CBT as Treatment for Bipolar Disorder

Bipolar disorder, known by many as manic depression, is a mental illness caused by a combination of factors, including neurological, biological, emotional, and environmental factors. It is most commonly described as mood cycling or mood swings, in which the patient cycles through moods of depression, mania, and normal behavior.

There are many treatment options for bipolar disorder. The most common treatment for bipolar disorder includes a combination of medication and therapy. However, some patients are not candidates for medication treatment. Patients that have a history of drug abuse, for instance, should in most cases not be placed on medication for bipolar disorder, as the risk for abuse is too great. Additionally, patients may not have a case of bipolar disorder severe enough to warrant medication. Other patients may choose to avoid the route of medication until it becomes absolutely necessary.

In response to these special cases in which medication treatment is not a viable option for bipolar disorder, that Cognitive Behavioral Therapy, or CBT, was developed. CBT is a type of therapy that assists patients in recognizing triggers and causes for their manic and depressive states. The patient can then learn techniques to avoid these triggers, and cope with symptoms during episodes. Seventy percent of bipolar disorder type one patients that undergo CBT experience one or fewer episodes within four years of starting the CBT treatment.

There are two main goals that are met by using CBT as treatment for bipolar disorder. The first goal is to recognize manic episodes before they become uncontrollable, and consciously change how they react to the episode. The second goal is to learn techniques, reactions, thoughts, and behaviors that can help to offset depression. These goals are realized through various techniques and activities prescribed by the therapist. With CBT, the treatment of bipolar disorder rests with the patient, who is given homework in the form of exercises and reading, which helps them to understand their condition and learn methods to cope with it.

The first step to successful treatment of bipolar disorder through CBT is to develop a treatment contract with the patient. This is a treatment plan that the patient agrees to follow, and also involves the patient's promise to complete all homework assignments and take any prescribed medication as directed. Because the success of CBT depends largely on the patient's responsibility and desire to cope with bipolar disorder, this is an important first step to successful treatment.

The second step to successful treatment of bipolar disorder through CBT is to monitor and grade moods. This is done with various worksheets that the therapist gives the patient. The patient may record their mood for the day, how many hours they have slept, their level of anxiety, and their level of irritability. Those with type two bipolar disorder may need to record their mood two or more times per day, as their moods cycle more often.

Understanding the pattern to mood cycling can help the patient then undergo the next step to CBT treatment for bipolar disorder. This step of CBT for treatment of bipolar disorder requires the patient to do homework in the form of worksheets and reading that will help the patient to understand how their thoughts effect their emotions. By understanding these things, the patient will be able to then practice altering their thoughts in a rational way to make emotions more rational as well, decreasing the number and severity of depressive and manic episodes.

The next step to CBT treatment for bipolar disorder is to learn how to recognize triggers. Triggers are the thoughts, emotions, situations, times of year, events, or environments that set off a depressive or manic episode. By learning how to understand and recognize their triggers, the patient can then learn to avoid the triggers entirely, thereby decreasing the number and severity of depressive and manic episodes.

Overall, CBT is a viable and quite successful treatment for bipolar disorder, and can be a healthy alternative to medication in some cases. If you feel you may be a candidate for CBT, you should contact your doctor or therapist to discuss this and other bipolar disorder treatment options.