Friday Counseling Issues: Bipolar Disorder Treatment

Is it possible to treat Bipolar Disorder without medical intervention?

Well, sure.  It’s also possible to eat popcorn without butter, but what would be the point of that? Image result for buttery popcorn

I stated in an earlier post that my hard-and-fast rule is that I will not see a client who has Bipolar Disorder unless that client is compliant and faithful with his meds. The reason for that is simple.  When a person is in a manic swing, he is not reasonable. There is no talk therapy that can bring him down so that you can have a helpful therapuetic conversation.  The medication is vitally important, and sometimes it takes a while to get the proper set of meds, properly balanced, for every client. Everyone’s chemistry is a little bit different from everyone else’s.

When a client is effectively medicated–and I don’t mean she’s in LaLa Land–then she is more able to listen and process conversation that can be helpful in controlling her behavior.

Here is something I will always say to a Bipolar client:  “I’m sorry you have Bipolar Disorder. That’s no fun, and I know it has caused you and those who love you a lot of pain.  One thing you need to know, however, is that having Bipolar Disorder does not give you a pass to behave horribly, or to not follow the rules everyone else has to follow.  It just means that things are going to be harder for you, and you’re going to have to learn some skills that will keep you from getting into trouble and hurting the people who love you.

“Understand that you’re not the only one who has to live with a difficult condition. Some people are deaf. Some are blind. Some have severe food allergies. Some are autistic.  This is part of life, and we all have to deal with what we’re given. You can feel sorry for yourself, or you can get a grip and work hard.  Coming to therapy on a regular basis will help you to stay on track.  Taking your meds faithfully will help, too.  Work with me,  It will help you.”

Here are some talk therapies that can be helpful for Bipolar Disorder:

  • Cognitive behavioral therapy
  • Interpersonal/social rhythm therapy
  • Psychoeducation
  • Prodrome detection therapy – particularly useful for preventing mania relapses
  • Family-focused therapy

Cognitive Behavorial Therapy is based on the premise that it is what you think about that controls how you feel and what you say and do. Learning to recognize common cognitive errors, and to tell yourself the truth, is, in my opinion, one of the best therapies out there.

For example, one cognitive error would be, “I have Bipolar Disorder, so I can’t help how I act or feel. There’s nothing I can do.”

That’s not true. There are many things you can do.  I will help you learn to recognize wrong thinking, and to replace it with truth.  The truth here is, “You have Bipolar Disorder, so you need to learn to recognize symptoms that you are going into a manic swing, and to put up safeguards. Your family can help you.”

Interpersonal and Social Rhythm Therapy (IPSRT) is designed to help people improve their moods by understanding and working with their biological and social rhythms. Originally developed as a form of psychotherapy for a single clinician and a single patient, the program has since been adapted to work in several different kinds of settings, including inpatient and outpatient groups. IPSRT is a compelling adjunctive therapy for people with mood disorders, and it emphasizes techniques to improve medication adherence, manage stressful life events, and reduce disruptions in social rhythms. IPSRT teaches patients skills that let them protect themselves against the development of future episodes.

A major goal of the IPSRT team is to expand the program’s use and the resources available to clinicians wishing to learn the IPSRT model, as well as to provide additional support to clinicians already trained in IPSRT.

( taken from

Psychoeducation is invaluable for both the patient and his family.  It is important to understand  exactly what Bipolar Disorder is, and how to cope with it.  There is wonderful information these days, easy to access on the internet, at the library, perhaps at your doctor’s office.

  • Prodrome detection therapy – particularly useful for preventing mania relapses. Here is an excellent resource for this information:

Family-focused therapy is helpful because it doesn’t separate the person who has Bipolar Disorder from the rest of the family members. It can help with conflict resolution as well as support and accountability for the patient.

Please understand that what I have mentioned here is only a bird’s-eye view.

There is more.  Some people swear by light therapy; others by a Bipolar-specific diet, others by supplements.  Keep in mind that there is a snake oil salesman out there for every condition imaginable.  You have to be discerning when you read about this stuff, and don’t go off on a tangent.  If it seems weird, it probably is.  If it seems too good to be true, it probably is.

Always consult a doctor or therapist who has experience in treating Bipolar Disorder.  I learn new things from my clients all the time. The study of the human brain continues to intrigue me. New and helpful information is always out there.

The main thing is not to give up. Never, never, never, never quit!


4 thoughts on “Friday Counseling Issues: Bipolar Disorder Treatment

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