Exploring Types of Therapy for Bipolar Disorder

Bay Area CBT Center

September 10, 2023

Living with bipolar disorder can be challenging, but with the right support and treatment, individuals can manage their symptoms and lead fulfilling lives. While medication is often the first line of defense, it is not the only tool available.

A comprehensive approach to treating bipolar disorder includes therapy sessions that address various aspects of the condition, from interpersonal relationships to emotional regulation and balancing circadian rhythms. This blog post will explore different types of therapy for bipolar disorder, shedding light on their unique benefits and approaches to help individuals and their families find the right fit for their needs.

Understanding Bipolar Disorder

Bipolar disorder is a chronic condition characterized by unpredictable episodes of mania and depression, necessitating effective bipolar disorder treatment. There are two major types of bipolar disorder: bipolar I disorder, which involves at least one manic episode or mixed episode and may be accompanied by major depression, and bipolar II disorder, marked by periodic episodes of major depression and hypomania, a less severe type of mania.

Bipolar depression is more challenging than unipolar depression or a major depressive episode. The rollercoaster of bipolar disorder, where individuals feel the intense highs (manic or hypomanic episodes) followed by debilitating lows (depressive episodes), makes the depressive episodes feel even more severe by contrast. In other words, people with bipolar disorder often experience more severe depressive symptoms than those with unipolar depression (major depressive disorder).

This unique emotional oscillation can lead to a complex relationship with one’s moods, akin to addiction or escapism. Paradoxically, individuals may sometimes find solace in the manic or hypomanic episodes, as painful as they can be, because they provide a temporary escape from the profound despair that characterizes bipolar depression. It can feel like a relentless pursuit of respite from the deep depressive abyss, making bipolar depression uniquely challenging for those who experience it. This is why medication adherence can be difficult for some with bipolar disorders.

Treating Bipolar Disorders

Treating bipolar disorder typically involves a combination of bipolar disorder medication, therapy, and lifestyle modifications. The American Psychiatric Association recommends a comprehensive approach, including therapy sessions with mental health professionals, to manage bipolar disorder effectively. To treat bipolar disorder and prevent extreme mood fluctuations that can impede an individual’s ability to lead a balanced and productive life, it hinges on early diagnosis and treatment.

In addition to medication, individuals with bipolar disorder should adopt a lifestyle that fosters wellness, such as surrounding themselves with supportive people, seeking professional counseling, and obtaining adequate rest to prevent depressive episodes. Working closely with healthcare providers to construct personalized treatment plans is another important step for those with bipolar disorder.

Treatment for Bipolar Disorders

Bipolar disorder is a complex mental health condition characterized by significant mood shifts, including manic and depressive episodes. Effective bipolar treatment often involves a combination of strategies, with medication playing a crucial role, particularly for individuals with bipolar I disorder. Mood stabilizers and medications are commonly prescribed to help manage symptom severity and reduce the frequency of mood episodes. Medication compliance is essential to ensure individuals receive the full benefits of these treatments and maintain symptom stability.

However, alongside medication, psychotherapy sessions are an integral part of bipolar treatment. Therapy can provide individuals with essential coping skills to navigate manic symptoms, depressive episodes, and the challenges that come with bipolar disorder.

It allows individuals to identify triggers, develop strategies for managing symptoms, and gain insight into their mood shifts. Psychotherapy also aids in improving medication compliance and overall treatment adherence.

Managing Circadian Rhythms in Bipolar Disorders

One of the fundamental aspects of bipolar disorder management is the regulation of circadian rhythms, the internal body clocks governing our sleep-wake cycles. This element often receives less attention than medication and talk therapy but plays a pivotal role in maintaining stability, particularly during maintenance treatment.

People with bipolar disorder frequently experience disruptions in their sleep patterns, which can trigger bipolar episodes. Irregular sleep-wake cycles can lead to mood swings, exacerbating both depressive and manic symptoms. This is why managing circadian rhythms is an essential component of comprehensive bipolar treatment.

In addition to talk therapy and medication, complementary treatments can aid in circadian rhythm management. Establishing a consistent daily routine, especially regarding sleep and wake times, helps individuals with bipolar disorder maintain a sense of balance. Social rhythm therapy, which incorporates elements of talk therapy, focuses on creating structure in daily life, which, in turn, supports circadian rhythm stability.

