Intro

Generally, people with severe bipolar disorder symptoms will not seek medical care on their own. A family member or close friend is usually the one seeking help for the person. The person needs to be seen by a medical professional in these situations:

When changes in personality, including extreme moodiness, start to affect a person's life, ruin relationships with others, or threaten basic health, the person should be seen by a medical professional. Medical conditions such as diabetes  and thyroid disorders can cause mood swings. These are relatively easy to detect and treat. They are the starting point of an evaluation of mood swings.

When changes in sleep and appetite begin to affect health, the person needs to be evaluated. Some people may not want any help. If they fear the stigma of having a mental illness, they need to know that many other things could be responsible for the changes in their behavior. This is especially true for anyone older than 40 years who develops signs of bipolar disorder.

When the mood swings have become so severe that a person cannot function at home or work

When a person has thoughts of suicide, especially with a specific plan as to how to take his or her own life

If the person might be a danger to self or others, he or she should be seen in a hospital emergency department.
Suicidal patients are hospitalized until their mood can be stabilized.
If the person refuses to go to the hospital, you may need assistance in getting him or her there. Call 911 if the situation is dangerous.
Above all, be sure of your own safety first. A person with bipolar disorder is probably not thinking clearly when in severe mania or depression . He or she may feel that the person calling for help is a traitor.

With a suicide attempt, call 911 so that the person can be treated in the emergency department. Don't try to take a person who has attempted suicide to the hospital by yourself.

Homicidal thoughts, threats, or behaviors require immediate intervention. Assure your own safety and then call 911 for help.

Other Therapy

For most people with bipolar disorder, medications do not relieve symptoms completely. Psychological counseling (psychotherapy) complements drug therapy.

Counseling usually begins in the hospital or when medical treatment begins.

Different types of therapy are used. Therapy may be individual or in a group—both can be effective if approached with a positive attitude.

The goal is to help the person accept and cope with the disease.

It is often very important for the spouse or other family members to be involved during visits to the therapist.

It is important to treat the whole family, not just the person with bipolar disorder, not because they are all "sick," but because this disorder affects them all.

Family members can learn valuable ways to deal with their loved one's mood swings.

Follow-up

Take your medication as directed. You will very likely be tempted to stop your medication. Many people with bipolar disorder do so. Don't do so. Instead, talk it over with your health-care provider. Stopping your medication will probably cause your symptoms to come back. It may also cause uncomfortable or alarming withdrawal symptoms.

Depending on which medication is used, you may need regular blood tests to monitor levels and to check for side effects of the drug.

You should have regular appointments with your health-care provider to see how well the treatment is working and detect any instability of your mood.

Regular sessions with a psychotherapist or counselor are also important.

Ongoing education for you and your family is crucial to help everyone deal with the disease.

You and your family should be taught to watch for early warning signs of crisis and ways to deal with stress to prevent recurrences.

Prevention

Nothing is known to prevent bipolar disorder. It is best to avoid drugs that may trigger the disease (such as cocaine or methamphetamine). Adopting a healthy lifestyle with regular sleep and exercise may help.

Relapses can be prevented or made less severe by following the treatment recommendations of your health-care providers. This includes taking medication as directed and attending counseling sessions.