For bipolar depression, the safest and often most effective approach involves mood stabilizers (like lithium, lamotrigine, valproate) or atypical antipsychotics (like quetiapine, lurasidone), with antidepressants used cautiously, typically added to a mood stabilizer to prevent triggering mania, with SSRIs (like fluoxetine, sertraline) or bupropion being common choices, but lurasidone is noted for fewer metabolic side effects.
Mood-stabilizing medicines help control manic or hypomanic episodes. They also may help depressive bouts. Examples include lithium (Lithobid), valproic acid, divalproex sodium (Depakote, Depakote ER), carbamazepine (Tegretol, Tegretol XR, Equetro, others) and lamotrigine (Lamictal).
Lithium is one of the most widely prescribed and studied medications for treating bipolar disorder. Lithium is a natural salt and will reduce symptoms of mania within two weeks of starting therapy, but it may take weeks to months before the manic symptoms are fully managed.
CAPLYTA is proven to deliver significant symptom relief in adults with bipolar I or bipolar II depression. CAPLYTA can be taken alone or with lithium or valproate. Based on total prescriptions dispensed across approved indications since CAPLYTA was FDA‑approved in 2019. MDD indication was approved in November 2025.
Lurasidone has demonstrated effectiveness in treating bipolar depression with minimal adverse effects and a low metabolic risk profile. Its low affinity for acetylcholine and histamine receptors 9. produces minimal risk of cognitive deficits and weight gain.
Lithium has been the gold standard for the treatment of bipolar disorder for seven decades due to its efficacy in preventing mood episodes and reducing risk of dying by suicide.
However, many people with bipolar disorder have found the following tools to be helpful in reducing symptoms and maintaining wellness:
Introduction
1. Lithium. Lithium (Lithobid) is a medication that's a type of mood stabilizer. It's been approved since 1970, but it remains a first-choice treatment option today.
Conditions such as borderline personality disorder, major depressive disorder, ADHD, and schizoaffective disorder may mimic aspects of bipolar disorder, including mood swings, impulsivity, or episodes of depression and mania-like behavior.
While some individuals may choose to manage their bipolar disorder without medication, this comes with significant risks. Untreated or unmedicated bipolar disorder can lead to severe consequences and dangerous behaviors.
Olanzapine, lamotrigine, divalproex sodium, and olanzapine/fluoxetine combination have been found to be effective in the treatment of nonspecific anxiety symptoms that are comorbid with BD. Lithium is not likely to be effective as monotherapy; augmentation of lithium with lamotrigine or olanzapine may improve efficacy.
Bipolar disorder type I
It is characterized by manic episodes lasting at least one week in duration or episodes that lead to hospitalization or other significant impairments in occupational or social functioning.
Bipolar disorder is the most likely psychiatric disorder to be passed down from family. If one parent has bipolar disorder, there's a 10% chance that their child will develop the illness. If both parents have bipolar disorder, the likelihood of their child developing bipolar disorder rises to 40%.
But as people with bipolar disorder get older, they become “rapid cyclers”—that is, they can cycle from the heights of mania to the depths of depression, sometimes in days or weeks as opposed to the months or years typical in the younger- or middle-aged bipolar patient.
Factors that may raise the risk of getting bipolar disorder or cause the first episode include: Having a first-degree relative, such as a parent or sibling, with bipolar disorder. Periods of high stress, such as the death of a loved one or another traumatic event. Drug or alcohol misuse.
There is no clear cause of bipolar disorder. Mental health experts think it's a result of chemical imbalances in the brain. It seems to run in families, but no genes have yet been linked to it. It causes unusual mood swings.
Antipsychotics are commonly prescribed to help with symptoms such as hallucinations, delusions, or racing thoughts, but can also be prescribed for individuals without those symptoms. Some antipsychotics are considered mood stabilizers because they, too, even out the highs and lows.
Lithium has an average rating of 7.3 out of 10 from a total of 503 ratings on Drugs.com. 66% of reviewers reported a positive effect, while 20% reported a negative effect. Vraylar has an average rating of 6.1 out of 10 from a total of 572 ratings on Drugs.com.
Stick to a routine
Having a routine can help you feel calmer if your mood is high, motivated if your mood is low, and generally more stable. Your routine could include: Day-to-day activities, such as the time you eat meals and go to sleep. Making time for relaxation, mindfulness, hobbies and social plans.
Many people with bipolar disorder don't have high levels of social support because depressive episodes can lead to them to shut themselves away and manic episodes can lead them to push people away, making it difficult to get a good support system in place.
How many hours should a bipolar person sleep? People should try to sleep at least 7 hours per night, regardless of whether they have a condition such as bipolar disorder.
Conclusions. Our study highlights the significant role that vitamin D, B9, and B12 deficiencies play in the mental and metabolic health of patients with schizophrenia, major depressive disorder, and bipolar disorder.
You can use a 48 hour rule where you wait at least 2 full days with 2 nights sleep before acting on risky decisions. Review your decision to avoid a tempting, but risky, behaviour.
A “Favorite Person” is someone with whom a person with BPD forms an intense emotional attachment. This relationship is often marked by a combination of deep admiration, dependence and fear of abandonment. The FP becomes a central figure in the individual's life, often absorbing much of their emotional energy and focus.