Types of Therapy for Bipolar Disorder

An essential component that should be incorporated into any bipolar treatment plan is social rhythm therapy. The importance of managing circadian rhythms in bipolar disorders cannot be overstated. This element of treatment, often overshadowed by other components, is critical for long-term stability and maintaining mental wellness.

By incorporating routines, adhering to sleep schedules, and learning to manage stress, individuals can enhance their overall quality of life and reduce the frequency and severity of bipolar episodes. Complementary treatments can further complement these strategies, offering holistic support for individuals living with bipolar disorders.

Establishing a consistent daily routine helps manage symptoms and reduce the risk of a mood episode or depressive symptoms. Behavioral activation techniques are crucial for addressing depressive symptoms, while deactivating behaviors are essential during manic or hypomanic episodes.

Treatment for affective disorders typically involves a combination of medications, such as mood stabilizers and antipsychotics, as well as psychotherapy, education, and support groups. Below we delve into each type of treatment and its benefits.

Interpersonal and Social Rhythm Therapy (IPSRT)

Interpersonal and Social Rhythm Therapy (IPSRT) is a form of psychotherapy that combines interpersonal therapy and social rhythm therapy to help individuals with bipolar disorder manage their relationships, stress levels, and daily routines. The fundamental components of IPSRT include interpersonal psychotherapy for unipolar depression (IPT) and a behavioral intervention, social rhythm therapy, which focuses on restoring disrupted social rhythms.

The objectives of IPSRT are:

To establish a connection between mood and life events
To recognize and address symptoms
To address the primary issue
To maintain consistent daily rhythms
To foresee and address potential triggers of rhythm disruption

The Social Rhythm Metric, a tool utilized in IPSRT, helps observe and track mood and activity.

IPSRT, through enhancing interpersonal relationships and stabilizing daily routines, assists individuals with bipolar disorder in reducing stress and preventing mood episodes. This therapy approach, when combined with medication, may significantly improve the overall well-being and functioning of those living with bipolar disorder.

Group Psychoeducation

Finding a support group is another therapeutic option for individuals with bipolar disorder, providing a supportive environment for them to learn about their condition, share experiences, and develop coping strategies. Its purpose is to assist individuals in gaining greater insight into their condition, recognizing and responding to symptoms, addressing stressful situations, and adhering to pharmacotherapy.

Group therapy has been demonstrated to be highly effective in averting relapse, providing individuals with bipolar disorder the opportunity to connect with others who share similar experiences and challenges. Moreover, Group Psychoeducation can be administered remotely using a telephone, smartphone, or Web platform, offering flexibility and accessibility to those in need.

Participating in group psychoeducation offers several benefits for individuals with bipolar disorder.

Building a support network
Learning from others’ experiences
Fostering a sense of community
Empowering individuals to manage their condition more effectively.

Mindfulness-Based Cognitive Therapy (MBCT)

Mindfulness-Based Cognitive Therapy (MBCT) combines mindfulness techniques with cognitive therapy to help individuals with bipolar disorder recognize and manage unhelpful thoughts and prevent emotional reactivity.

Cognitive behavioural therapy (CBT) is the most effective form of therapy for those suffering from bipolar disorder, according to the American Psychological Association. CBT helps to change how a person views and reacts to a situation using cognitive, somatic, and behavioral interventions.

The cognitive component of CBT focuses on identifying and changing negative thought patterns that can lead to unhealthy behaviors. It helps to identify and challenge irrational beliefs and replace them with more realistic and positive ones.

MBCT aims to enhance awareness, allowing emotional reactivity to dissipate rather than manifest as bipolar symptoms by recognizing early warning signs.

Role-playing in CBT

Role-playing in Cognitive-Behavioral Therapy (CBT) provides individuals with bipolar disorder an opportunity to practice new behaviors and coping strategies in a safe and supportive environment. This therapeutic technique explores and practices new behaviors and coping strategies, helping individuals develop skills, gain insight, and improve their ability to handle real-life situations.

Engaging in role-playing exercises in CBT (Cognitive Behavioral Therapy) enables individuals with bipolar disorder to:

Gain insights into their own behavior and responses
Cultivate skills to better manage real-life scenarios
Face challenges with confidence and resilience

Behavioral Activation/Deactivation

Behavioral activation/deactivation is a therapeutic approach that focuses on increasing or decreasing specific behaviors to improve mental health. It involves identifying and engaging in activities that bring pleasure, satisfaction, and a sense of accomplishment, while also reducing or avoiding activities that contribute to negative emotions or behaviors.

