Bipolar Disorder therapy can be extremely helpful in assisting both child and adult clients in predicting and managing their moods. This is in combination with mood stabilizers anti psychotics or medications prescribed by psychiatrists.
Therapy helps clients to cope with the symptoms when they are present but also on helps them to deal with symptoms when they return.
Bipolar disorder therapy consists of understanding how stress impacts the clients mood states, and how through self monitoring, understanding the impact of their thoughts on their feelings and behaviors, and the reduction of stress, the client can minimize the impact of their mental illness.
Bipolar disorder therapy first starts with relationship building, self monitoring, and psycho-education. Understanding the illness and symptoms of each particular mood state is a key focus of treatment. This looks different for each person. In my office I like to involve everyone in a clients life who wants to participate. For example, a child's parents and siblings, or an adults spouse. Often those closer to a client are better able to read the signs of a mood state than we are, and they can help support the client during these times.
Sometimes it is helpful to note that changes that appear behavioral are often mood state related. Significant others can be taught that when they are feeling angry or frustrated with the person they love, it is often because the bipolar person is going through an unstable mood state.
For example, If your loved one or partner cannot get out of bed, cannot go grocery shopping and cries all day long- they are not lazy, they are not weak, they are in a depressed mood state!
If your child is angry and oppositional during a certain period of time each evening, it suggests not that they are badly behaved, ( if they are diagnosed with bipolar disorder), but perhaps they are struggling with an unstable mood state.
Reaching the goal of understanding symptoms can be done with journaling and mood charts. I often will outline the symptoms on paper and continuously refer back to them. Bipolar Disorder does not go away. Even when stable on meds, it is likely that someone with bipolar will continuously struggle with mood episodes and will need to get pretty proficient at recognizing them.
Bipolar disorder therapy can help clients to challenge their negative or unrealistic thoughts and manage their symptoms.
Challenging unrealistic thoughts is a key function of therapy. If the client is not stable we can start to use the language of their symptoms to assist them with monitoring the effect of their medicine.
If the client is stable we can help the client to recognize what may be triggers for their moods and avoid those triggers. This will be important in different phases in treatment to prevent or manage future episodes.
Here is an actual example of mood symptoms written down by one of my clients:
How do I know when I am experiencing depression?
I don’t want to cook
I feel hopeless and overwhelmed; I can’t deal with small tasks
I start to worry about my marriage and husband leaving me
I start to think I am a loser and I will never be able to accomplish anything
I eat a lot more
What might be a trigger for my symptoms?
Credit card bills being ignored
This particular client was able to learn that when she is thinking “I am a loser and can’t accomplish anything” she was likely depressed. Bipolar disorder therapy helped her to learn how to recognize and challenge this thought. This is not a real thought, this is a depressed thought. She learned that when she does not feel depressed she doesn’t t have this thought. Cognitive therapy taught her the skills to recognize and challenge thoughts that are distorted.
Challenging thoughts includes coming up with examples of how she is not a loser, and all of the things she has actually accomplished.
Bipolar disorder therapy can teach coping skills to the individual and the family.
Therapy for clients with bipolar disorder can help them to learn how certain situations and coping skills will trigger their mood states and the stress that triggers their mood states. When family members are involved the benefits of these strategies are magnified because the family can learn how their patterns add to the clients stress and then they can modify those patterns.
Long Term Management
Bipolar disorder therapy remains an important way to assist the client in managing their illness, their relationships, and their behaviors that might contribute to the illness. These are only a few examples of how cognitive therapy for bipolar can be helpful! There are many ways this approach can be combines with others to effectively treat bipolar patients.
Cognitive therapy for bipolar disorder is not helpful for children and teens that are not stable. In my practice I will tell parents we cannot expect your child to make progress or benefit from therapy until they are stable on their meds. Depending on the severity of the adults cycling and illness they may also need to be stabilized on their meds first prior to benefiting from cognitive therapy for bipolar disorder.
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