Treatment plan for bipolar disorder: A comprehensive clinical guide

August 28, 2025

•

min read

Outline

This is also a heading but really long so
This is also a heading but really long so
This is a heading

With approximately 2.4% of adults experiencing bipolar disorder, it’s quite likely for most therapists to encounter the condition in their practice.

This guide demonstrates systematic approaches to bipolar disorder treatment planning, including examples as a jumping-off point for time-strapped clinicians.

Example treatment plan for bipolar disorder

I. Primary diagnosis

Bipolar I Disorder, Current Episode Depressed, Moderate Severity - F31.32 Secondary: Generalized Anxiety Disorder - F41.1

II. Presenting problems

Current depressive episode: Sarah presents with persistent depressed mood for six weeks, marked anhedonia affecting work performance, hypersomnia (10-12 hours nightly), psychomotor retardation, and concentration difficulties impacting her graduate coursework. Reports feelings of worthlessness and guilt regarding recent manic episode consequences.
Recent manic episode history: Three months ago experienced seven-day manic episode involving elevated mood, decreased sleep need (2-3 hours), grandiose beliefs about academic abilities, hypergraphia, excessive goal-directed activity, and impulsive financial decisions resulting in $8,000 credit card debt.
Functional impairment: Missing 60% of graduate classes, withdrawn from social activities, difficulty maintaining basic self-care routines. Relationship strain with partner due to mood episode aftermath and financial stressors.
Anxiety symptoms: Persistent worry about future mood episodes, social anxiety regarding academic peers who witnessed manic behavior, physical symptoms including muscle tension and sleep onset difficulties despite increased sleep duration.

III. Objectives

Objective 1 (Mood stabilization & psychoeducation):

Sarah will demonstrate understanding of bipolar disorder cycle by accurately identifying her personal early warning signs for both manic and depressive episodes within three sessions.
Complete daily mood tracking using 1-10 scale with sleep, medication adherence, and trigger notation for four consecutive weeks.

Objective 2 (Functional restoration):

Attend 80% of graduate classes within six weeks through implementation of behavioral activation strategies and academic accommodation utilization.
Establish consistent sleep-wake cycle (11 PM - 7 AM) for three consecutive weeks using sleep hygiene protocols and light therapy.

Objective 3 (Anxiety management & interpersonal functioning):

Demonstrate three specific anxiety reduction techniques (progressive muscle relaxation, cognitive restructuring, grounding exercises) during triggered moments by session eight.
Initiate one meaningful social interaction weekly to rebuild peer relationships damaged during manic episode.

IV. Interventions

Cognitive-behavioral therapy focus: Address cognitive distortions specific to depressive episode ("I've ruined everything permanently") and anxiety about future episodes. Implement behavioral activation targeting academic re-engagement and social reconnection.
Interpersonal and social rhythm therapy elements: Establish consistent daily routines targeting sleep-wake cycle, meal timing, and social contact. Monitor relationship between routine disruption and mood changes.
Psychoeducation with financial counseling: Education about bipolar disorder course, medication importance, and practical financial recovery planning for manic episode consequences.
Relapse prevention planning: Develop detailed crisis plan including partner involvement, early warning sign identification, and specific action steps for mood episode prevention.

V. Progress monitoring

Weekly mood and anxiety ratings: Beck Depression Inventory-II, GAD-7, and Young Mania Rating Scale administered biweekly.
Daily functioning metrics: Sleep logs, academic attendance tracking, medication adherence monitoring via pill counting and pharmacy coordination.
Social functioning assessment: Relationship quality scale and social activity tracking to measure interpersonal recovery progress.

I. Primary diagnosis

Getting the right Dx is about more than putting the right heading on your documentation.

Thoughtful differential diagnosis that takes into account the varied mood states, episodic nature, and severity of bipolar disorder allows you to deliver better care while avoiding audits, clawbacks, and denials.

Common ICD-10 codes for bipolar disorder

Common diagnostic codes include:

F31.0: Bipolar disorder, current episode hypomanic
F31.2: Bipolar disorder, current episode manic severe with psychotic features
F31.30: Bipolar disorder, current episode depressed, mild or moderate severity, unspecified
F31.31: Bipolar disorder, current episode depressed, mild
F31.7: Bipolar disorder in remission

Upheal automatically suggests appropriate ICD-10 codes based on your session content and clinical documentation, reducing coding errors and ensuring compliance.