Activities suitable for behavioral activation/deactivation include:

Exercise
Social activities
Hobbies
Relaxation techniques

The advantages of this approach include enhanced mood, heightened motivation, enhanced functioning, and enhanced quality of life.

Focusing on increasing engagement in positive activities and reducing engagement in negative activities can lead to better management of mood and functioning, ultimately improving the overall well-being of individuals with bipolar disorder, acting as a natural mood stabilizer.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) is a subtype of cognitive behavioral therapy originally developed to treat individuals living with borderline personality disorder (BPD) and those who were chronically suicidal. Today, DBT is the standard for treating various conditions, including eating disorders, post-traumatic stress disorder (PTSD), chronic depression, substance abuse, and bipolar disorder.

DBT is a skill-based approach that emphasizes emotion regulation, targeting difficulty with emotion regulation in individuals with bipolar disorder and potentially improving emotion regulation. Research has demonstrated that DBT can be beneficial in treating various conditions, including bipolar disorder, particularly in cases featuring severe suicidality.

DBT, by focusing on enhancing emotional regulation skills, can assist individuals with bipolar disorder in managing their emotions and improving their overall quality of life. Moreover, DBT’s structured approach provides a supportive framework for individuals to develop the skills necessary to cope with the challenges of living with bipolar disorder.

Family-Focused Therapy (FFT)

Family-Focused Therapy (FFT) is a manualized treatment developed by Miklowitz, aiming to reduce overall stress levels for those with bipolar disorder through the enhancement of family and primary relationship functioning. The purpose of FFT is to promote open communication within the family, enhance trust between family members, and foster a sense of unity among them.

FFT is made up of three main steps. These are: psychoeducation, communication enhancement training and problem-solving. Together, they provide a comprehensive approach to help individuals manage their emotions and behavior. Through these phases, FFT can assist in resolving family disputes, providing family members with knowledge regarding the implications of living with bipolar disorder, and reducing the number of occasions where emotional reactions in relationships may exacerbate mood episodes.

Involving family members in the treatment process can have several benefits.

It can improve the support system for individuals with bipolar disorder.
It can foster a sense of understanding and empathy among family members.
It can contribute to a healthier family dynamic.
It can help in better management of the condition.

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy (ACT) is a form of therapy that focuses on:

Accepting thoughts and feelings without judgment
Committing to actions that align with personal values
Promoting psychological flexibility in individuals with bipolar disorder

ACT is a type of psychotherapy that concentrates on aiding individuals to accept their thoughts and feelings rather than trying to alter or remove them.

Accepting thoughts and feelings without judgment and committing to actions consistent with personal values and objectives allows individuals with bipolar disorder to cultivate psychological flexibility, a crucial factor in managing the condition. Research has demonstrated that ACT can be an effective intervention for a variety of mental health conditions, such as anxiety, depression, and substance abuse.

Embracing the principles of ACT can help individuals with bipolar disorder lead more balanced lives, as they learn to navigate their thoughts and emotions with greater resilience and adaptability.

Treatment Considerations for Children and Adolescents

Treating bipolar disorder in children and teenagers requires a tailored approach, taking into account symptoms, medication side effects, and other considerations. Referral to a child psychiatrist with expertise in bipolar disorder is advised for accurate diagnosis and appropriate treatment.

Specialized therapy approaches for children and adolescents with bipolar disorder include Rainbow and MF-PEP. Rainbow is a bipolar therapy approach for children between the ages of 7 and 13, incorporating cognitive behavioral therapy (CBT), interpersonal psychotherapy, and mindfulness-based approaches, as well as skill-building and education about bipolar disorder. MF-PEP, on the other hand, is a family-based therapy approach that focuses on providing psychoeducation, developing communication and problem-solving skills, and teaching emotion regulation techniques.

Taking into consideration the unique needs of children and adolescents with bipolar disorder and collaborating closely with child psychiatrists can result in appropriate and effective treatment plans to support the well-being of these young individuals.

Finding the Right Therapist

When seeking a therapist for bipolar and mood disorders, it is important to consider factors such as experience, therapeutic approach, and personal compatibility. At the Bay Area CBT Center, we provide a holistic, evidence-based, integrative approach to treatment. Our expert therapists specialize in the latest research-based treatments, ensuring effective care. We also offer online therapy for bipolar disorder.

