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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 medication is available? 

If you are diagnosed with bipolar disorder, it’s likely that your psychiatrist or GP will offer to prescribe medication. This might include: 

  • antipsychotics 
  • lithium 
  • anticonvulsants 
  • antidepressants 

Which medication you are offered will depend on: 

  • Your current symptoms, for example, if you are currently experiencing a manic or depressive episode. 
  • Your past symptoms, such as whether you are mainly manic or mainly depressed, and how long the episodes have lasted. 
  • How you have responded to treatments in the past. 
  • The risk of another episode, and what has triggered episodes in the past. 
  • Your physical health, in particular whether you have kidney problems, weight problems or diabetes. 
  • How likely you are to take the medication consistently. 
  • Your sex and age (for example, if you could become pregnant your doctor shouldn’t offer you valproate, as it carries significant risks to your baby). 
  • In older people, a test of mental processes such as the one used to diagnose dementia may be carried out prior to, and after commencing medications. 

Before you take any medication Before you decide to take any medication, you should make sure you have all the facts you need to feel confident about your decision. For guidance on the basic information you might want to know about any drug before you take it, see our pages on: 

  • what you should know before taking any psychiatric drug 
  • receiving the right medication for you 
  • your right to refuse medication 

Antipsychotics for bipolar disorder 

You are most likely to be prescribed an antipsychotic if you have an episode of mania or severe depression in which you experience psychotic symptoms, such as hearing voices. However, some antipsychotics are increasingly prescribed even if you haven’t had psychotic symptoms, as their side effects might be less unpleasant, and they’re safer in pregnancy. 

The National Institute for Health and Care Excellence (NICE) treatment guidelines recommend the following antipsychotics: 

  • haloperidol (Dozic, Haldol, Haldol decanoate, Serenace) 
  • olanzapine (Zalasta, Zyprexa, ZypAdhera) 
  • quetiapine (Atrolak, Biquelle, Ebesque, Seroquel, Tenprolide, Zaluron) 
  • risperidone (Risperdal, Risperdal Consta) 

If your first antipsychotic doesn’t work, you should be offered a different one from the list above. If the second antipsychotic doesn’t work you may be offered lithium to take together with an antipsychotic. 

If you’re prescribed an antipsychotic, you’ll need to have regular health checks with your doctor. 

(See our pages on antipsychotics for more information about these drugs, including potential side effects.) 

Lithium for bipolar disorder 

Lithium can be effective for reducing the likelihood of: 

It is typically a long-term method of treatment, usually prescribed for at least six months. For lithium to be effective, the dosage must be correct. You’ll need regular blood and health checks while taking lithium, to make sure your lithium levels are right for you. 

(For more information see our pages about lithium, and taking lithium safely.) 

“Lithium helps [me cope] and I just have to keep reminding myself that whichever feeling I’m going through won’t last forever.” 

Anticonvulsants for bipolar disorder 

There are three anticonvulsant drugs used as mood stabilisers which are licensed to treat bipolar disorder: 

  • carbamazepine 
  • valproate 
  • lamotrigine 

Carbamazepine (Tegretol) is also sometimes prescribed to treat episodes of mania. It can be prescribed if lithium is ineffective or unsuitable for you. 

Valproate (Depakote, Epilim) can be used to treat episodes of mania and is typically a long-term method of treatment. It can be prescribed if lithium is ineffective or unsuitable for you. However, if you could become pregnant your doctor shouldn’t offer you valproate unless there is a pregnancy prevention programme in place, as it carries significant risks to your baby. 

Lamotrigine (Lamictal) has antidepressant effects and is licensed to treat severe depression in bipolar disorder. NICE guidelines recommend that it is not used to treat mania. If you are pregnant and taking Lamotrigine, NICE recommends you are checked regularly. 

(See our pages on mood stabilisers for more information about these drugs.) 

Antidepressants for bipolar disorder 

In some circumstances you might also be offered antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs) – a commonly prescribed type of antidepressant. You might be offered antidepressants in combination with one of the medications described above. 

Remember: You should always check with your doctor or pharmacist before taking any drugs together, or closely following one another, in case they could interact with each other badly. For example, combining lithium with SSRI antidepressants can increase the risk of serotonin syndrome (a serious side effect). 

(See our pages on antidepressants for more information about these drugs, including potential side effects.)

