Psychotherapy for Bipolar Disorder

Psychotherapy, or "talk" therapy, is an important part of treatment for bipolar disorder. During therapy, you can discuss feelings, thoughts, and behaviors that cause you problems. Talk therapy can help you understand and hopefully master any problems that hurt your ability to function well in your life and career. It also helps you stay on your medication. It can help you maintain a positive self-image.

The types of psychotherapy used to treat bipolar disorder include:

• Behavioral therapy. This focuses on behaviors that decrease stress.
• Cognitive therapy. This type of approach involves learning to identify and modify the patterns of thinking that accompany mood shifts.
• Interpersonal therapy. This involves relationships and aims to reduce strains that the illness may place upon them.
• Social rhythm therapy. This helps you develop and maintain a normal sleep schedule and more predictable daily routines.

Support groups also help people with bipolar disorder. You receive encouragement, learn coping skills, and share concerns. You may feel less isolated as a result. Family members and friends may also benefit from a support group. They can gain a better understanding of the illness, share their concerns, and learn how to best support loved ones with bipolar disorder.

Education is another integral part of treatment for you and your family. People with bipolar disorder (and their families) often benefit from learning about the disorder -- its symptoms, early signs of an episode, and types of treatment. This type of education can also help to come up with a plan in case your insight or ability to see you system is compromised.

Also, taking these steps may help you cope with bipolar disorder:

• Establish routines. Regular sleep, eating, and activity appear to help people with bipolar disorder manage their moods.
• Identify symptoms. Even though the early warning signs of an approaching episode vary from person to person, together with a psychiatrist you can identify what behavior changes signal the onset of an episode for you. It may be needing less sleep to feel rested, buying things you can’t afford or don't need, or becoming suddenly involved in religion or new activities and interests.
• Adapt. This can help you avoid embarrassing behavior during manic episodes and set realistic goals for treatment. Your doctor can help you prepare for possible future episodes and manage fear about having more. A key part of adapting is to understand the types of stressors that might increase the risk for manic or depressive episodes and the lifestyle changes that can reduce them.
• Maintain a regular sleep pattern. Go to bed and wake up around the same times each day. Changes in sleep can disrupt the normal functioning of brain circuits involved in the processing of emotions, potentially triggering mood episodes.
• Do not use alcohol or street drugs. These substances can trigger or mimic mood episodes. They can also interfere with the effectiveness of medication.

Special Problems in Bipolar Disorder

For many people with bipolar disorder, there is risk of having other psychiatric problems. Typically, these are alcohol and drug abuse, an anxiety disorder, an eating disorder, or a personality disorder.

An estimated 60% of all people with bipolar disorder have drug or alcohol problems. Drug abuse can mimic the symptoms of depression or mania, making it important to treat substance abuse problems in order to make an accurate diagnosis of bipolar or other mood disorders.

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