabilize mood, manage symptoms, and prevent relapses. Here’s an overview of the primary treatment approaches [4] [5]:
Medication Treatment
Mood Stabilizers
Mood stabilizers are the cornerstone of bipolar disorder treatment. The most commonly prescribed mood stabilizers include:
- Lithium: Considered a first-line treatment for both manic and depressive episodes, as well as for suicide prevention.
- Valproate (Depakene): Effective for managing manic episodes.
- Lamotrigine (Lamictal): Particularly useful for preventing depressive episodes.
Antipsychotics
Atypical antipsychotics are often used in combination with mood stabilizers or as monotherapy. Some commonly prescribed antipsychotics include:
- Quetiapine (Seroquel): Effective for both manic and depressive episodes.
- Olanzapine (Zyprexa): Used for managing manic episodes and as maintenance treatment.
- Risperidone (Risperdal): Available in long-acting injectable form for maintenance treatment.
Antidepressants
Antidepressants are sometimes used cautiously in bipolar depression, always in combination with a mood stabilizer or antipsychotic to prevent switching to mania.
Psychosocial Interventions
Psychoeducation
Individual or group psychoeducation improves treatment adherence and prevents relapses.
Cognitive Behavioral Therapy (CBT)
CBT helps identify and change negative thought patterns and behaviors associated with bipolar disorder.
Interpersonal and Social Rhythm Therapy (IPSRT)
IPSRT focuses on regularizing daily routines and improving interpersonal relationships to prevent mood episodes.
Other Treatment Options
Transcranial Magnetic Stimulation (TMS)
TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain, primarily used to treat depression for those people who do not respond to antidepressants. It is also used for other neurological or psychiatric disorders.
Electroconvulsive Therapy (ECT)
ECT may be considered for severe depression, mania, or when medication options are limited.
Treatment Phases
- Acute Phase: The goal is to treat the current manic, hypomanic, or depressive episode.
- Continuation Phase: Aims to prevent relapse of the most recent mood episode.
- Maintenance Phase: Focuses on preventing new mood episodes and improving overall functioning.
Treatment plans are individualized and may require adjustments over time. Ongoing medication management and regular follow-ups with healthcare providers are essential for optimal outcomes in bipolar disorder treatment.
Improving Mental Health in Utah
Treatment for suicidal ideation is available in Utah. Are you or a loved one looking for a compassionate space to heal from anxiety, trauma, PTSD, other mental health conditions, or addictions? Our licensed trauma-informed professional therapists and counselors at Corner Canyon Health Centers can provide compassionate help using a range of therapeutic and holistic techniques.
Reach out to our Admissions team now at Corner Canyon. We’re in a peaceful setting bordered by the beautiful Wasatch Mountains.
Sources
[1] ClevelandClinic. Bipolar Disorder.
[2] CAMH. Bipolar Disorder.
[3] Table 12DSM-IV to DSM-5 Bipolar I Disorder Comparison.
[4] Connolly KR, Thase ME. The clinical management of bipolar disorder: a review of evidence-based guidelines. Prim Care Companion CNS Disord. 2011;13(4):PCC.10r01097.
[5] US Department of Veterans Affairs. VA/DoD Clinical Practice Guidelines. Management of Bipolar Disorder. Quick Reference Guide Version 2.0 | 2023.
