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Bipolar Disorder: Managing Mania

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Treatments for Mania in Bipolar Disorder


Treating Bipolar Mania continued...

Treatment of severe mania often requires hospitalization as the risks for unpredictable, reckless behavior and noncompliance with treatment is high. For people with extreme mania, pregnant women with mania, or those people whose mania can't be controlled with mood stabilizers, doctors sometimes also recommend electroconvulsive therapy (ECT).

If mania occurs while on maintenance therapy for bipolar disorder, your doctor may simply change your medication dose or add an antipsychotic or other additional drug to lessen symptoms.

Nondrug treatments such as psychological therapy and establishing a well-ordered routine may help patients in their maintenance phase and are often suggested along with medication.

Here are summaries of each type of treatment:


Lithium (brand names Eskalith, Lithobid) is the drug used and studied longest for treating bipolar disorder. Lithium helps reduce the severity and frequency of manic states and may also help relieve or prevent bipolar depression in some sufferers.

Studies show that lithium can significantly reduce risk of suicide among people with bipolar disorder. Lithium also helps prevent future manic episodes. As a result, it may be prescribed for long periods of time (even in between episodes) as maintenance therapy.

What It Is: Lithium is a drug that acts on a person's central nervous system (brain and spinal cord). Doctors don't know exactly how lithium works to stabilize a person's mood, but one current theory is that it helps foster the growth and survival of nerve cells in brain pathways that regulate mood, thinking and behavior. Its intended effect is to help people with bipolar disorder have more control over their emotions, sleep, energy, and possible extremes in behavior.

What to Expect: It usually takes at least several weeks for lithium to begin working. Your doctor will want to take regular blood tests during your treatment because lithium can affect kidney or thyroid function. Lithium works best if the amount of the drug in your body is kept at a constant level. It is important that the level of Lithium in your body not be too low or too high. Your doctor will also probably suggest you drink eight to 12 glasses of water or fluid a day during treatment and maintain a normal amount of salt in your food. Both salt and fluid can affect the levels of lithium in your blood, so it's important to consume a steady amount every day.

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I can tell I'm becoming manic when: