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Staying well in the future

When you feel better, your care team should discuss with you, and your family and carers if you agree, whether to continue the treatment you have been having, or change to a different treatment, to help you stay well in the future. Your care team should give you written information that is clear and easy to understand. They should also talk with you about:

  • how bipolar disorder might affect you in the future

  • how to tell if you are becoming unwell again

  • things you can do to prevent more episodes of bipolar disorder

  • whether you might become unwell again if you stop taking medication

  • how long you may need to take medication

  • what to do if you decide to have a baby.

Where to get long‑term treatment and support

You should continue to be offered care and treatment from the specialist bipolar team or early intervention in psychosis service. When you are well enough, you should be offered the choice to move your care to your GP. If you do this, your care team should agree, together with you, on a plan for your care. They should do this before you move to your GP, and should encourage you to visit your GP to go over the plan before you move. The plan should show:

  • what your recovery goals are

  • what to do if you have a crisis or become unwell again

  • what medication you will take and when it should be checked.

Your care team should give a copy of the plan to you and one to your GP, and encourage you to share it with your carers.

Long‑term psychological therapy

Adults aged 18 and over

To help you stay well or treat any symptoms you still have, you should be offered a psychological therapy specially designed for bipolar disorder. Your therapist should explain what bipolar disorder is and give you information about it. They should talk with you about thoughts you sometimes have, or things you do, that can change your mood, and how you can try to control them. If you live with your family or are in close contact with them you should also be offered a therapy called family intervention. For more information on family intervention therapy, see our guidance on psychosis and schizophrenia in adults, which is listed in other NICE guidance.

Young people aged 13 to 17

You should be offered a psychological therapy, either on your own or with your family.

Long‑term medication

NICE does not recommend long‑term medication to treat bipolar disorder in young people aged 17 and under.

When discussing long‑term medication with you, your care team should take into account medication that has helped you during episodes of mania or depression. They should ask you whether you would prefer to continue this treatment or change to lithium. Lithium usually works better than other types of medication for long‑term treatment.

However, if lithium doesn't work well enough or causes you problems, you may be offered valproate, olanzapine or quetiapine.

For more information on long‑term medication see taking medication.

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