What Is Therapy for Bipolar Disorder?

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What Is Therapy for Bipolar Disorder?

Medication is the mainstay for treating bipolar disorder, but the most successful and durable treatment involves a combination of both medication and therapy. Effective therapies for bipolar disorder include cognitive-behavioral therapy (CBT), family-focused therapy, and interpersonal and social rhythm therapy. Group psychoeducation and peer-support programs are also useful therapies for bipolar disorder.

Read on for what to know about the importance of properly treating bipolar disorder, what the different therapy types involve, how therapy can help people with bipolar disorder, and how to find a therapist you feel comfortable with.

Types of Therapy for Bipolar Disorder

Bipolar disorder is a mental health condition characterized by extreme mood swings, including depressive and manic episodes. There is no “cure” for bipolar disorder—it’s something you must manage throughout your life. As such, people with bipolar disorder need to be on medication through the duration of their lifetime.

But medication on its own isn’t enough to effectively manage symptoms, and keep recurrences of episodes at bay. Instead, the most effective strategy for managing bipolar disorder is to treat it on an ongoing basis with both medication and therapy.

According to 2019 research published in Psychiatry Online, therapy modalities that have been found to be most effective at treating bipolar disorder include:

  • Psychoeducation, especially in groups
  • Cognitive-behavioral therapy (CBT)
  • Interpersonal and social rhythm therapy
  • Family-focused therapy
  • Peer-support programs

Therapies which have less evidence behind them but which show promise in the treatment of bipolar disorder include:

  • Mindfulness-based cognitive therapy
  • Functional remediation
  • Illness management and recovery

Techniques of Therapy for Bipolar Disorder 

Each type of evidence-based therapy for bipolar disorder is a little different, and one therapy type might work better for you, depending on your particular needs.

Let’s take a look at what each kind of therapy for bipolar offers.

Cognitive-Behavioral Therapy (CBT)

CBT is a type of therapy that teaches people to be more in tune with their thoughts and how these thoughts influence emotions and behaviors. CBT is considered the most effective type of psychotherapy for bipolar disorder.

Group Psychoeducation

Psychoeducation involves learning about bipolar disorder, understanding what early warning signs of depressive and manic episodes look like, and learning how to stick to lifestyle routines that make living with bipolar disorder more manageable. Education is a vital part of living with bipolar disorder and keeping symptoms under control.

Research has found that education that happens in a group, and with other family members, is most effective.

Interpersonal and Social Rhythm Therapy (IPSRT)

IPSRT involves people with bipolar disorder logging in information about their daily activates to ensure they are making healthy choices. Information recorded might include bedtimes, morning and nighttime wake ups, along with other activities such as eating and exercising. Along with a therapist, people will be able to recognize how adhering to a healthy routine affects their moods and ability to function well.

Family-Focused Therapy (FFT)

Bipolar disorder can affect the whole family unit. In FFT, both you and your family members or spouses are included in therapy sessions. Sessions consist of education about bipolar disorder, recognizing signs an uptick in symptoms may be happening, and how to decrease new episodes from occurring. Communication and conflict resolution skills are also addressed.

Peer-Support Programs

Peer-to-peer support is a powerful way for people with bipolar disorder to connect to others who live with similar challenges. Support may be one-on-one, or may happen in larger groups. These days, there are many support groups that are offered online, though in-person support may also be available. Peer support is often considered a maintenance treatment for people with bipolar disorder.

What Therapy for Bipolar Disorder Can Help With

People who are dealing with the high and lows of bipolar (depression and mania/hypomania) may find it very difficult to function in day-to-day life. Bipolar disorder can affect your interpersonal relationships, your ability to work and care for children, and your ability to take care of yourself. Having bipolar disorder also increases your risk of suicide.

Symptoms of bipolar disorder differ depending on whether you are experiencing a manic or depressive episode.

Manic symptoms include:

  • Feeling excited or “high”
  • Racing thoughts, trouble concentrating
  • Not feeling like you need much sleep
  • Risky behaviors
  • Reduced appetite
  • Talking fast
  • Feeling important and powerful

Depressive symptoms include:

  • Feeling sad and hopeless
  • Not wanting to get out of bed
  • Having trouble completing activities
  • Decreased interest in activities you used to enjoy
  • Feeling slow, and having trouble thinking clearly
  • Having thoughts of suicide

Therapy for bipolar disorder can help you decrease the severity of these symptoms. It can help you learn to identify and work to change the challenging thoughts, emotions, and behavioral patterns that accompany bipolar disorder. Moreover, it can offer both you and your family educational support and ongoing treatment guidance as you navigate the condition.

