The 7 Most Effective Ways to Manage Bipolar 1 Disorder

The first step to managing bipolar 1 disorder is getting diagnosed — something that can be easier said than done. People who have bipolar 1 experience extreme mood episodes that swing between elation or irritability and depression, but usually don’t think those euphoric feelings are a problem, which can hinder their (or their doctor’s) ability to recognize the disorder.

“People don’t come in when they feel great. They only come in when they’re feeling depressed,” says Diane Solomon, PhD, a psychiatric nurse practitioner in Portland, Oregon. That’s why, she explains, “The average time from first symptoms to a correct diagnosis is 10 years.”

Bipolar 1 disorder is distinguished by a manic episode that lasts at least 7 days, followed by a period of depression.

During mania, a person with bipolar 1 may act in unusual and impulsive ways that may put them at risk for physical, social, or financial harm (think gambling or driving recklessly). They can also feel invincible, be irritable, sleep far less than usual, experience racing thoughts, and have false perceptions, according to Cleveland Clinic. When a person with bipolar 1 is depressed, they may lose interest in activities, feel exhausted and helpless, be agitated, and have insomnia.

If you’ve been diagnosed with bipolar 1, there are some key steps that can help you manage your bipolar 1 disorder.

Best Ways to Manage Bipolar 1 Disorder

While these shifts in mood, energy, and behavior can be challenging to manage, finding the right healthcare providers and treatment, which may include medication and psychotherapy, can make a difference, as can finding the right support and practicing self-care. Some effective strategies to try:

1. Learn about social rhythm therapy. People with bipolar 1 disorder can sometimes be triggered by changes in routine, which is why it’s important to follow a regular schedule. Your therapist may refer to this as interpersonal and social rhythm therapy (IPSRT). “It really just means having a regular schedule, eating at normal times, sleeping regularly, having good sleep hygiene, getting some exercise, and taking your medications,” says Dr. Solomon. “I tell people I can throw a truckload of medication at them, but unless they are sleeping well, eating well, and taking care of themselves, it's not going to do anything.”

2. Find the right therapist. “You need to partner with a provider that is very comfortable with and enjoys working with people with bipolar,” says Solomon. If you don’t currently have one, you might want to ask your primary care provider for a recommendation or visit the Depression and Bipolar Support Alliance. You can also go to the Psychology Today database and filter for bipolar disorder providers.

3. Find the right medication and take it as directed. Some people with bipolar disorder are incorrectly prescribed antidepressants, which aren’t enough to treat the condition on their own. “For someone with bipolar, antidepressants need to be used very carefully — and only [with] a mood stabilizer,” says Solomon.

Your treatment will be tailored to your personal symptoms and the severity of your condition. Work with your therapist to find the right dosage and combination of medications to manage your bipolar, and then take them exactly as prescribed. “Even a day of missed medication can set some people with bipolar off,” says Solomon.

4. Keep a mood diary. Using a mood tracker app or writing your moods down in a diary can help you track changes that can predict a bipolar episode. A study published in the journal Neuropsychiatric Disease and Treatment found that self-monitoring daily moods can be effective at preventing recurrence for bipolar. You may only need to do this for a few months to learn your natural rhythms and triggers, says Solomon.

5. Ask your loved ones to help monitor your mood. See what your kids, parents, partner, or close friends say about how you’re doing. This can help you understand what you’re like when you’re experiencing an episode and what your triggers may be.

6. Know what to do if an episode is starting. “You also need to have a plan worked out with your provider on the steps to take and what we call rescue medication,” says Solomon. For example, if you're going into mania, your doctor can prescribe you a sleep medication to make sure you’re getting enough sleep. This can then help stave off a full-blown episode.

7. Find a bipolar support group. “Support groups are a great resource, because people can learn a lot more by listening to other people with bipolar and avoid mistakes they’ve made,” says Solomon. Check out the Depression and Bipolar Support Alliance or ask your therapist for local recommendations.

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