Bipolar disorder, previously known as manic depression, is a condition that affects your mood, causing it to swing from one extreme (depression, or periods of feeling very low) to another (mania, or periods of feeling very high). Cognitive Behavioural Therapy (CBT) is a commonly practised therapy, and the National Institute for Health and Care Excellence (NICE) recommends it as the most effective way of treating bipolar. We asked two RSCPP therapists to explain what CBT is, and how it could be used to help treat your bipolar.
Cognitive Behavioural Therapy (CBT) is a form of psychotherapy that was pioneered in the US in the 1960s and has become increasingly popular, mostly due to research evidence suggesting the efficacy of treatment. The focus of therapy will be on the here and now, and sessions are fairly structured in comparison to counselling. The therapy focuses on how you think and behave, and there is an additional focus on skills acquisition through homework.
My clients who are challenged by bipolar depression use the five-part model (situations, thoughts, emotions, responses, behaviours) of CBT to good therapeutic effect. This model shows how situations provoke thoughts, thoughts shape emotions, and emotions have physiological responses. All the aforementioned are interdependent and interconnected, and combine to result in behaviours. We all experience negative automatic thoughts (NATs); the five-part model of CBT works to reminds you that, at any given moment in your human experience, you are composed of thoughts, feelings, and physiological experiences. Negative automatic thinking arises unbidden within you, and can be characterised as being, largely, either false or a gross exaggeration. The model encourages you to evaluate your thoughts: Are they reasonable? Appropriate to the situation? And, if not, to modify them and therefore create a more favourable emotional experience, ultimately leading to improved behavioural results.
NICE recommends on average 16-20 sessions with a follow up.
Following therapy, you can expect to be able to manage your mood and regulate your emotions better, and recognise important triggers that cause day-to-day difficulties and the onset of your episodes.
CBT can result in positive outcomes by enabling an increased insight into yourself, which leads to earlier and enhanced awareness of the onset of your symptoms. On a daily basis, therefore, you may better understand your symptoms, and symptom modification leads to improved personal and social functioning. You learn that your sometimes chaotic thoughts and feelings need not significantly disturb and unnerve you, and that both high and low states can have a positive impact. CBT has been clinically proven to have a beneficial effect on relapse and recovery experiences. GP input however should always be sought when considering each individual care plan.
You need to ensure that you receive therapy from an experienced and chartered psychologist or, if another type of therapist, someone who is accredited with a professional body and has had training and experience in treating bipolar disorder. You may also need medication depending on the severity of the illness and your risk level, which you can discuss with your GP or psychologist.