What Happens When Bipolar Meds Don’t Work?

Bipolar disorder is a severe and life-altering condition. Left untreated, bipolar manic cycles can last between 3 and 6 months. Bipolar-related depression can last even longer, sometimes up to 12 months. Treatment for bipolar aims to manage your episodes for the most balanced life possible.

When your bipolar medication doesn’t work

Diagnosing bipolar is tricky enough. Successful treatment plans can be even more complex and take time to evolve. Finding the proper treatment and medications often takes quite a lot of trial and error. Some medications take weeks or months to take effect fully.  You are going to have to exercise patience. 

Your doctor will usually adjust one medicine at a time in a complicated cocktail to figure out what works and what doesn’t. Many of the medications for bipolar disorder come with side effects. These must be managed as your symptoms change and your doctor can observe how you react to your medications. 

If you experience severe side effects, do not stop taking your medications. If you abruptly stop them, your symptoms may worsen. You may also start to experience withdrawal symptoms on top of the other side effects. You could become depressed, suicidal, manic, or hypomanic. However,  your body will often adjust to your medications over time, and the side effects will become milder. 

Possible side effects of bipolar medications depend on which medicine is used. Some of them are:

How to tell if your bipolar meds don’t work

When your medical provider prescribes your medicine, they know that there are possible side effects. Be honest with them about how your medicines make you feel. If you don't feel the benefits outweigh the side effects, ask your doctor to change your medications. If you dislike how you feel when you take a particular medication, don’t hesitate to say so.

However, other side effects may be mild and may go away on their own as your body becomes acclimated. It might be a good idea to wait out mild or moderate responses. Your body could be adjusting, or the side effect could be manageable in the long run. Regardless, always let your doctor know.

Occasionally your doctor will give you another medication to help counteract the side effects of the first medication. Taking multiple medications is quite common, and there is no need to worry. But it is also your choice whether or not you want to take various medications. There are so many options for treating bipolar disorder that you should feel comfortable asking to try out different options.

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Treatment options

When you find the right treatment plan, symptoms of bipolar disorder will usually start to get better within 3 months. Usually, treatment involves a combination of medications and actions. This can include any combination of the following:

  • Medications to help with mania and depression-like mood stabilizers, taken every day for an extended time. 
  • Medications for when you are either feeling manic or depressed as they occur. 
  • Learned awareness of your triggers or signs of depression or mania. 
  • Talk therapies like seeing a therapist to cope with your feelings and relationships. 
  • Healthy lifestyle habits such as regular exercise, a nutritious balanced diet, and enough sleep.
  • If your symptoms are very severe, you may have to stay in a hospital or participate in an in-patient program for a while. 

Some of the specific medications used to treat bipolar disorder are:

  • Mood stabilizers. These are very commonly used to help with mania or hypomania. They quite literally stabilize your mood. Examples of mood stabilizers are lithium, valproic acid, divalproex sodium, carbamazepine, and lamotrigine
  • Antipsychotics. If your mania and depression continue after you start using other medications, your doctor may suggest using an antipsychotic. Examples of these are olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, lurasidone or asenapine.
  • Antidepressants. If you experience depression despite taking other medications, you might start taking an antidepressant to help with it. However, antidepressants can be triggers for manic episodes and are usually accompanied by mood stabilizers and antipsychotics. 
  • Antidepressant-antipsychotic. Some medications combine antidepressants and antipsychotics in one medication. 
  • Anti-anxiety medications. These types of medications such as benzodiazepines can help relieve anxiety and sleeplessness. However, they are normally only prescribed for short periods. 

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