Therapy and Lifestyle Changes

Therapy and Lifestyle Changes

Classic psychotherapy does not help most patients with bipolar disorder. Nevertheless, many newer approaches are proving to be very useful. Trained mental health professionals can:

• Educate patients about bipolar disorder and its treatments
• Help them comply with drug regimens
• Monitor the patient's on-going status
• Intervene early in manic and depressive episodes to reduce the severity of the attack

In addition, trained professionals can help patients:

• Adjust to the reality of the illness and understand the negative consequences of mania -- particularly important for patients who consider their mania to be positive, creative, and exhilarating
• Cope with feelings of guilt and remorse that occur after manic episodes
• Deal with feelings of imperfection and despair

Cognitive-Behavioral Therapy

Therapists trained in cognitive-behavioral therapy (CBT) may be particularly helpful for many patients. CBT is a structured, conscious method that aims to help a patient recognize negative thoughts and behavioral patterns and to change them. CBT is known to be helpful for other mood disorders, including depression and anxiety, and some studies suggest that it benefits bipolar disorder patients as well. For example, in a 2003 study, patients who were given mood stabilizers and underwent a CBT program that was specifically designed to prevent relapse experienced fewer and shorter episodes and improved social functioning compared to those on mood stabilizers alone.

Using Cognitive-Behavioral Therapy for Bipolar Disorder. Typical goals of CBT for bipolar disorder patients include learning how to:

• Recognize manic episodes before they become full-blown and change behaviors during an episode
• Cope with depression by developing behaviors and thoughts that may help offset the negative mood

Monitoring and Grading Mood. One useful technique is a method that helps the patient predict or recognize an impending episode. This is done using a graph and diary that records and grades the effect of the patient's mental state on energy and physical activity.