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Bipolar Disorder

Disclaimer:

This publication is based on a Mind UK publication and the original version may be found here: https://www.mind.org.uk/information-support/a-z-mental-health/

Thank you to Mind UK for sharing their valuable content with us. Content included in Mental Health A-Z is made available free of charge and does not form part of any commercial activity. The adaptation has been done independently by Mind HK and is intended for general information purposes only.

What treatments can help? 

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – suggests that treatment for bipolar disorder should include both talking treatments and medication. 

This section covers: 

  • What treatment could I get to manage a current episode? 
  • What can I do in the longer term? 
  • Which talking therapies might I be offered? 
  • How can talking therapies help in the long term? 
  • What treatment can I get in a crisis? 

The exact combination of treatments you’re offered will depend on whether you’re managing a current bipolar episode, or managing your mental health in the long term. For information on drug treatments, see our separate page on medication for bipolar disorder. 

“[I find] the biggest step is accepting that is who you are. Changing your ways with meds and therapy is a hard slog.” 

What treatment could I get to manage a current episode? 

This will usually depend on what kind of episode you’re experiencing. 

During depressive episodes 

  • You’re likely to be offered medication – this might be new medication or adjusting your current medication. 
  • You might also be offered a structured psychological treatment that’s proven to help with depression, such as cognitive behavioural therapy (CBT). (See our pages on CBT for more information about this treatment.) 

(See our pages on depression for more information on treatments and self-care tips for depression.) 

During manic or hypomanic episodes 

  • You’re likely to be offered medication – this might be new medication or adjusting your current medication. 
  • You’re unlikely to be offered a talking treatment if you are currently experiencing a manic or hypomanic episode. 

(See our pages on hypomania and mania for more information on treatments and self- care tips for mania and hypomania.) 

What can I do in the longer term? 

The aim of treatment should be to help you maintain stable moods and manage your symptoms well. As you start to feel more stable, the majority of your support could come from  an integrated community centre for mental wellness (ICCMW) or your GP, although your GP should arrange for you to still be in touch with a mental health specialist. 

Your health professionals should work with you to help you identify: 

  • Clear emotional and social recovery goals for you to work towards and regularly reflect on and revise with your doctor. 
  • A crisis plan, so you know what to do if you experience any of your early warning signs or triggers, or begin to feel very distressed. 
  • How you feel day-to-day, so you can be aware of how best to manage your mood and notice any changes. 
  • A medication plan, including dates where you can review your dose, how well the medication is working and any side effects that you experience. 

If you are receiving a talking therapy, you might set some of these goals with your therapist. You should share these goals with your GP. You may also want to share them with your family, friends and carer if you have one. 

“It has been 13 years since I was hospitalized or sectioned, and [I’ve] done so well. My medication is working.” 

Which talking therapies might I be offered? 

There are several talking therapies you might be offered to help you manage your bipolar disorder in the long term. These are a few that have been tested and shown to work well for some people, although other therapies may work too: 

  • Cognitive behavioural therapy (CBT) – looks at how your feelings, thoughts and behaviour influence each other and how you can change these patterns. 
  • Interpersonal therapy – focuses on your relationships with other people and how your thoughts, feelings and behaviour are affected by your relationships, and how they affect your relationships in turn. 
  • Behavioural couples therapy – focuses on recognising and trying to resolve the emotional problems that can happen between partners. 

Other types of talking therapies you may be offered are: 

  • Enhanced relapse prevention/ individual psychoeducation – this is a brief intervention to help you learn coping strategies. 
  • Group psychoeducation – this involves working in a group of people with shared experiences, led by a trained therapist, to build up knowledge about bipolar disorder and self-management. 
  • Family-focused therapy – this involves working as a family to look at behavioural traits, identify risks and build communication and problem-solving skills. 

Some of these treatments are more widely available than others. What you are offered can also depend on what you and your doctor agree would be most useful for you. 

(For more information on different types of talking therapies, including how to access them, see our pages on talking therapies.) 

How can talking therapies help in the long term? 

Talking therapies can help you: 

  • understand or make sense or meaning out of your bipolar disorder, and reflect on the impact it has had throughout your life 
  • identify early warning signs and symptoms 
  • develop strategies to cope with early symptoms, triggers and episodes 
  • make a crisis plan 
  • set goals and plans for staying well 

“Bipolar disorder is one of those things that if you have it and it’s well controlled, you can use it productively… it’s in [my] best interest to take [my] meds, see [my] shrink regularly and stay well.” 

What treatment can I get in a crisis? 

If you start to feel very unwell, or if an episode of depression or mania is lasting for a long time and your regular treatment isn’t working, you may need to access crisis services to help you get through it. This may include: 

  • emergency support, such as going to A&E 
  • getting support from a crisis service if urgent help is needed
  • hospital admission 

(See our pages on crisis services for more detailed information about your options in a crisis, how to access services, and how you can plan ahead.) 

Is ECT ever used to treat bipolar disorder? 

