From http://www.psycheducation.org/depression/ADwithoutAD.htm

1. Depression is the most common symptom in bipolar disorder.
2. Antidepressant medications (Prozac, Paxil, Celexa, Effexor, etc.) can be very effective against depression.
3. Result: antidepressants are commonly used in bipolar disorder.

That's where we are at the present time, in practice. But here is more logic to consider.

1. Antidepressants can make bipolar disorder worse (some of these are controversial; here are the data on that).
* They can cause hypomania where there was none.
* They can induce cycling, or make it worse.
* They may keep a person from becoming truly stable.
2. Therefore: antidepressants should be avoided, as much as possible, in bipolar disorder treatment. (This statement in particular is controversial).

Now, let's combine these two bits of logic:

1. Some antidepressant tool is commonly necessary in bipolar disorder.
2. Yet true "antidepressants" should be avoided, if possible, in bipolar treatment.
3. Therefore, one should maximize use of all other antidepressant approaches before using typical "antidepressants". (Again, this is my personal conclusion, not an expert opinion or mandate).

Fortunately, there are at least nine such approaches to consider. These approaches are not associated with increasing cycling, long-term destabilizing, or the concerns about possible long-term harm which have been raised about typical antidepressants. They all have other risks, but so do any treatments you might consider. For any approach you take, you will always be balancing risks versus possible benefits.