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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.

Medication

What medication is available? 

If you are diagnosed with bipolar disorder, it’s likely that your psychiatrist or GP will offer to prescribe medication. This might include: 

  • antipsychotics 
  • lithium 
  • anticonvulsants 
  • antidepressants 

Which medication you are offered will depend on: 

  • Your current symptoms, for example, if you are currently experiencing a manic or depressive episode. 
  • Your past symptoms, such as whether you are mainly manic or mainly depressed, and how long the episodes have lasted. 
  • How you have responded to treatments in the past. 
  • The risk of another episode, and what has triggered episodes in the past. 
  • Your physical health, in particular whether you have kidney problems, weight problems or diabetes. 
  • How likely you are to take the medication consistently. 
  • Your sex and age (for example, if you could become pregnant your doctor shouldn't offer you valproate, as it carries significant risks to your baby). 
  • In older people, a test of mental processes such as the one used to diagnose dementia may be carried out prior to, and after commencing medications. 

Before you take any medication Before you decide to take any medication, you should make sure you have all the facts you need to feel confident about your decision. For guidance on the basic information you might want to know about any drug before you take it, see our pages on: 

  • what you should know before taking any psychiatric drug 
  • receiving the right medication for you 
  • your right to refuse medication 

Antipsychotics for bipolar disorder 

You are most likely to be prescribed an antipsychotic if you have an episode of mania or severe depression in which you experience psychotic symptoms, such as hearing voices. However, some antipsychotics are increasingly prescribed even if you haven't had psychotic symptoms, as their side effects might be less unpleasant, and they're safer in pregnancy. 

The National Institute for Health and Care Excellence (NICE) treatment guidelines recommend the following antipsychotics: 

  • haloperidol (Dozic, Haldol, Haldol decanoate, Serenace) 
  • olanzapine (Zalasta, Zyprexa, ZypAdhera) 
  • quetiapine (Atrolak, Biquelle, Ebesque, Seroquel, Tenprolide, Zaluron) 
  • risperidone (Risperdal, Risperdal Consta) 

If your first antipsychotic doesn't work, you should be offered a different one from the list above. If the second antipsychotic doesn't work you may be offered lithium to take together with an antipsychotic. 

If you're prescribed an antipsychotic, you'll need to have regular health checks with your doctor. 

(See our pages on antipsychotics for more information about these drugs, including potential side effects.) 

Lithium for bipolar disorder 

Lithium can be effective for reducing the likelihood of: 

It is typically a long-term method of treatment, usually prescribed for at least six months. For lithium to be effective, the dosage must be correct. You'll need regular blood and health checks while taking lithium, to make sure your lithium levels are right for you. 

(For more information see our pages about lithium, and taking lithium safely.) 

“Lithium helps [me cope] and I just have to keep reminding myself that whichever feeling I’m going through won't last forever.” 

Anticonvulsants for bipolar disorder 

There are three anticonvulsant drugs used as mood stabilisers which are licensed to treat bipolar disorder: 

  • carbamazepine 
  • valproate 
  • lamotrigine 

Carbamazepine (Tegretol) is also sometimes prescribed to treat episodes of mania. It can be prescribed if lithium is ineffective or unsuitable for you. 

Valproate (Depakote, Epilim) can be used to treat episodes of mania and is typically a long-term method of treatment. It can be prescribed if lithium is ineffective or unsuitable for you. However, if you could become pregnant your doctor shouldn't offer you valproate unless there is a pregnancy prevention programme in place, as it carries significant risks to your baby. 

Lamotrigine (Lamictal) has antidepressant effects and is licensed to treat severe depression in bipolar disorder. NICE guidelines recommend that it is not used to treat mania. If you are pregnant and taking Lamotrigine, NICE recommends you are checked regularly. 

(See our pages on mood stabilisers for more information about these drugs.) 

Antidepressants for bipolar disorder 

In some circumstances you might also be offered antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs) – a commonly prescribed type of antidepressant. You might be offered antidepressants in combination with one of the medications described above. 

Remember: You should always check with your doctor or pharmacist before taking any drugs together, or closely following one another, in case they could interact with each other badly. For example, combining lithium with SSRI antidepressants can increase the risk of serotonin syndrome (a serious side effect). 

(See our pages on antidepressants for more information about these drugs, including potential side effects.)