monotherapy is rarely successful in bipolar disorder from what I read.

Most bipolar people can spend most of their time in depression. Therefore, they need an anti-depressant. Problem is, AD's cause mania in many bipolar people, and therefore NEED a stabilizer present to keep that from happening.

Stabilizers are suppose to keep people from going too high or low, but they are not ideal at treating depression in most cases.

If a person has delusions or hallucinations while episodic, they need an anti-psychotic to ease those symptoms.

Medications are added when symptoms require it. For some people, one medication might be enough.

The reality is, there is very little science behind polypharming. Doctors are simply trying to ease symptoms. Some people require more medicinal help to get stable.

I'm in the US, and my doctors didn't polypharm me until I asked about using a combo. Doctors are doing a lot more guess work when prescribing medications, than I care to consider. But if people need help, you got to try everything.

I didn't realize that polypharming wasn't as common in other countries.