Psychotherapy for Bipolar Disorder

Bipolar disorder is a type of brain disorder that results in a sudden shift of a person's mood, energy, activity, and sometimes, how a person carries out his or her daily activities. It has always been known that pharmacotherapy is the effective treatment for people with bipolar disorder. However, through medication, only partial relief can be achieved. In fact, pharmacotherapy alone has been associated with high recurring rates of the disease and residual symptoms.

Thus, a particular therapy that is bipolar-oriented is recommended when tackling the disorder. When added to medications, therapy gives more advantages compared to using pharmacotherapy alone.

The reasons as to why psychotherapy has continued to be accepted in the treatment of bipolar disorder include:

1. The stress-vulnerability model of the bipolar disorder has gained much acceptance.
2. Pharmacology, however advanced, has failed to provide successful treatments. For example, relapses continue to occur while still taking medication.

When treating bipolar disorder using psychotherapy, three main therapies are used: cognitive behavioral approach, family therapy, and psychoeducation. These therapies also improve the adherence with medication. Furthermore, intervention studies have proven that there are additional benefits of psychotherapy when treating a bipolar disorder.

Psychotherapy Approaches to Bipolar Disorder

Psychoeducation

This method can be gradually delivered as a structured intervention or in a single package over several weeks. Psychoeducation can be carried out either individually, as a family, or in various support groups. The primary goal of psychoeducation is to communicate the following:

• The main cause of the disorder
• Which direction is the illness heading?
• How to use the medication given and managing any side effects that may result from the medication
• Improving how you manage your life and control those issues that can create stress to your life
• How to monitor your moods in case of signs of relapse

The General Practice: How Is Psychoeducation Delivered? 

All individuals suffering from a bipolar disorder are assisted to know as much as they can about the disorder. A patient's awareness about his or her condition is very crucial in ensuring that they take the medications that they have been given, immediately after the diagnosis. Some patients might stop using their medications after some time. 

For psychoeducation to be effective, the following techniques are used:

• The patient’s symptoms are tracked using a mood-monitoring tool. They are also taught on how to know the early signs of relapse.
• Information and fact sheets are distributed to patients or available for download to help them understand more about the disease.
• Providing relevant videos to patients and their partners to further educate them about the disorder.
• Recommendation of an appropriate website where they can get information or other relevant resources such as articles or books about bipolar disorders.
• Patients may be asked if they have any alcohol-related problems, so they can be treated accordingly.
• Evaluation of the medication process, rationalization regarding the type of medication, and provision of information about the possible side effects.

Cognitive Behavioral Therapy

Cognitive behavioral therapy emphasizes the connection between how we feel, think, and do things since one aspect can easily influence the other. This approach will show patients how to identify their behavioral patterns and change them as well as challenging and changing their negative thoughts. In the long run, they become aware of their behavior and have thoughts that bring the best out of them.

The cognitive behavioral approach will target the main ways on how the disorder affects an individual. The therapy focuses on the following approaches:

• Coming to terms with diagnosis - You will be required to accept that your symptoms are related to your disorder. However, one's acceptance is not that easy and simple. But by teaching the patients on the causes, symptoms, and treatment of the disorder, they will be able to accept the idea that they need help. Furthermore, the feeling that they are facing the problem alone will be eradicated.

• Mood monitoring - Have a sheet where you will keep the details of your moods on a daily basis. You will then review the details with your therapist to see whether there is any progress. The primary objective of the monitoring is to make you aware of any mood changes or triggers.

• Problem-solving activities - This will be an activity where you will know how to evaluate a problem and come up with potentially viable solutions. You will be first taught during therapy and then continue practicing it in between therapies, and sometimes, after therapies. Problem-solving activities will ensure that the risks of having a relapse are minimized.

• Cognitive reconstruction - This process will involve correcting your negative thoughts by identifying those thoughts that play a role in your moods. Your therapist will teach you how to identify any thought distortions to assist you in achieving a balanced thinking.

• Routine stabilization - Regularly engaging in activities and known patterns will establish some rhythm to your day. This routine keeps your moods in check as well as prevents sudden changes. These activities can include doing chores in the house, setting schedules for your meals that you must follow, exercising in the afternoon, having a consistent sleep pattern, and creating social plans.

Family-Oriented Therapy

The primary objective of a family-oriented therapy is to improve family functioning. Coping strategies, communication skills, and problem-solving techniques will be taught. In most cases, it will include psychoeducation, teaching the family on bipolar disorders and how to identify any signs of relapse. By observing family therapy, there will be an increase in medication adherence, decrease in relapse rate, and a reduction in depressive episodes.

Other Types of Psychological Treatment

Having Well-Being Plans

These plans are put in place to monitor the psychological wellness of the patients as they undergo treatment. It also addresses the possibility of early relapse signs and how they can attend to it. The wellness plan is typically drawn by the patient in conjunction with the treatment team, which maintains a balance in between mental and physical aspects both in short-term and long-term treatment plans.

The plan should not be imposed on anyone. Only the patient should own it after being helped by relevant consultants. In your wellness plan, ensure that it addresses issues such as your routine, changes in lifestyle, compliance with medication, and how to cope with stressful situations.

Interpersonal and Social Rhythm Therapy

This therapy addresses any interpersonal conflicts, grief, disputes, and other personal issues. This type of therapy usually includes psychoeducation, cognitive and behavioral intervention, and social rhythm regulation.

However, this therapy is done in research facilities as there is still debate on its effectiveness.

How to Maximize Your Treatment for Bipolar Disorder

To ensure that you get the best out of your treatment, you will need to:

• Acknowledge that you have a bipolar disorder, and therefore, follow your doctor’s advice by taking necessary medications to ease your moods.
• Cognitive behavioral therapy will require you to do some work in between therapy sessions on your own. The reason is that skills will be built through regular practice.
• Continue getting information about bipolar disorder by frequently engaging with your doctor and therapist.
• Join support groups.

The most convenient way to control the disorder is by being active in the entire treatment process.