Psychological Model of Bipolar Treatment

Bipolar disorder is often treated by psychiatric means, particularly because of the manic episode risks. Prescribed medications can help stabilize mood swings; however, they do not provide for symptom management techniques, which could be needed if medications aren't taken. The psychological model of bipolar treatment can teach coping skills through education, family involvement and individual psychotherapy.

Family Focused Therapy

• Family focused therapy is psychotherapy that, regardless of the issue's cause, involves the family as part of the solution or focus during treatment. Family roles, styles and relationships are explored rather than causes or family history. A study published in the Canadian Psychiatry Review showed that family-focused therapies were successful in preventing bipolar disorder symptom relapses into depression as well as displaying depressive symptoms within a 2-year follow-up. However, family focused therapy is time consuming, whereas the study involved 21 1-hour sessions over a 9-month period.

Bipolar Disorder

• Bipolar disorder is considered a mood disorder according to the Diagnostic Statistical Manual of Mental Health (DSM-IV) that mental health professionals use for diagnosis. In the Bipolar 1 variant, patients experience alternating moods of extreme mania, balance and then depression, which can last for weeks or months at a time. Bipolar 2 patients experience hypomania, balance and then depression; but the depressive episodes are more chronic. Rapid cycling bipolar disorder involves mood cycles that can happen weekly, daily or even within 24 hours.

Education

• Psychoeduation is a key component of bipolar treatment. By educating the patient as well as family members, he could better predict the sources of triggers and which moods he may be reaching. Encouraging the understanding of bipolar disorder could give the patient a better sense of control. For example, bipolar 2 patients consider their hypomanic and depressive episodes. Although hypomania is considered easier to control versus mania, chronic depression could increase the risk of suicide. With this knowledge, a bipolar patient with this education could set up a contingency plan if he knows he is slipping into depression.

CBT Approach

• The cognitive behavioral theory (CBT) approach involves having an analysis of the bipolar disorder patient's thoughts, feelings and behaviors. Psychotherapists, for example, analyze a list of automatic thoughts that occur whenever the patient feels she's about to exhibit negative manic behavior. Those thoughts would be discussed, and a strategy to replace those thoughts with more beneficial ones might be outlined.

Regular Schedule

• Bipolar patients are encouraged to maintain a regular schedule of sleep, medications (if prescribed) and daily activity. Regulation can help prevent triggers that could lead into depression or manic episodes. Part of scheduling could also involve the use of mood charts where the patient records his daily mood on a scale ranging between manic to depressive. Irritability levels, medications taken, number of sleep hours and significant events would also be recorded. This would be used to discern a pattern in which treatment options can be adjusted, such as less of one medication or reduction in certain bipolar triggers.