This article is Part II of “Types of Therapy Used to Treat Bipolar Disorder.” You can read Part I here.

Therapy is a highly effective treatment for bipolar disorder when used alongside medication. However, it can be difficult to establish a good relationship with a therapist. Sometimes it takes seeing a few different people to decide where you feel most comfortable. The more comfortable you are with a person, the more you will get out of the sessions. Another complicating factor in choosing a therapist is choosing which type of therapy is right for you. Not all therapy is generic talk therapy. Each style has its own way of approaching and treating bipolar disorder.

In Part I we discussed two types of therapy- cognitive behavioral therapy and family-focused treatment. These are only the beginning. There are at least three more types of therapy commonly used to treat bipolar disorder.

Psychoeducation
Psychoeducation is a very basic type of therapy for bipolar disorder. The premise is educating the patient (and possibly family) about the disorder itself. The end goal of psychoeducation is to provide ample and accurate information about bipolar disorder. In this way, patients can make informed decisions about their care including pinpointing risk factors and personal symptom patterns.

Psychoeducation has been shown to reduce the number of manic episodes and increase the time between all types of episodes. Hospitalization rates also decrease with the use of psychoeducation.

Interpersonal and Social Rhythm Therapy
Interpersonal and social rhythm therapy (IPSRT) was designed specifically to treat bipolar disorder. It is based on research showing circadian rhythm abnormalities in those with the disorder. When circadian rhythm is off, it can affect sleep, hormone levels (including stress hormones) and metabolism. When this happens, symptoms can increase or it can even cause a relapse. In IPSRT, therapists assess patients’ sleeping and social patterns (daily routines) to detect problem areas. The goal is to regulate routines with productive behaviors in order to stave off episodes.

IPSRT has been shown to lengthen time between episodes for most participants, sometimes at least two years. Episodes may also be shorter when IPSRT is used during an acute episode. It also shows great improvement in occupational functioning and quality of life.

Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) was originally developed to treat borderline personality disorder, but is also being used to treat other psychological disorders as well. The idea behind it is that some people react more intensely to certain stimulations and attain a higher level of stimulation than most people. They react quicker and calm more slowly. This can lead to non-productive behavior and thought patterns.

In order to help people cope with these extreme emotions, DBT has two parts. The first is group skills training. Patients meet as a group for 24 weeks in which they are taught coping skills and assigned homework where they use these coping skills. The second part is individual therapy that runs concurrently with the group therapy. More individualized coping skills are taught along with some kind of cognitive behavioral talk therapy. Individual therapy can last indefinitely. The skills taught in DBT are mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation.

In preliminary research for bipolar disorder, patients learning DBT skills have shown lower depressive symptoms, higher mindfulness skills (which can reduce anxiety) and fewer hospital visits.

 

Therapy is an excellent complement to medication in treating bipolar disorder. All of these types of psychotherapy have shown to improve the lives of their patients. It is up to the individual (or family) to see which style is most effective for them. Personally, my therapist does a combination of DBT and traditional cognitive behavioral therapy. I do not attend group sessions. Take the time to find what is right for you and let it help you live a better life.

 

 

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