Bipolar disorder

Explains what bipolar disorder is, as well as different diagnoses and treatments. Offers information on how you can support someone with bipolar and tips for self-management.

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Treatment for bipolar disorder

The two main types of treatment for bipolar disorder are medication and talking therapies.

The exact combination of treatments offered will depend on whether you're managing a current mood episode, or managing your mental health in the longer term.

This page covers:

See our page on medication for bipolar disorder to find out more about the different types of medication you may be prescribed.

What treatment could help me manage a current episode?

Your treatment for a bipolar usually depends on what kind of episode you're experiencing.

During depressive episodes:

Your doctor is likely to offer you medication. This might be new medication or a change to your current bipolar medication.
Your doctor might offer you a structured psychological treatment that's used to treat depression, such as cognitive behavioural therapy (CBT).

During manic or hypomanic episodes:

Your doctor is likely to offer you medication. This might be new medication or a change to your current bipolar medication.
Your doctor is unlikely to offer a talking treatment if you’re currently experiencing a manic or hypomanic episode.

See our pages depression or hypomania and mania for more information on these treatments, and tips for taking care of yourself.

“When my mood dips, CBT helps me to cope to some extent, but it doesn’t really help me get out of this state and it doesn't prevent the mood swings – that’s what my medication does.”

What treatment could help me in a crisis?

You may need to access crisis services if:

You start to feel very unwell
A mood episode is lasting for a long time
Your regular treatment isn't helping

Crisis services may include:

Emergency support, such as going to A&E
Support from a crisis resolution and home treatment (CRHT) team
Hospital admission

For more information about your options in a crisis, see our pages on crisis services.

What treatment could help me in the longer term?

Long-term treatment aims to help you maintain stable moods and manage your symptoms. As you start to feel more stable, most of your support could come from a community mental health team or your GP. But your GP should also put you in touch with a mental health specialist.

Health professionals should work with you to help you identify:

Clear emotional and social recovery goals. You can work towards these, regularly reflect on them and revise them with your doctor.
A crisis plan. This helps you know what to do if you experience any of your early warning signs or triggers, or start feeling very distressed.
How you feel day-to-day. It helps to be aware of how best to manage your mood and notice any changes.
A medication plan. This includes dates where you can review your dose, how well the medication is working and any side effects.

If you're receiving a talking therapy, you might set some of these goals with your therapist. You should share these goals with your GP. You may also want to share them with others in your life, such as your family, friends, partner or carer.

“It has been 13 years since I was hospitalised or sectioned, and I've done so well. My medication is working.”

Talking therapies for bipolar disorder

Your doctor might offer one of several talking therapies to help you manage bipolar disorder in the longer term. These could include:

Cognitive behavioural therapy (CBT). Looks at how your feelings, thoughts and behaviour influence each other and how you can change these patterns.
Interpersonal therapy. Focuses on your relationships with other people. Looks at how your relationships affect your thoughts, feelings and behaviour – and how they affect your relationships.
Behavioural couples therapy. Focuses on recognising and trying to resolve emotional problems between partners.
Individual psychoeducation. Involves a brief intervention helping you to identify triggers, spot warning signs and develop coping strategies.
Group psychoeducation. Involves working in a group of people with shared experiences. Aims to build knowledge about bipolar disorder and self-management. It is led by a trained therapist.
Family-focused therapy. Involves working as a family to look at behavioural traits, identify risks and build communication and problem-solving skills.

Some of these treatments are more widely available than others. It can also depend on what you and your doctor agree would be most useful for you.

For more information, see our pages on talking therapies.

How can talking therapies help in the longer term?

In the longer term, talking therapies for bipolar disorder can help you to:

Understand, make sense of, or find meaning in your bipolar disorder
Reflect on the impact of bipolar disorder throughout your life
Identify early warning signs and symptoms
Develop strategies to cope with early symptoms, triggers and episodes
Make a crisis plan
Set goals and plans for staying well

“In a lot of ways being so in tune with my brain is very useful; I can often spot a mood shift pretty early on which can help me try to prevent it spiralling out of control.”

Electroconvulsive therapy for bipolar disorder

Doctors should only consider electroconvulsive therapy (ECT) as a treatment option for bipolar disorder in extreme circumstances.

The National Institute for Health and Care Excellence (NICE) produces guidelines on best practice in healthcare. It advises that doctors could consider ECT if you meet both of the following criteria:

You're experiencing a long and severe period of depression, or a long period of mania.
Other treatments have not worked, or the situation is life-threatening.

If you feel like you're in this situation, you should discuss it with your doctor. They must explain ECT in a clear and accessible way before you make any decisions.

See our pages on ECT to find out more. Our pages on consent to treatment and the Mental Capacity Act 2005 also have information on treatment, consent and your rights.