You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence (NICE) website. Show
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at: The NHS doesn’t have to follow these recommendations. But they should have a good reason for not following them. What medications are recommended?Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms. The mood stabilisers we talk about in this factsheet are:
Mania and hypomania If you are taking antidepressants your doctor may advise you to withdraw from taking them. You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:
If the first antipsychotic you are given doesn’t work, then you should be offered a different antipsychotic medication from the list above. If a different antipsychotic doesn’t work, then you may be offered lithium to take alongside it. If the lithium doesn’t work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication. Sodium Valproate shouldn’t be given to girls or young women who might want to get pregnant. Your doctor should think about giving you benzodiazepine medication short term. Your doctor will suggest different dosages and combinations to you depending on what works best for you. Your personal preferences should be listened to. Depression
Fluoxetine is an antidepressant. Lamotrigine is an anticonvulsant medication. Your doctor can prescribe the above medication alongside:
If you would like to take medication, doctors will use different dosages and combinations depending on what works best for you. Your personal preferences should be listened to. You can find more information about:
What psychological treatments are recommended?If you have an episode of depression you should be offered medication and a high intensity talking therapy, such as:
What is cognitive behavioural therapy (CBT)? What is interpersonal therapy? You can find more information about ‘Talking therapies’ by clicking here. What are the long-term treatments for bipolar disorder?Bipolar disorder is a life-long and often recurring illness. You may need long term support to help manage your condition. What medication options are there?Your doctor will look at what medication worked for you during episodes of mania or depression. They should ask you whether you want to continue this treatment or if you want to change to lithium. Lithium usually works better than other types of medication for long-term treatment. Your doctor should give you information about how to take lithium safely. If lithium doesn't work well enough or causes you problems, you may be offered:
Your doctor should monitor your health. Physical health checks should be done at least once a year. These checks will include:
What psychological treatments are recommended?You should be offered a psychological therapy that is specially designed for bipolar disorder. You could have individual or group therapy. The aim of your therapy is to stop you from becoming unwell again. This is known as ‘relapse.’ Your therapy should help you to:
If you live with your family or are in close contact with them, you should also be offered ‘family intervention.’ Family intervention is where you and your family work with mental health professionals to help to manage relationships. This should be offered to people who you live with or who you are in close contact with. The support that you and your family are given will depend on what problems there are and what preferences you all have. This could be group family sessions or individual sessions. Your family should get support for 3 months to 1 year and should have at least 10 planned sessions. Is there any other support?Your mental health team should give you advice about exercise and healthy eating. If you want to return to work, you should be offered support with that including training. You should get this support if your care is managed by your GP or by your community mental health team. You might not be able to work or to find any. Your healthcare professionals should think about other activities that could help you back to employment in the future. Your healthcare team should help you to make a recovery plan. The plan should help you to identify early warning signs and triggers that may make you unwell again and ways of coping. Your plan should also have people to call if you become very distressed. You should be encouraged to make an ‘advance statement.’ This is an instruction to health professionals about what you would like to happen with your care if you ever lack mental capacity to make your own decisions. What is the Care Programme Approach?You may be assessed under the Care Programme Approach (CPA) if you have complex needs or you are vulnerable. CPA is a package of care that is used by secondary mental health services. You will have a care plan and someone to coordinate your care. All care plans should include a crisis plan. CPA aims to support your mental health recovery by helping you to understand your:
CPA should be available if you have a wide range of needs from different services or you are thought to be a high risk. Both you and your GP should be given a copy of your care plan. Your carers can be involved in your care plan and given a copy if you give your consent for this to happen. You can find more information about:
What if I’m not happy with my treatment?If you aren’t happy with your treatment you can:
There is more information about these options below. How can I speak to my doctor about my treatment options?You can speak to your doctor about your treatment. Explain why you aren’t happy with it. You could ask what other treatments you could try. Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you aren’t given this treatment, ask your doctor to explain why it isn’t suitable for you. What’s a second opinion?A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis. You don’t have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion. What is advocacy?An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard. There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like. NHS complaints advocates can help you if you want to complain about the NHS. You can search online to search for a local advocacy service. What is the Patient Advice and Liaison Service (PALS)?PALS is part of the NHS. They give information and support to patients and a good place to start if you’re not happy with any aspect of the NHS. You can find your local PALS’ details through this website link: How can I complain?You can complain about your treatment or any other aspect of the NHS verbally or in writing. See our information on ‘Complaining about the NHS or social services’ for more information. You can find out more about:
What can I do to manage my symptoms?You can learn to manage your symptoms by looking after yourself. Selfcare is how you take care of your diet, sleep, exercise, daily routine, relationships and how you are feeling. What lifestyle changes can I make?Making small lifestyle changes can improve your wellbeing and can help your recovery. Routine helps many people with their mental wellbeing. It will help to give a structure to your day and may give you a sense of purpose. This could be a simple routine such as eating at the same time each day, going to bed at the same time each day and buying food once per week. Your healthcare professionals should offer you a combined healthy eating, exercise and sleep programme. You can find more information about wellbeing any physical health at: What are support groups?You could join a support group. A support group is where people come together to share information, experiences and give each other support. You might be able to find a local group by searching online. The charity Bipolar UK have an online support group. They also have face to face support groups in some areas of the country. Their contact details are in the Useful contacts at the bottom of this page. Rethink Mental Illness have support groups in some areas. You can find out what is available in your area if you follow this link: www.rethink.org/about-us/our-support-groups. Or you can contact our General Enquiries team on 0121 522 7007 or [email protected] for more information. What are recovery colleges?Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your symptoms. They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college. But the college may inform your care team. Unfortunately, recovery colleges aren’t available in all areas. To see if there is a recovery college in your area you can use a search engine such as Google. What is a Wellness Recovery Action Plan (WRAP)?Learning to spot early signs of mania or depression is important in self-management. The idea of the WRAP is to help you stay well and achieve what you would like to. The WRAP looks at areas like how you are affected by your illness and what you could do to manage them. There are guides that can help with this. You can ask your healthcare professional to make one with you or ask them for a template of one. There is more information about the WRAP in the further reading section at the bottom of this page. What disorder includes both depression and mania?Overview. Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities.
What is it called when you are manic and depressed at the same time?Dysphoric mania is when you have symptoms of depression and mania at the same time. It's sometimes called a "mixed state," "mixed mania," "mixed episode," or "mixed features." While experts used to think it was rare, they now realize it's common. About 40% of people with bipolar disorder have dysphoric mania at times.
Does BPD have manic and depressive episodes?Although people with BPD often cycle through their emotions more quickly than people with bipolar disorder, it is possible for someone to experience a very short manic or depressive episode. It's even possible to experience both at the same time—this is called a mixed episode.
What mental illnesses cause manic episodes?You might have hypomania and/or mania on their own or as part of some mental health problems – including bipolar disorder, seasonal affective disorder, postpartum psychosis or schizoaffective disorder.
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