Clients with bipolar disorder usually need to take medication, such as a mood stabilizer. But CBT is often used as an added treatment. The medication can help stabilize a person’s mood so that he or she is receptive to psychotherapy and can get the most out of it. CBT can help a person cope with bipolar symptoms and learn to recognise when a mood shift is about to occur. CBT also helps a person with bipolar disorder stick with a treatment plan to reduce the chances of relapse (e.g., when symptoms return).
As part of CBT Clients learn that they can reduce the negative impact of bipolar manic depression by learning to identify and correct habitual and automatic thought and judgment distortions that would lead them to exaggerated and harmful conclusions.
Clients are taught to write down their perceptions alongside the events that trigger those perceptions, and then to examine what they have recorded for evidence of bias or inaccuracy.
Throughout this process of learning, exploring and testing perceptions, clients gain bipolar disorder coping strategies while improving skills of awareness, introspection and evaluation.
Clients’ improved coping and reality testing skills, properly applied, will help you to decrease the extremeness of your mood swings (where possible), reduce the impact of the bipolar illness on your social and occupational relationships, improve your motivation to remain on bipolar medication, and generally function to help reduce their chance of catastrophic relapse.
Clients must possess a certain level of insight into their bipolar symptoms before CBT can be useful. For this reason, CBT is most appropriate for medicated and reasonably stable patients, and more specifically those medicated patients who are fairly verbal and able to reflect about their bipolar disorder.
It is unlikely that clients who are in the midst of any sort of extreme bipolar manic depressive episode will benefit from CBT.
We can work together to find adaptive ways of appraising and responding, such as testing ideas at an early stage.
Many people with bipolar disorder spend their time switching between different states of mind depending on their mood. During sessions, with monitoring of moods, thinking, behaviours, and social situations, these different states become more evident. They emerge from the conflicting extreme personal beliefs that become activated in different internal states and social contexts.
In therapy, you the client and I can work on developing this higher level understanding, and in tandem they can work on building a positive, healthy self that can be added to the repertoire. So, the aim is not to eliminate the other states of mind, but to notice when they are occurring and therefore provide you the client with the choice whether to maintain that state.
For example, when meeting new mothers at a party, she took the risk of being herself rather than either trying not to attract attention or overcompensating by hyping herself up and talking more than usual.
In cognitive-behavioral therapy, the goal is to help you gain a new outlook on your situation by directly challenging unhelpful thoughts and fears you may have and teaching you to control or get rid of them.
The therapy is generally short-term and directly focused on eliminating or managing specific problems. We will work collaboratively to address specific problems.