Individuals who present with bipolar disorder will be in one phase of the disorder, either a major depressive episode or a degree of a manic episode. This episode of either acute major depression or mania should be the focus of initial treatment. Since the treatment of this disorder nearly always involves medication (usually lithium), evaluation of the patient and proper prescription of an appropriate psychopharmacological agent is necessary. Usually the episodes will not be severe enough to warrant hospitalization, although partial hospitalization may be considered to stabilize the individual on the medication. Suicidality should always be assessed, especially for those suffering from a major depressive episode.

One of the central reasons a patient presents with this disorder, after having been previously treated, is because he or she has stopped taking prescribed medication. Medication compliance should always be an aspect of any treatment in bipolar disorder and compared with other life-long maladies, such as diabetes, where the removal of medication can result in death. Maintenance of the client on medication over a long period of time is common, resulting in a good prognosis. Most people can lead active, healthy lives with this disorder, if in proper treatment.

When an individual presents to a clinician while suffering from an acute episode of either mania or depression, the therapist should seek to stabilize the client quickly. This means treating the episode with the appropriate pharmacologic agent and scheduling followup sessions with a psychotherapist or case management. Closely monitoring lithium levels (if appropriate) can prevent future relapses into mania or depression. The physician should be acutely aware of the roller-coaster-like emotional states experienced by someone with bipolar disorder and follow the patient carefully while in treatment.

While there appears to be a genetic component to this disorder (as with most mental disorders), the research is still clear that there is no known single cause for the disorder. Many theories are proposed, ranging from the psychological to the biomedical. As is the case with all mental disorders, it is likely an important combination of factors which lead to someone having this disorder and treatment should reflect that combination appropriately. Emphasis on one form of treatment over another will likely lead to future relapses for the patient.