“With bipolar medications, some are fast-acting and can take effect in a matter of hours or days,” says Naomi Torres-Mackie, PhD, a clinical psychologist at Northwell Health’s Lenox Hill Hospital in New York City. “The most common medications prescribed for bipolar disorder become effective over a couple of weeks to six months. That’s because it takes time for the medications to build up in your system and be at a therapeutic level.”
Psychotherapy has a similar timeline, with effects becoming noticeable in three to five months, she says. Due to the length of this timeframe, it’s helpful to track symptoms so you can start noticing when treatment starts to feel like it’s working. Here are five signs to consider.
1. Fewer Mood Episodes
2. Consistently Better Sleep
Sleep and bipolar disorder are closely linked, says Alex Dimitriu, MD, a psychiatrist and the founder of Menlo Park Psychiatry and Sleep Medicine in California and a medical reviewer for Everyday Health.
With effective treatment, sleep quality tends to improve, which means you have an easier time falling asleep, a more consistent sleep schedule, and you’re waking up refreshed instead of groggy, says Dr. Dimitriu. And as your sleep becomes more consistent, it may also help prevent the recurrence of mood episodes.
3. Less Brain Fog
In addition to less-frequent mood episodes and better sleep, bipolar treatment can improve everyday function overall, says Joshua Norman, DO, a psychiatrist with the Ohio State University Wexner Medical Center in Columbus.
“When treatment is effective, symptoms will be much less likely to interfere with work, school, and daily activities,” Dr. Norman says. “That’s because it’s easier to concentrate and be organized.”
4. More Consistent Daily Routines
When bipolar disorder is not well-managed, it’s much more difficult to establish and maintain even simple routines.
“A sign that treatment is working well is that daily routines are easy to manage and becoming more consistent,” he says. “That can [also] provide a sense of wellness overall.”
5. Reduced Anxiety
Not all mania or hypomania is euphoric, says Dimitriu. Such episodes can involve feelings of distress instead.
That means decreased reactivity and less anxiety can be signs that treatment is working. This can be more difficult to track than more obvious signs like sleep quality, mood episodes, or the need for emergency care, but it can be helpful to pay attention to situations that would have caused you anxiety or irritability in the past, but feel more manageable for you now, says Dimitriu.
“One way to assess whether there’s less anxiety is whether there’s improvement in relationships,” he says. That could mean less arguing with a spouse or partner, better interactions with colleagues or a boss, and more enjoyment during time spent with friends.
What to Do if Symptoms Are Worsening
If symptoms are getting worse instead of improving, even after months of treatment, it’s crucial to talk with your healthcare provider, says Torres-Mackie. Signs that your treatment may not be a good fit include:
- Return of depressive or manic episodes
- Increased irritability
- Difficulty functioning
- Major sleep disruptions
- Feeling restless or more agitated than usual
- Poor concentration or short-term memory loss
If this is the case — or if you’re simply not seeing effective symptom management — it’s important not to make any changes to your treatment plan without consulting your healthcare provider first.
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