Key takeaways
- Medications are often the first-line treatment approach for bipolar disorder.
- Drug interventions are most effective when combined with psychotherapy, such as cognitive behavioral therapy or family-focused therapy.
- Emerging treatments, such as non-medication strategies, may also help manage symptoms of bipolar disorder.
Living with bipolar disorder can be challenging. The fluctuating highs and lows can leave you feeling on top of the world one moment, then plummeting swiftly into depression the next. And because the rapid shifts in mood are out of your control, you may wonder what your treatment options are and whether treating bipolar disorder without medication is a possibility.
Medications are often a first-line treatment approach for bipolar disorder, according to a journal article in American Family Physician, but there are a number of other therapeutic interventions to consider for a comprehensive approach to managing your condition.
In this article, we’ll take a look at some ways to help manage bipolar disorder with and without medication and other factors you may want to consider to manage and prioritize your mental health.
For most people, bipolar disorder is a chronic condition that requires lifelong treatment, much like other long-standing health conditions.
Even though symptoms may wax and wane in severity, typically, the condition doesn’t go away on its own. Those with bipolar disorder may find day-to-day tasks challenging, have a difficult time maintaining a job or relationships, and have an increased risk of suicide, according to the
Medications
Medications aimed at stabilizing the mood, such as lithium, antipsychotics and anticonvulsants, are widely considered the most effective treatments for bipolar disorder. Typically, your healthcare professional will recommend that you continue your bipolar medications indefinitely to reduce or prevent symptom recurrence, even if you begin to feel better.
Other treatments that may help manage the depressive symptoms associated with bipolar disorder include pramipexole, a medication typically prescribed to treat Parkinson’s disease, and N-acetylcysteine (NAC), a drug prescribed to treat acetaminophen overdose and thin mucus associated with certain respiratory conditions. NAC also comes in an over-the-counter supplement.
With time, you and your doctor may find that a lower dose is still effective at keeping your symptoms in check.
Medical Perspective“Your bipolar medication may take several weeks to be fully effective. But initially, you will notice some improvements in your symptoms, such as more consistent sleep, less extremes in mood, and more stable energy levels.”
Learn the difference between bipolar 1 disorder and bipolar 2 disorder here.
Quotes represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Psychotherapy
In addition to medication strategies, psychotherapy can be beneficial to help people living with bipolar disorder develop the skills necessary to live with the condition. Research demonstrates that the majority of people who treat their bipolar disorder with a combination of medication and psychotherapy have better outcomes than those who treat it with medication alone.
Some types of psychotherapies that have shown to help improve outcomes for people with bipolar disorder include:
- Cognitive behavioral therapy (CBT): CBT is a type of talk therapy that helps identify thoughts, behaviors, and beliefs that may be contributing to the condition.
- Family-focused therapy (FFT): FFT is a form of talk therapy that helps people living with bipolar disorder and their family members gain a better understanding of the illness and improve relationships through building communication and problem-solving skills.
- Interpersonal and social rhythm therapy (IPSRT): IPSRT is a form of talk therapy that focuses on improving relationships, as well as helping to establish a more consistent daily routine.
In recent years, several new medication and non-medication strategies for managing bipolar disorder have emerged, particularly for those living with bipolar disorder with depressive episodes that have been resistant to other types of treatment.
Some of those emerging treatment options include:
- Electroconvulsive therapy (ECT): Performed under general anesthesia, ECT is a medical procedure where small electrical currents are passed through the brain to trigger a brief, controlled seizure intentionally. The procedure is thought to rapidly shift brain chemistry.
- Transcranial magnetic stimulation (TMS): TMS uses magnetic pulses to stimulate specific regions of the brain that control mood.
- Ketamine: Ketamine is an anesthetic that, when used in low medical doses, may help the brain rewire areas that have been damaged by long-term mood swings. Ketamine is administered via intravenous (IV) infusion. A similar version of the drug, esketamine, is available as a nasal spray.
- Vagal nerve stimulation (VNS): With VNS, A small device is implanted under the skin that sends signals to the brain via the vagus nerve, which may help to stabilize mood.
- Thyroid medication: Supplementing with thyroid hormone supports metabolism and energy levels and may reduce depressive symptoms and help other treatments work more effectively.
Managing bipolar disorder is rarely a one-size-fits-all approach, and the most successful treatment plans usually involve a combination of different tools. While medications are considered the gold standard to manage bipolar long term, emerging treatment options, such as ECT, TMS, and ketamine, offer more possibilities for those who haven’t found relief through traditional means or aren’t able to tolerate medication side effects.
By pairing medical treatments with talk therapies, including CBT or IPSRT, you can learn valuable skills to help manage mood fluctuations associated with your bipolar disorder.
Disclaimer: While Healthline strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.