To find the right mental health professional, organizations like NAMI, DBSA, Bipolar UK, Bipolar Australia, and the Mood Disorders Society of Canada are valuable resources. The Bipolar Support Alliance can also assist. Carefully compile your questions and concerns for the initial appointment with a therapist, focusing on experience, therapeutic approach, and personal compatibility. This thoughtful selection ensures you receive the most effective treatment and support on your journey toward better mental health.

Summary

This blog post has explored various types of therapy for bipolar disorder, emphasizing the importance of a comprehensive approach that combines medication, therapy, and lifestyle modifications. By considering different therapy options, individuals with bipolar disorder and their families can find the best fit for their unique needs.

It is essential to work closely with mental health professionals, such as a psychologist in San Francisco, CA, actively participate in therapy sessions, and commit to a healthier lifestyle to achieve the best possible outcomes in the treatment of bipolar disorder. Here at the Bay Area CBT Center, we specialize in treating bipolar disorders and offer a comprehensive range of services.

Our team of San Francisco therapists offers a variety of options for therapy in San Francisco, including individual therapy, group therapy, and workshops. These services are designed to cater to your diverse needs, providing both in-person and california online therapy options for greater accessibility and convenience. Our goal is to support our clients through every step of their journey towards better mental health and well-being, utilizing a range of therapeutic modalities and educational resources.

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Frequently Asked Questions

What is evidence-based therapy?

Evidence-based therapy involves interventions that are scientifically proven to be effective for particular issues. In this approach, a strong partnership based on trust and collaboration is formed between you and your therapist. Within this supportive and unbiased environment, you can freely express yourself without fear of judgment. Over a series of sessions, you and your therapist will work together to address obstacles and set goals aimed at personal growth and fulfillment. This method ensures that the techniques and strategies used are not only supportive but also empirically validated to help you achieve your therapeutic goals.

Who do we work with?

The Bay Area CBT Center provides therapy services for everyone, from children to adults, and welcomes individuals, couples, and groups. We help with various concerns like anxiety, depression, trauma, relationship issues, and behavior challenges. We value diversity and cultural differences, offering personalized and culturally sensitive care to each client.

Why is it so important to find the right therapist?

Studies show that the bond between you and your therapist, known as the therapeutic alliance, is a key factor in treatment success. This alliance is characterized by the strength of your relationship and how well you both agree on treatment goals. Research indicates that individuals with a solid therapeutic alliance experience better treatment outcomes including greater productivity at work, more satisfying relationships, improved stress management, and decreased engagement in risky behaviors.

What should I expect from the matching appointment?

You can expect a 15-30 minute phone call with our care coordinator, who is extensively trained in ensuring the perfect match for you. During this conversation, our matching expert will collaborate with you to understand your therapy needs, preferences, and scheduling availability. This discussion builds upon the information you provided during sign-up and offers an opportunity for you to address any personal questions or concerns you may have about therapy or our services at The Bay Area CBT Center. Following your conversation, we’ll pair you with the therapist who best aligns with your needs, goals, and preferences.

When will I be matched to a Therapist?

At your matching appointment, we will match you with a therapist specifically chosen for you and schedule your first session. Depending on your availability, you can expect to meet your therapist anywhere from one day to a week after this appointment.

Do you provide in-person or virtual therapy?

Our approach to therapy includes a flexible hybrid model, blending both online and face-to-face sessions. This option is perfect for clients situated close to our clinics in the Bay Area who prefer the flexibility of choosing between virtual consultations or meeting their therapist in person. Our aim with hybrid care is to ensure every client is matched with the ideal therapist and therapy environment, be it from the convenience of your own home or in one of our clinics.

Do you accept insurance?

At the Bay Area CBT Center, we accept PPO insurance plans that allow you to use out-of-network providers. This means if your insurance plan is a PPO and it includes mental health benefits, you could get back some or all of the money you pay for our services, depending on what your insurance company allows. When you see one of our therapists, they’ll give you a superbill. You can send this superbill to your insurance company to ask for reimbursement. If you’re not sure if your insurance covers services from providers not in their network, it’s a good idea to give them a call and check.

You may be eligible to have 60-80% of your costs covered by out-of-network benefits.

Also, if you have an FSA (Flexible Spending Account), you can usually use it to pay for individual counseling sessions. It’s wise to double-check with your FSA provider or talk to your accountant to make sure that counseling sessions are considered an allowed expense.