Electroconvulsive therapy (ECT) should only be considered a treatment option for bipolar disorder in extreme circumstances. According to NICE guidelines, this could be if: 

  • you’re experiencing a long and severe period of depression, or a long period of mania, AND 
  • other treatments have not worked, or the situation is life-threatening. 

If you feel like you’re in this situation, your doctor should discuss this option with you in a clear and accessible way before you make any decisions. 

(See our pages on ECT for more information about this treatment and when it can be performed.)

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What is iACT Service?

Improving Access to Community Therapies (iACT®) is one of the services from Mind HK. Trained Wellbeing Practitioners will offer initial assessment and early intervention for people dealing with mild to moderate symptoms of depression, anxiety, or other emotional difficulties.

 

The service includes 6-8 sessions of low-intensity psychological support, the flexibility of the service allows individuals to receive free and timely support when needed.

If you’re aged between 18 – 65 and are facing some emotional challenges, we would like to invite you to take an online assessment for us to gain a better understanding of your current emotional struggle.

 

If you’re eligible, we’ll get you connected with a Wellbeing Practitioner within two weeks to sort out the next steps.

The service runs for about 3 months and includes 6-8 support sessions, tailored to your needs.

 

We encourage you to attend all sessions and actively practice the tips and exercises provided by your Wellbeing Practitioner.

We take your privacy seriously. Your chats with the Wellbeing Practitioner are confidential.

 

We won’t share any of your info unless you’ve provided consent or if there are risks detected.

This programme isn’t suitable for people facing emergencies, major setbacks, or those diagnosed with serious or complex mental health conditions.

 

If you’re having thoughts of suicide or self-harm, this programme might not meet your needs, so please seek help right away. You can check out Mind HK’s “Find Help Now” page for immediate information and services.

Most of our Wellbeing Practitioners have backgrounds in psychology or counselling and are passionate about mental health. They’ve gone through about 140 hours of intensive training and completed at least 120 hours of supervised clinical practice over 9 months to ensure the quality of service.

 

They’re trained by accredited local experts in the mental health field, including clinical psychologists, counselling psychologists, counsellors, and psychiatrists. Plus, we regularly check how effective our services are. All service outputs and performances are subject to consistent monitoring.

Who is suitable for participating in this programme?

This programme welcomes anyone between the ages of 18 and 65 who may be feeling lost or facing emotional difficulties. Please note that this programme is not suitable for individuals diagnosed with severe or complex mental health conditions.

This programme is not suitable for individuals diagnosed with severe or complex mental health conditions, but suitable for those who experience mild to severe moderate anxiety, mild to moderate depression, or other emotional challenges. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

After signing up, our Wellbeing Practitioner will contact you within two weeks to schedule a convenient time for a 45-minute conversation, either via video or phone call, according to your preference. During the conversation, the Wellbeing Practitioner will understand your current situation and help you gain a better understanding of your emotional state based on the questionnaire you filled out during application. Additionally, they will provide recommendations for appropriate community resources based on your needs, helping you take an important first step in taking care of your mental health.

Although the intervention procedure is mostly standardised, Wellbeing Practitioners will work flexibly with clients to address individual presenting problems and unique characteristics.

Our Wellbeing Practitioners are trained to support people who experience mild to moderate mental health difficulties primarily. This programme is not suitable for the situations mentioned above. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

Your conversations with the Wellbeing Practitioner are absolutely confidential. Any information about you will not be shared with anyone without your consent unless you or others are at immediate risk or the Wellbeing Practitioner has reason to believe that you may be in imminent danger.
Supervisors will monitor trainees’ development throughout the placement to ensure that they are meeting the required level of competency to pass the training course at the end of the placement.

Yes, it is necessary to book an appointment in advance by filling out the form. Additionally, you can select one of the five stores yourself. We will allocate clients to different Wellbeing Practitioners based on their chosen location.

Before having the conversation, we will ask you to fill out a basic questionnaire for preliminary screening assessment. This screening process aims to ensure that the training received by the Wellbeing Practitioners is sufficient to meet the needs of the individuals receiving the service. If it is determined after the screening assessment that the service is not suitable for you, Mind HK will provide alternative recommendations to ensure your safety and support.

For adults who are suitable for this service, all Wellbeing Practitioners have received training on how to identify and respond to safety and risk issues. If you have any concerns about the support process, the Wellbeing Practitioners have appropriate measures in place and will develop response plans based on the urgency of the situation. They can also access support from clinical practitioners from Mind HK or participating organisations.

What private training does Mind HK provide?

Mind HK provides 4 themes of mental health training, including: Supporting Self, Supporting Others, Family Wellbeing and DEI (Diversity, Equity and Inclusion).

 

Check out the brochure here for more information.

Mind HK provides a wide range of standardised mental health training, which can be tailored to different circumstances. Chat with our team to explore more! 

Our trainers come from a diverse, accredited pool of clinically experienced professionals. Check out our trainers’ biographies here.

Yes, the Mental Health First Aid class of Mind HK is internationally accredited by the MHFA International. The content and certification is delivered by trainers certified from the Mental Health Association of Hong Kong. You can find out our trainers accreditation here.

