Does psychotherapy work as treatment for bipolar disorder?

While medication remains the cornerstone of treatment for bipolar disorder, it's widely reconized now that psychotherapy is also an important part of treatment for this illness. Bipolar disorder is in part a biological illness, which is why medications are almost always necessary; but the environment, as well as how a person thinks about and interprets things, also plays a big role in bipolar episodes.

There are some treatments that have been proven effective in the treatment of bipolar disorder: cognitive behavior therapy (CBT) and interpersonal social rhythm therapy (IPSRT) are two of these.

The basic premise of CBT is that our emotions, thoughts, and behaviors are all inter-connected; and that therefore, if we can change one of these, we'll have an impact on the other two. For example, if we can change the way we think about a situation, we'll be able to change our feelings about and behaviors in that situation.

IPSRT focuses on helping clients understand how disruptions to their routines, as well as the quality of their relationships (and their social roles, such as a parent or spouse) can influence their moods.

Unfortunately, even these treatments which have been well-researched aren't "the answer" when it comes to bipolar disorder, so we continue to look for other treatment options and to consider how we can make psychotherapy more effective in helping people prevent bipolar episodes.

Recently, I have been doing some research on a newer therapy developed in the 1980's by psychologist Marsha Linehan, called Dialectical Behavior Therapy (DBT). This therapy is based on the same underlying premise as CBT, but also focuses on helping people live their lives more in the present moment, and with acceptance. In my research, DBT has helped people with bipolar disorder to reduce symptoms of depression, improve their self-awareness, and reduce their fear of their emotions.

At present, neither medication nor psychotherapy can "cure" bipolar disorder; but if we keep working at it, hopefully we'll at least be able to help people stay well longer and live healthier lives in spite of their illness.

A review of scientific studies of psychological treatment for bipolar disorders found that certain models have led to increased interest in psychotherapeutic interventions with people living with bipolar disorder. It also found that longterm treatment is better than on-and-off treatment for long-term prevention of episodes. The evidence from this review showed that psychological treatment has been linked to a reduction in symptoms, relapses, and hospitalizations and an enhancement of social adjustment and functioning. However, because of the wide variety of variables studied, some therapies were found to be more effective with mania than depression, while others had the opposite effect. They suggest that further studies be done to find standardized interventions that would apply to everyday practice.

Although psychotherapy may have a stigma in some social circles, many people now find that it's not as uncommon as it used to be for someone to seek mental health treatment for a wide variety of conditions. Therefore, the fear of stigma should not prevent you from getting the help you need. Psychotherapy can help you explore your feelings in a safe place without judgment. And with the guided support of a mental health professional, you may learn strategies for overcoming lifelong anxieties or other disturbing emotions.