If left untreated, manic or depressive phases may last for months and even as long as one year. Depressive phases are particularly harmful as they may lead to suicidal thoughts and urges to act on them. With treatment, symptoms usually subside after around three months and a stable mood is restored.

Treatment outline

• Antidepressant medication.
• Mood stabilizers to prevent episodes of mania, hypomania, depression and establish a stable mood. Mood stabilizers may need to be taken daily and over long periods. One of the most commonly used agents of this class, lithium, is usually prescribed for periods of 6 months. The use of lithium may lead to severe side effects including vomiting and diarrhea and therefore requires regular monitoring. In addition, the drug should not be withdrawn or stopped abruptly as this may cause a flare-up of symptoms.
• Anticonvulsant drugs can also act as mood stabilizers.
• Antipsychotics for the treatment of psychosis and mania may also be used.
• Talking therapy, cognitive behavioural therapy, family and group therapy, and counselling are all useful approaches for treating patients with bipolar disorder.
• In individuals who experience a rapid cycling of high and low moods, combination therpy is prescribed.
• Lifestyle changes including regular exercise, adoption of a healthy and balanced diet, cessation of smoking or substance abuse, and reduction of alcohol and caffeine intake.