How to Pick a Treatment for Bipolar Disorder

On Monday, I talked about what to do if you’ve just been diagnosed with bipolar disorder, and if you’ve read that piece then you know, I recommended a lot of breathing and thinking. I notably did not suggest decision-making.

Well, you can’t live in a yoga studio forever.

What Treatments Are Available for Bipolar Disorder?

There are many. Many, many. Of the many, these can be broken down into therapy, medical, lifestyle, and alternative.

Therapy for Bipolar Disorder

Therapy for bipolar disorder comes in various forms and pretty much any of them can help in some way. Therapy is used to understand what triggers mood, and how we can help eliminate that trigger psychologically. Therapy is also used as a professional support system that can provide support in a way that the loved one in the bipolar’s life may not be able to. Therapy can also be used by those around the bipolar to help understand the disorder, how to help and to get support of their own. There is also shorter-term therapy such as cognitive-behavioral therapy (CBT) that aims to give people concrete tools with which to handle moods and triggers.

Who it’s good for: people who want to get an understanding of mood causes and to gain tools with which to handle bipolar moods. I don’t know anyone who can’t benefit by investing in therapy.

Medication Options for Bipolar Disorder

In medical options, I include everything with supporting scientific evidence. This encompasses a wide range of treatment options but medication is the most common.

Medication is, for better or worse, something almost all bipolars will be on and, most of us, will have to remain on. I understand the backlash to this idea, but I suggest getting a handle on it, at least as a short-term bipolar treatment during a serious episode.

Likely first-line bipolar medication treatments are going to be lithium, an anticonvulsant (also called a mood-stabilizer) or an antipsychotic medication. Your doctor’s first choice will depend on how you present – whether you’re depressed or manic. In the short-term, I recommend selecting the one with the most statistical evidence behind it, you will learn more as you go. Keep in mind that these drugs can be very effective - quickly - which is good news when you’re in a desperate situation. Yes, long-term, there are many other issues to consider.

Who it’s good for: people who are in crisis or who need help to consistently stabilize mood (this describes almost all people with bipolar disorder).

Lifestyle Changes for Bipolar Disorder

Lifestyle components are something that every bipolar should learn about. While a daily routine of eating, sleeping, and exercising is important for everyone, bipolars can be particularly sensitive to these things. Because bipolar disorder is basically moods out of balance, balance and consistency has to exist in the parts of the world we can control. Of particular import is sleep routine.

Who it’s good for: everyone!

Alternative Treatments for Bipolar Disorder

Finally, there are alternative treatments for bipolar disorder available, as there are for any condition. As these don’t have scientific evidence behind them, I can’t recommend them and I particularly don’t recommend them if you’re in a crisis. Sorry.

Who it’s good for: people who wish to pursue alternative treatment methods.

Initial Bipolar Treatment Recommendations

From everything we know, the most effective treatment for bipolar disorder is a combination of therapy and medication, and most reputable doctors will tell you the same thing. If at all possible, this needs to be the initial approach. Things may change down the road, but this is a good place to start. Lifestyle changes can be integrated into this approach as well, but this can take time.

Therapy, lifestyle and medical options each require greater elaboration, but as a starting point, that’s where to look. The important part is to work with your doctor, preferably a bipolar specialist, to pick a bipolar medication treatment and to find a therapist who specializes in bipolar disorder to help you through this process.

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