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Although there is no known cure for bipolar disorder, it is among the most treatable of mental illnesses. There is no known way to prevent bipolar disorder itself, but individual episodes may be prevented with the use of medications. Hospitalization may be necessary during severe episodes.

Medications are generally the first line of treatment for bipolar disorder. They are used to quickly control and eliminate dangerous or disabling symptoms and prevent further episodes. If thyroid dysfunction is present, it must be treated before symptoms of bipolar disorder can be addressed.

Mood stabilizing drugs are the primary medications for bipolar disorder. Different types of mood stabilizers may be more effective in different patients and a second mood stabilizer may be added if a single medication is not effective. Lithium is the most commonly used mood stabilizer, and generally the first medication used to treat bipolar disorder. It is typically more effective when started early in the course of the condition. It is also effective in preventing new episodes of both mania and depression and appears effective in reducing suicide among patients with bipolar disorder. However, lithium is not very effective in controlling acute manic symptoms in patients with mixed episodes.

Anticonvulsant drugs may be used for difficult and complex types of bipolar disorder (e.g., rapid cycling). They may also be used when other conditions, such as substance abuse, are present, or if there is a concern about lithium side effects. Lifelong maintenance with mood stabilizers is generally required to prevent new episodes and reduce the likelihood that subsequent episodes will be more severe.

Antidepressants are known to cause or worsen manic episodes in bipolar patients. However, they may occasionally be carefully used with mood stabilizers in the treatment of depressive episodes. Monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs) appear to be the safest antidepressants for use in the treatment of bipolar disorder.

Patients should be aware that a physician may need to adjust the dosage or change medications to achieve the best results with minimal side effects. In addition, the U.S. Food and Drug Administration (FDA) has advised that antidepressants may increase the risk of suicidal thinking in some patients and all people being treated with them should be monitored closely for unusual changes in behavior.

Other possible treatments for bipolar disorder are currently being studied. For instance, researchers are investigating whether certain antipsychotic medications are effective in reducing symptoms of the condition. In addition, omega-3 fatty acids, which are found in fish oil and flaxseed oil, may have benefits when prescribed with conventional medication. However, the research is not conclusive and further study is needed regarding the benefits or risks of omega-3 fatty acids.

Psychotherapy is typically only used when the most severe symptoms are under control. It is often effective in medication-stabilized patients. Psychotherapy encourages patients to take medication properly, assists patients and families in establishing and maintaining appropriate behavioral boundaries and provides counseling and support. Psychotherapies commonly used in the treatment of bipolar disorder include:

• Cognitive behavioral therapy (CBT). The patient learns to change and control inappropriate thought patterns and behaviors.
  
  
• Psychoeducation. Teaches patients about bipolar disorder, its treatment and how to recognize early signs of new episodes so that early intervention can take place. This is often helpful for family members of patients with bipolar disorder as well.
  
  
• Family therapy. Reduces the levels of distress within the family that may contribute to or result from the symptoms of bipolar disorder.
  
  
• Interpersonal therapy (IPT) and social rhythm therapy. Improve the interpersonal relationships of patients and normalize their daily routines and sleep schedules to give them more control of their lives and their condition.
  
  
• Group therapy. Focuses on acceptance of bipolar disorder and the need for long-term medication. This may include families.