What treatments are available?
There are a range of treatments available for hypomania and mania. You might find that you need to try a number of options, along with some of the self-help techniques above, to manage your symptoms effectively. Before you start any treatment, your GP or psychiatrist should discuss all your options with you, and your views and preferences should be taken into account.
If you are concerned about the treatment that you might be given if you become very unwell, you may find it useful to make an advance statement. Advance statements, while not always legally binding, set out your views and preferences about treatments that you do not want to receive, as well as things you have found helpful.
The aim of most talking treatments is to help you to understand yourself better and develop strategies to reduce the chance of you experiencing hypomania or mania in the future. A talking treatment is likely to be most effective when your mood is stable.
Cognitive behaviour therapy (CBT)
You may be offered cognitive behaviour therapy (CBT) if you have experienced a mild episode of hypomania, or if you experience hypomania along with depression. CBT is normally short-term and very practical. It aims to help you identify patterns in your thinking that can lead to hypomania (and depression, if you experience both), and develop ways to change these patterns.
Psychotherapy is a longer-term treatment that aims to help you understand the past in order to bring about change in the present.
Mindfulness-based cognitive therapy (MBCT)
Mindfulness-based cognitive therapy is an approach to wellbeing that involves paying attention to the present moment, using techniques like meditation, breathing exercises and yoga. It has been shown to help people become more aware of their thoughts and feelings, so that instead of being overwhelmed by them, it is easier to manage them. Mindfulness based cognitive therapy is usually done in groups.
Access to talking treatments
If you think a talking treatment would be useful for you, your GP should be able to give you more information and refer you to a local practitioner. You might also be referred by your community mental health team (CMHT) or hospital. Depending on your circumstances, you may also choose to see a therapist from a voluntary organisation or privately. (See ‘Useful contacts’)
If your doctor is concerned that your hypomania might develop into mania, or if you are given a diagnosis of mania or bipolar disorder, it is likely that you will be offered medication. Before you are prescribed any medication, your doctor should explain to you what the medication is for, and discuss any possible side effects and alternative treatment options.
Drugs licensed for mania, called antipsychotics, are sometimes also used for hypomania. The most commonly offered drugs are:
- olanzapine (Zyprexa)
- quetiapine (Seroquel)
- risperidone (Risperdal).
Mood stabilisers are used to treat bipolar disorder and, less commonly, recurrent depression. These include:
- lithium (Camcolit, Liskonum, Priadel)
- valproate semisodium (Depakote)
- carbamazepine (Tegretol)
- lamotrigine (Lamictal).
All these drugs can cause side effects. Treatment with these drugs should be started by a psychiatrist and not by a GP.