Bipolar disorder

Explains what bipolar disorder is, what kinds of treatment are available, and how you can help yourself cope. Also provides guidance on what friends and family can do to help.

Your stories

What it felt like to be diagnosed with bipolar disorder

Megan shares her experience of struggling with her mental health and receiving a diagnosis.

Megan
Posted on 14/05/2014

Caring for my husband with bipolar

Kate Devlin
Posted on 11/06/2015

My battle with bipolar and medication

Ruth talks about her experiences with bipolar and how she came to terms with the diagnosis.

Posted on 07/11/2014

What treatments can help?

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – suggests that treatment for bipolar disorder should include both talking treatments and medication. This page covers:

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

For information on drug treatments, see our separate page on medication for bipolar disorder.

[I find] the biggest step is accepting that is who you are. Changing your ways with meds and therapy is a hard slog.

What treatment could I get to manage a current episode?

This will usually depend on what kind of episode you're experiencing.

During depressive episodes

  • You're likely to be offered medication – this might be new medication or adjusting your current medication.
  • You might also be offered a structured psychological treatment that's proven to help with depression, such as cognitive behavioural therapy (CBT). (See our pages on CBT for more information about this treatment.)

(See our pages on depression for more information on treatments and self-care tips for depression.)

During manic or hypomanic episodes

  • You're likely to be offered medication – this might be new medication or adjusting your current medication.
  • You're unlikely to be offered a talking treatment if you are currently experiencing a manic or hypomanic episode.

(See our pages on hypomania and mania for more information on treatments and self-care tips for mania and hypomania.)

What should my long-term treatment plan involve?

The aim of treatment should be to help you maintain stable moods and manage your symptoms well. As you start to feel more stable, the majority of your support could come from a community mental health team or your GP, although you should still be in touch with a mental health specialist. Your health professionals should work with you to help you identify:

  • Clear emotional and social recovery goals for you to work towards.
  • A crisis plan, so you know what to do if you experience any of your early warning signs, triggers or begin to feel very distressed.
  • How you feel day-to-day, so you can be aware of how best to manage your mood and notice any changes.
  • A medication plan, including dates where you can review your dose, how well the medication is working and any side effects you experience.

If you are receiving a talking treatment, 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 your family, friends and carer if you have one.

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

Which talking treatments might I be offered?

There are several talking treatments you might be offered to help you manage your bipolar disorder in the long term. These include:

  • Enhanced relapse prevention/individual psychoeducation – this is a brief intervention to help you learn coping strategies.
  • Group psychoeducation – this involves working in a group of people with shared experiences, led by a trained therapist, to build up knowledge about bipolar disorder and self-management.
  • Interpersonal and social rhythm therapy – this looks at any problems you have in communicating and interacting with other people, or relationship problems. It aims to help you balance your sleep cycle, work-life balance and daily routines.
  • Family-focused therapy – this 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. What you are offered can also depend on what you and your doctor agree would be most useful for you.

(For more information on different types of talking treatments, including how to access them, see our pages on talking treatments.)

How can talking treatments help in the long term?

Talking treatments can can help you:

  • understand your bipolar disorder, and reflect on the impact it has had 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

Bipolar disorder is one of those things that if you have it and it's well controlled, you can use it productively... it's in [my] best interest to take [my] meds, see [my] shrink regularly and stay well.

What treatment can I get in a crisis?

If you start to feel very unwell, or if an episode of depression or mania is lasting for a long time and your regular treatment isn't working, you may need to access crisis services to help you get through it. This may include:

(See our pages on crisis services for more detailed information about your options in a crisis, how to access services, and how you can plan ahead.)

Is ECT ever used to treat bipolar disorder?

Electroconvulsive therapy (ECT) should only be considered a treatment option for bipolar disorder in extreme circumstances. According to NICE guidelines, this could be if:

  • you're experiencing a long and severe period of depression, or a long period of mania, AND
  • other treatments have not worked, or the situation is life-threatening

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

(See our pages on ECT for more information about this treatment and when it can be performed. Also see our legal pages on consent to treatment and the Mental Capacity Act 2005 for information about your legal rights regarding treatment.)


This information was published in October 2015. We will revise it in 2018.


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