Try Upheal, an intelligent platform for therapists that automatically suggests ICD-10 codes so you don't have to look them up.

II. Presenting problems

Effective treatment planning begins with comprehensive assessment of presenting symptoms. Common presentations include:

Mood episode patterns: Recurrent manic, hypomanic, or depressive episodes with distinct onset, duration, and severity characteristics
Functional impairment: Significant disruptions in work, academic, social, or interpersonal functioning during mood episodes
Sleep disturbances: Decreased need for sleep during mania/hypomania, or hypersomnia during depressive episodes
Cognitive symptoms: Racing thoughts, distractibility, poor concentration, or executive functioning deficits
Behavioral changes: Impulsivity, risky decision-making, social withdrawal, or psychomotor agitation/retardation
Interpersonal difficulties: Relationship conflicts, social isolation, or challenges maintaining stable connections
Medication adherence issues: Inconsistent medication compliance, often related to side effects or lack of insight
Comorbid conditions: Frequently co-occurring anxiety disorders, substance use disorders, or ADHD

III. Objectives

Research demonstrates that structured psychotherapy significantly improves recovery rates when combined with pharmacotherapy.

Effective treatment planning requires specific, measurable, achievable, relevant, and time-bound (SMART) objectives.

Upheal’s Compliance Checker feature reviews your notes against established payer criteria, flagging potential issues before submission.

Goal ideas for bipolar disorder treatment

Symptom stabilization goals
- Maintain euthymic mood for specified periods
- Reduce episode frequency and intensity
- Improve sleep hygiene and circadian rhythm regulation
Functional improvement goals
- Return to baseline occupational or academic functioning
- Rebuild and maintain interpersonal relationships
- Develop independent living skills
Self-management goals
- Demonstrate medication adherence strategies
- Utilize mood monitoring and early warning sign recognition
- Implement personalized coping strategies

Upheal's Golden Thread feature analyzes your session content and intake materials to automatically suggest clinically appropriate SMART goals.

These AI-generated objectives can be edited and customized to match your specific clinical approach, saving valuable planning time while ensuring comprehensive coverage of treatment domains.

IV. Interventions

For clinicians, it’s not uncommon to experience a kind of intervention blindness.

Therapeutic work happens organically in session, but articulating those interventions clearly in documentation proves challenging.

Thoughtfully planning interventions from the beginning of treatment can help you hold the treatment plan with integrity, while making it easier to describe what you’re doing in each session.

Upheal's AI clinical notes captures the nuanced therapeutic work happening in your sessions, automatically translating clinical moments into professionally appropriate, modality-specific intervention language.

Common evidence-based interventions for bipolar disorder

Psychoeducation and Illness Management:
- Comprehensive disorder education
- Medication adherence strategies
- Trigger identification and management
Cognitive-Behavioral Techniques:
- Cognitive restructuring for mood episode prevention
- Behavioral activation during depressive episodes
- Sleep hygiene and routine establishment
Interpersonal and Social Rhythm Therapy (IPSRT) Elements:
- Daily routine stabilization
- Social rhythm monitoring
- Interpersonal problem-solving
Crisis Planning and Safety:
- Detailed relapse prevention planning
- Emergency contact protocols
- Safety planning for suicidal ideation

V. Progress monitoring

Continuous monitoring ensures treatment plan effectiveness and provides crucial data for insurance — namely, justification of medical need.

Common ways to measure progress in BPD treatment

Standardized assessment tools
- Young Mania Rating Scale (YMRS)
- Hamilton Depression Rating Scale (HAM-D)
- Global Assessment of Functioning (GAF)
- Mood Disorder Questionnaire (MDQ)
Daily functioning metrics
- Sleep patterns and quality
- Medication adherence rates
- Social and occupational functioning
- Interpersonal relationship quality
Episode tracking
- Frequency and duration of mood episodes
- Severity ratings
- Triggering events or stressors
- Treatment response patterns

Upheal's Golden Thread features automatically weave consistent narratives of medical necessity throughout your documentation.

From treatment plans to progress notes, our AI ensures each piece of documentation builds upon previous sessions, clearly demonstrating therapeutic progress and maintaining compliance standards.

This integrated approach eliminates documentation gaps that can trigger insurance reviews while providing clinicians with comprehensive client progress visualization.