What treatments are available?
There are a range of treatments available for hypomania and mania. You may 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, you should consult a general practitioner or medical professional regarding all of the options available to you, and express any concerns or preferences that you may have.
If you are concerned about the treatment that you may be given if you become or while you are very unwell, you may find it useful to make an Advance Statement (sometimes called an Advance Directive or a Statement of Wishes). An Advance Statement is a statement in which you indicate, when well, the form of health care that you would like to have at a future time when you may be severely unwell. It serves to provide general practitioners, medical professionals, friends and family members alike a clear indication of your preference for care and treatment should you become unable to make decisions on your own.
The aim of talking treatments, such as cognitive behavioural therapy, is to help you understand yourself better and develop strategies to deal with or reduce the chance of experiencing hypomania or mania in the future. A talking treatment is be most effective when your mood is stable.
Cognitive behaviour therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking treatment that can be used to help manage bipolar disorder through a number of ways. It aims to help patients manage the symptoms of their hypomania or mania, and identify and prevent behaviours which trigger a hypomanic or manic episode, Although the vast majority of research on CBT has been focused on depressive episodes, there has been increasing indications that CBT may be quite useful in the treatment of bipolar disorder.
Mindfulness-based cognitive therapy (MBCT)
Mindfulness-based cognitive therapy (MBCT) is a talking treatment which combines elements of cognitive behavioural therapy and mindfulness meditation techniques, such as meditation, breathing techniques, and yoga, with the goal of developing an awareness of distressing thoughts and feelings and an ability to acknowledge such thoughts and feelings without reacting negatively. It has been found that MBCT is useful in alleviating the symptoms associated with bipolar disorder. MBCT is usually implemented in groups.
Access to talking treatments
If you think a talking treatment would be useful for you, your general practitioner should be able to give you more information and refer you to a medical professional. You may also be referred to your community psychiatric service or hospital. Depending on your circumstances, you may also choose to see a medical professional from a voluntary organisation or a private-practicing medical professional (see ‘Useful contacts’).
If your general practitioner 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 general practitioner should explain to you what the medication is and what it is for, discuss any possible side effects of the medication, and discuss alternative treatment options.
Antipsychotics may be prescribed to treat mania, and sometimes hypomania. The most commonly prescribed antipsychotics are:
- Olanzapine (Zyprexa)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
Mood stabilisers may be prescribed treat bipolar disorder and, less commonly, recurrent depression. The most commonly prescribed mood stabilisers are:
- Lithium (Camcolit, Liskonum, Priadel)
- Valproate semisodium (Depakote)
- Carbamazepine (Tegretol)
All of these drugs can cause side effects, such as lethargy, cognitive slowing, weight gain, decreased motor coordination, and digestion difficulties. Treatment with these drugs should be prescribed by a psychiatrist and not by your family doctor.