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Cognitive Therapy for Bipolar Disorder

Bipolar disorder is a serious mental disorder known as a spectrum disorder. This name refers to the fact that it involves mood swings that fall on different areas of the spectrum of depression. Unlike unipolar depression – usually referred to simple as ‘depression’, bipolar depression or bipolar depression involves both extreme moods: major depression and mania. This can be extremely unpleasant and dangerous for both the sufferer and those close to them. Cognitive therapy bipolar disorder solutions however will attempt to stabilise their mood by addressing faulty thought patterns and providing them with skills and psychological ‘tools’ with which to control their mood swings.

This means that patients display different symptoms depending on which point of their ‘cycle’ they are going through. During manic phases the patient will experience high energy, increased sex drive, racing thoughts, high ‘creativity’ and euphoria. This can be perceived as a positive effect, and indeed some sufferers find that they can perform better than normal during manic episodes. However mania should not be taken lightly as it can also cause patients to become aggressive, to lose sleep, to behave recklessly, to flirt inappropriately, drive dangerously and gamble. In extreme cases they can also suffer from delusions of grandeur and hallucinations, often claiming to have special powers or be of high importance. In some cases these patients will require hospitalisation to prevent them harming themselves or others. However it is also possible to suffer ‘hypomania’, which describes a far milder form of the condition.

During the depressed stages however, the patient will suffer the opposite symptoms, finding themselves feeling tired, ‘drained’, sad, suicidal, low self esteem, pessimistic and ‘hopeless’. During depressed episodes it is not unusual for the patient to become isolated or withdrawn, and to be at high risk of suicide. Often it is impossible for sufferers to go to work or to socialise normally. Again a milder form exists called ‘dysthymia’.

These are the two main symptoms of bipolar disorder, but there are many different patterns of cycling resulting in different forms of the condition and this will affect how cognitive therapy bipolar disorder focused works. While it is usual for patients to suffer more depressed episodes than manic and for these to last longer (type 2), some patients will experience both in equal amounts (type 1). Similarly while some will experience periods of normality, others will cycle rapidly between each extreme (rapid cycling) or between hypomania and dysthymia (cyclothymia). Some patients will even experience ‘mixed episodes’ with elements from both mania and depression presenting at once.

Cognitive behavioural therapy, CBT, or cognitive therapy, is a school of clinical psychology that attempts to help patients to monitor and control their own thought patterns and ‘ruminations’. This applies well to mood disorders and there are many cognitive therapy bipolar disorder techniques that can help sufferers to manage and control their mood. Specifically cognitive therapists will aim to teach patients to recognise the signs of manic or depressive episodes before they occur so that they can manage them, and to endure the episodes while causing minimal harm to themselves and others.

To do these things a patient is taught ‘mindfulness’, which is one of the most important cognitive therapy bipolar disorder tools. Here the sufferer is taught to ‘watch’ their own thoughts pass by ‘like clouds’. This can be seen as a form of meditation and at first it can be useful to find a quiet place to practice. The patient is asked not to try and direct their thoughts, but simply to observe their content and decide whether they are healthy. This way, as thoughts begin to turn increasingly negative, or absurd, the patient will be able to notice phrases like ‘there’s no point in going on’, or ‘I just have too many fantastic plans that I have to get started on!’.

By recognising these, the patient then has a clue that they are entering the beginning of an episode. Another cognitive therapy bipolar disorder tool is to then be able to replace these unhealthy thoughts as much as possible. This might involve using positive affirmations such as ‘I am a worthwhile and happy person’ during depressive episodes, or using realistic statements during manic episodes such as ‘I need rest and I am behaving irrationally’. By changing their thought patterns as they manifest they can then prevent the emotions that they cause. Eventually cognitive therapy bipolar disorder practices will enable the sufferer to consciously rationalise each of their thoughts.

Even though this may not necessarily prevent or end episodes, it can certainly help patients to act rationally during these periods and to use reality checks and affirmations to maintain a healthy outlook and acknowledge their condition. Patients are also encouraged to keep diaries in which they note down their feelings and thoughts so they can see them on paper in front of them making them more concrete and real. This can help the patients again to recognise and spot warning signs, not only in their own thought patterns, but also in external and social aspects that may exacerbate their moods.

They will also be asked to rate each day in terms of their mood. This way they can look for causes or triggers that may cause certain emotional reactions, such as alcohol consumption, lack of sleep, menstruation, or problems at work, and so can look to address these issues.

As well as using the cognitive therapy bipolar disorder tools, a cognitive therapist will also recommend certain medications to help the patient’s chemical balance in the brain and encourage them to use these rather than self medicate with alcohol or cigarettes. A combination of mood stabilisers and cognitive behavioural therapy has been demonstrated to be one of the most effective treatments for bipolar disorder (a side note is that it’s highly important that patients are not misdiagnosed, as straightforward antidepressants can actually exacerbate the rapid cycling of moods).

Other schools of psychology will treat bipolar disorder in other ways. Family therapy for example will look at the role of each family member in creating the condition and teach them to help the patient. Often it is suggested that the patient is trying to fill a ‘sick role’ or communicate something to the rest of the family. While this system takes into account the broader picture, it does not explain cases of bipolar disorder that occur in individuals living alone and is difficult and expensive due to the need for all family members to be present. Meanwhile psychodynamic therapists will look at early childhood events and traumas that could result in mood disorders in adult life, and will look at the condition from the perspective of the ID, ego and superego. This will involve free association, dream interpretation and hypnosis as well as in depth discussion regarding emotions and memories.

Still though, cognitive therapy bipolar disorder tools have proved the most effective and are also the cheapest and simplest. Most therapists however these days use an ‘integrative’ approach, combining the multiple schools of psychology to find the method that works best for the individual case. This combined with a course of mood stabilisers will prove the most comprehensive and effective method of treatment.