learn: bipolar symptoms


Guidelines, advice
and responsibility

The National Institute for Health and Care Excellence (NICE) produces guidelines for how health professionals should treat certain conditions.

Medical Practitioners don’t have to follow these recommendations. But they should have a good reason for not following them.


Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.

• Lithium
• Certain antipsychotic medication
• Certain anticonvulsive medication
• Certain benzodiazepine medication

Medication is important but it won't work on it's own...

Symptom Care

Depression and Anxiety

Depressive symptoms are eased with Antidepressant or Anticonvulsant medication.

Psychological Treatments

Medication alone won’t fix Bipolar Disorder, sufferers need mental and emotional support

Mania and Hypomania

Successful treatment normally includes Mood Stabiliser or Antipsychotic medication

learn: treating bipolar

Depression and Anxiety

Sadly there is no ‘Wonder-Drug’ medication for Bipolar. Your doctor will suggest different dosages and combinations to you depending on what works best for you. This applies to treating all symptoms of Bipolar Disorder. On diagnosis, your doctor should offer you medication to treat your depressive symptoms.

You may be offered the following medication:


Fluoxetine is an antidepressant. Lamotrigine is an anticonvulsant.

Often taking just a single type of medication won’t alleviate your symptoms. If this is the case, your doctor may prescribe the following additional medication:

Lithium, or
Sodium Valproate

Sodium Valproate an anticonvulsive drug, shouldn’t be given to young women who might want to get pregnant.  Your own preferences should be listened to.

learn: treating bipolar

Mania and Hypomania

You should be offered a mood stabiliser to help manage your mania or hypomania. Doctors may refer to them as ‘antimanic’ medication. If you are taking antidepressants your doctor will advise you to withdraw from taking them as this could exasperate symptoms.

You will usually be offered an antipsychotic medication at first. Common antipsychotics used for bipolar disorder treatment are:


As mentioned, not all drugs are affective on all sufferers therefore you may be offered an alternative. As with depression, if an antipsychotic drug alone doesn’t work, you may be offered lithium or Sodium valproate to take alongside it.

Remember, doctors will use different dosages and combinations depending on what works best for you and Sodium Valproate shouldn’t be given to young women who might want to get pregnant. Your personal preferences should be listened to.

learn: treating bipolar

Psychological Route

If you have an episode of depression, you should be offered medication and a high intensity talking therapy

If you have an episode of depression, you should be offered
medication and a high intensity talking therapy, such as:

Therapy (IPT)

Interpersonal therapy is a talking therapy that focuses on you and your relationships with other people.

Cognitive Behavioural
Therapy (CBT)

CBT is a therapy that can help you manage your problems by changing the way you think and behave.

What psychological care is 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:

understand your condition,
think about the effect that your thoughts and behaviour have onyour mood,
monitor your mood, thoughts and behaviour,
think about risk and distress,
make plans to stay well,
make plans to follow if you start to become unwell,
be aware of how you communicate,
manage difficulties you may have in day to day life.

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.

learn: coping mechanisms

Mental Training