We are here to support your mental health education journey! Reach out to us and chat with our team.

Treatments

What treatments can help? 

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – suggests that treatment for bipolar disorder should include both talking treatments and medication. 

This section covers: 

  • What treatment could I get to manage a current episode? 
  • What can I do in the longer term? 
  • Which talking therapies might I be offered? 
  • How can talking therapies help in the long term? 
  • What treatment can I get in a crisis? 

The exact combination of treatments you’re offered will depend on whether you’re managing a current bipolar episode, or managing your mental health in the long term. For information on drug treatments, see our separate page on medication for bipolar disorder. 

“[I find] the biggest step is accepting that is who you are. Changing your ways with meds and therapy is a hard slog.” 

What treatment could I get to manage a current episode? 

This will usually depend on what kind of episode you're experiencing. 

During depressive episodes 

  • You're likely to be offered medication – this might be new medication or adjusting your current medication. 
  • You might also be offered a structured psychological treatment that's proven to help with depression, such as cognitive behavioural therapy (CBT). (See our pages on CBT for more information about this treatment.) 

(See our pages on depression for more information on treatments and self-care tips for depression.) 

During manic or hypomanic episodes 

  • You're likely to be offered medication – this might be new medication or adjusting your current medication. 
  • You're unlikely to be offered a talking treatment if you are currently experiencing a manic or hypomanic episode. 

(See our pages on hypomania and mania for more information on treatments and self- care tips for mania and hypomania.) 

What can I do in the longer term? 

The aim of treatment should be to help you maintain stable moods and manage your symptoms well. As you start to feel more stable, the majority of your support could come from  an integrated community centre for mental wellness (ICCMW) or your GP, although your GP should arrange for you to still be in touch with a mental health specialist. 

Your health professionals should work with you to help you identify: 

  • Clear emotional and social recovery goals for you to work towards and regularly reflect on and revise with your doctor. 
  • A crisis plan, so you know what to do if you experience any of your early warning signs or triggers, or begin to feel very distressed. 
  • How you feel day-to-day, so you can be aware of how best to manage your mood and notice any changes. 
  • A medication plan, including dates where you can review your dose, how well the medication is working and any side effects that you experience. 

If you are receiving a talking therapy, you might set some of these goals with your therapist. You should share these goals with your GP. You may also want to share them with your family, friends and carer if you have one. 

“It has been 13 years since I was hospitalized or sectioned, and [I've] done so well. My medication is working.” 

Which talking therapies might I be offered? 

There are several talking therapies you might be offered to help you manage your bipolar disorder in the long term. These are a few that have been tested and shown to work well for some people, although other therapies may work too: 

  • Cognitive behavioural therapy (CBT) – looks at how your feelings, thoughts and behaviour influence each other and how you can change these patterns. 
  • Interpersonal therapy – focuses on your relationships with other people and how your thoughts, feelings and behaviour are affected by your relationships, and how they affect your relationships in turn. 
  • Behavioural couples therapy - focuses on recognising and trying to resolve the emotional problems that can happen between partners. 

Other types of talking therapies you may be offered are: 

  • Enhanced relapse prevention/ individual psychoeducation – this is a brief intervention to help you learn coping strategies. 
  • Group psychoeducation – this involves working in a group of people with shared experiences, led by a trained therapist, to build up knowledge about bipolar disorder and self-management. 
  • Family-focused therapy – this involves working as a family to look at behavioural traits, identify risks and build communication and problem-solving skills. 

Some of these treatments are more widely available than others. What you are offered can also depend on what you and your doctor agree would be most useful for you. 

(For more information on different types of talking therapies, including how to access them, see our pages on talking therapies.) 

How can talking therapies help in the long term? 

Talking therapies can help you: 

  • understand or make sense or meaning out of your bipolar disorder, and reflect on the impact it has had throughout your life 
  • identify early warning signs and symptoms 
  • develop strategies to cope with early symptoms, triggers and episodes 
  • make a crisis plan 
  • set goals and plans for staying well 

“Bipolar disorder is one of those things that if you have it and it's well controlled, you can use it productively... it's in [my] best interest to take [my] meds, see [my] shrink regularly and stay well.” 

What treatment can I get in a crisis? 

If you start to feel very unwell, or if an episode of depression or mania is lasting for a long time and your regular treatment isn't working, you may need to access crisis services to help you get through it. This may include: 

  • emergency support, such as going to A&E 
  • getting support from a crisis service if urgent help is needed
  • hospital admission 

(See our pages on crisis services for more detailed information about your options in a crisis, how to access services, and how you can plan ahead.) 

Is ECT ever used to treat bipolar disorder? 

Electroconvulsive therapy (ECT) should only be considered a treatment option for bipolar disorder in extreme circumstances. According to NICE guidelines, this could be if: 

  • you're experiencing a long and severe period of depression, or a long period of mania, AND 
  • other treatments have not worked, or the situation is life-threatening. 

If you feel like you're in this situation, your doctor should discuss this option with you in a clear and accessible way before you make any decisions. 

(See our pages on ECT for more information about this treatment and when it can be performed.)