Benefits of Therapy for Bipolar Disorder

Research has found some clear benefits to sticking to a care routine that includes both therapy and medication. In particular, therapy for bipolar disorder can do a few specific things to keep symptoms in check.

According to Psychiatry Online, evidenced-based therapies for bipolar disorder may quicken the amount of time it takes for someone with bipolar disorder to go into remission. It can also help people learn the skills necessary to manage their symptoms and maintain healthy relationships.

Research published in FOCUS—Psychiatry Online found that people with bipolar disorder who utilize therapy are more likely to recover more quickly from depressive episodes and are less likely to experience a new episode. It also improves daily functioning and overall well being.

Effectiveness

There is not a lot of published data on the effectiveness of therapy for bipolar disorder. But a 2020- systematic review published in JAMA Psychiatry offers some answers. Study researchers analyzed 39 trials that included a total of 3,863 people diagnosed with bipolar disorder. Their conclusion was that people who used both medication and therapy to treat bipolar disorder managed better than people who used medication alone.

Specifically, they found that people who used both medication and therapy had decreased rates of symptom recurrence than people who didn’t. They found that in terms of therapy type, cognitive behavioral therapy was most successful, followed by family-focused therapy and interpersonal therapy. Additionally, they found that group or family psychoeducation was more successful than individual psychoeducation.

How to Get Started

After receiving a bipolar disorder diagnosis, it’s common to feel overwhelmed. It’s important that you adhere to your healthcare provider’s instructions about the medication that is necessary to keep you stable, along with the lifestyle modifications that will help you live a full and healthy life.

As you consider adding therapy to your routine, you might start by asking your healthcare provider or your psychiatrist for a recommendation. It’s vital that you see a therapist who is experienced in helping people with bipolar, and they may know providers in the area who have a track record of success.

If you have health insurance, you can get a list of providers from your insurance companies. But you’ll want to vet the providers to make sure they have experience with bipolar disorder. You might consider asking a friend or family member to help you research.

Another place to look are organizations that specialize in bipolar disorder, such as International Bipolar Foundation (IBPF), Depression and Bipolar Support Alliance (DBSA), and International Bipolar Foundation (IBPF). These organizations have listings of local providers who specialize in bipolar disorder.

Once you have found a few therapists, you can start making appointments. A good therapist is one who has the right kind of experience and background to help you, but it’s important to find one who you feel comfortable with.

It can sometimes take a few appointments to know if a therapist is a good match, and sometimes you need to try a few different therapists until you find one you feel comfortable with. That’s normal and OK. Don’t give up if the first therapist you meet isn’t right for you.

The bottom line is that you deserve support as you live with bipolar disorder. Therapy is one of the best ways to ensure that you will get the care you need to live a full life with bipolar disorder. You deserve that.

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Novick DM, Swartz HA. Evidence-Based Psychotherapies for Bipolar Disorder. Focus (American Psychiatric Publishing). 2019;17(3):238-248. doi:10.1176/appi.focus.20190004

  2. Miklowitz DJ, Efthimiou O, Furukawa TA, et al. Adjunctive Psychotherapy for Bipolar Disorder: A Systematic Review and Component Network Meta-analysis. JAMA Psychiatry. 2021;78(2):141–150. doi:10.1001/jamapsychiatry.2020.2993

  3. Miklowitz DJ. Psychotherapy in Addition to Medication Helps Bipolar Disorder Patients Avoid Relapse and Manage Their Symptoms, Study Determines. Brain and Behavior Research Foundation.

  4. Miklowitz DJ. Different Types of Therapy for Bipolar Disorder. National Alliance on Mental Illness.

  5. Johns Hopkins Medicine. Bipolar Relationships: What to Expect.

  6. National Institute of Mental Health. Bipolar Disorder.

  7. Swartz HA, Swanson J. Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence. Focus (American Psychiatric Publishing). 2014;12(3):251-266. doi:10.1176/appi.focus.12.3.251

By Wendy Wisner
Wendy Wisner is a health and parenting writer, lactation consultant (IBCLC), and mom to two awesome sons.