Treatment for Bipolar Disorder

Our treatments for Bipolar Disorder include psychoeducation, cognitive behavior therapy (CBT), interpersonal and social rhythm therapy, family-based services, social skills training, illness self-management, treatment for alcohol and substance use disorders, and treatment for weight management. You can learn more about these here and more about Bipolar Disorder in general in our education handout.

Psychoeducation

Psychoeducation provides patients with an understanding of their illness and the most effective ways of treating symptoms and preventing relapse. Psychoeducation covers topics such as the nature and course of bipolar disorder, the importance of active involvement in treatment, the potential benefits and adverse effects of various treatment options, identification of early signs of relapse, and behavior changes that reduce the likelihood of relapse.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a blend of two therapies: cognitive therapy and behavioral therapy. Cognitive therapy focuses on a person’s thoughts and beliefs and how they influence a person’s mood and actions. CBT aims to change a person’s way of thinking to be more adaptive and healthy. Behavioral therapy focuses on a person’s actions and aims to change unhealthy behavior patterns. CBT is used as an adjunct to medication treatment and includes psychoeducation about the disorder as well as problem-solving techniques. Individuals learn to identify what triggers episodes of the illness, which can reduce the chance of relapse. This can help individuals with bipolar disorder minimize the types of stress that can lead to a hospitalization. CBT also helps individuals learn how to identify maladaptive thoughts, logically challenge them, and replace them with more adaptive thoughts. CBT further targets depressive symptoms by encouraging patients to schedule pleasurable activities. Individuals who receive both CBT and medication treatment have better outcomes than those who do not receive CBT as an adjunctive treatment.

Interpersonal and Social Rhythm Therapy

In Interpersonal and Social Rhythm Therapy (IPSRT), patients first learn to recognize the relationship between their circadian rhythms and daily routines, and their mental health symptoms. IPSRT then focuses on stabilizing sleep/wake cycles, maintaining regular patterns of daily activities (i.e., sleeping, eating, exercise, and other stimulating activities), and addressing potential problems that may disrupt these routines. This often involves resolving current interpersonal problems and developing strategies to prevent such problems from recurring in the future. When combined with medication, IPSRT can help individuals increase their targeted lifestyle routines and reduce both depressive and manic symptoms.

Family-Based Services

Mental illness affects the whole family. Family services teach families to work together towards recovery. In family-based services, the family and clinician meet to discuss problems the family is experiencing. Families then attend educational sessions where they will learn basic facts about mental illness, coping skills, communication skills, problem-solving skills, and ways to work with one another toward recovery. Individuals with bipolar disorder who participate in family interventions along with taking medication have fewer relapses, longer time between relapses, better medication adherence, less severe mood symptoms, and increased positive communication between family members. There is a range of family programs available to fit the specific needs of each family. Some families benefit from just a few sessions, while more intensive services are especially helpful for families that are experiencing high levels of stress and tension and for individuals with bipolar disorder who are chronically symptomatic or prone to relapse. These longer-term interventions generally last 6-9 months.

Social Skills Training

Many people with bipolar disorder have difficulties with social skills. Social skills training (SST) aims to correct these deficits by teaching skills to help express emotion and communicate more effectively so individuals are more likely to achieve their goals, develop relationships, and live independently. Social skills are taught in a very systematic way using behavioral techniques, such as modeling, role playing, positive reinforcement, and shaping.

Illness Self-Management

Components of illness self-management include psychoeducation, coping skills training, relapse prevention, and social skills training. Individuals learn about their psychiatric illness, their treatment choices, medication adherence strategies, and coping skills to deal with stress and symptoms. Relapse prevention involves recognizing situations that might trigger symptoms, tracking warning signs and symptoms of relapse, and developing a plan to cope with triggers and warning signs to prevent relapse. This treatment approach also teaches individuals social skills in order to improve the quality of their relationships with others.

Treatment for Alcohol and Substance Use Disorders

Many individuals with bipolar disorder also struggle with an alcohol or substance use disorder. Co-occurring disorders are best treated concurrently, meaning that treatment for bipolar disorder should be integrated with the treatment for the alcohol or drug problem. Integrated treatment includes motivational enhancement and cognitive-behavioral interventions. Integrated treatments are effective at reducing substance use, preventing relapse, and keeping individuals in treatment longer.

Treatment for Weight Management

Weight gain is a significant and frustrating side effects of some medications used to treat the symptoms of bipolar disorder. Weight gain can lead to problems such as diabetes and hypertension, making it a serious health issue for many individuals. Our weight program includes education about the role of antipsychotic medications in weight gain, general nutrition, and portion control. Participants learn skills to monitor their daily food intake and activity levels, have regular weigh-ins, and set realistic and attainable personal wellness goals. Participation in this program can help prevent additional weight gain and lead to modest weight loss.