image by David Kessler (lic)Though bipolar illness is classified as a mental illness, its causes are very physical in nature. As mentioned previously, evidence strongly suggests that bipolar disorders are biologically based in the nervous, endocrine, and perhaps immune systems of the body. Because of this, the primary means of bipolar disorder treatment is medication. It functions by directly manipulating the chemistry in the brain and body. Talk therapies are not generally appropriate as the primary method of bipolar disorder treatment. However, they can be quite helpful and even essential when combined with medication treatments.
Often two types of medication are used in bipolar disorder treatment. These are antidepressants and mood stabilizers. Antidepressants help the patient to come back "up" and out of depressive states. Mood stabilizers help to keep patients' moods even and centered as much as possible. There are also a few medications that have anti-manic effects that are used occasionally. Patients with bipolar disorder who are treated with antidepressants alone have a heightened risk of swinging into mania. Patients treated with mood stabilizers alone often end up spending more time in dangerous depressive states than is necessary.
Doctors dealing with a new case of depression can never be sure whether they are dealing with regular major depression, or bipolar depression, as they basically take similar forms. It would be easy for doctors to appropriately diagnose patients if they came in during a period of mania. However, patients don't do this typically because they feel good during the periods of mania. A doctor may start a given patient on antidepressants, only to find that the patient becomes manic or hypomanic as a result. In such cases, the doctor must adjust and add bipolar medications to quickly and appropriately respond to the new, more complex bipolar symptom picture.
The list of bipolar medications is extensive. This is due to the complex and variable nature of the disorder, as well as individual reactions to medications (some of which have serious side effects). We describe and discuss the major medications used for bipolar disorder treatment in the following sections.