Talk Therapy and BP

Lithium, the first drug treatment used for bipolar disorder, was considered so effective when it was introduced that medication has been the primary focus of bipolar treatment ever since. Relatively little attention has been paid to psychosocial treatments for bipolar disorder, a condition characterized by alternating depression and mania.

The number one way to treat bipolar disorder without drugs is psychotherapy. Research shows that it is even more effective when used in conjunction with medication.

Here is a great article that discusses the effectiveness of talk therapies for bipolar disorder.

Many types of therapy have been shown to work for bipolar disorder including:

  • Cognitive behavioral therapy
  • Interpersonal/social rhythm therapy
  • Psychoeducation
  • Family-focused therapy

Cognitive Behavioral Therapy

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave. It’s most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.

CBT is based on the concept that thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap a person in a vicious cycle.

CBT aims to help someone deal with overwhelming problems in a more positive way by breaking them down into smaller parts. Patients learn how to change these negative patterns to improve the way they feel.

Unlike some other talking treatments, CBT deals with current problems, rather than focusing on issues from the past. It looks for practical ways to improve state of mind on a daily basis.

This article goes into greater detail and lists 6 CBT techniques specific to bipolar disorder.

Supporting Studies

According to a study published in January 2015 in the journal Psychology and Psychotherapy: Theory, Research and Practice, bipolar mood swings are influenced by your thoughts. The researchers found that having extremely negative thoughts may bring on what’s called “descent behaviors” (such as withdrawing from friends) associated with depression, while overly positive thoughts can lead to “ascent behaviors” (such as risk taking) associated with mania.

A study published in January 2015 in The British Journal of Psychiatry supports adding CBT to bipolar disorder treatment. In the study, researchers compared two groups of people recently diagnosed with bipolar disorder. One group received standard treatment, which included medication and support from community groups, a psychiatrist, or a regular doctor. The other group received standard treatment and CBT. The researchers found that the latter group achieved a better, longer-lasting recovery than the group that didn’t receive CBT.

This article lists the Pros and Cons of CBT as well as other relevant considerations.

Interpersonal and Social Rhythm Therapy

This technique teaches people with bipolar disorder to maintain a more regular schedule in all aspects of life, including sleeping, waking, eating, and exercise. It has been shown to improve daily functioning, according to a study published in 2015 in Bipolar Disorders.

This website lists greater details, supporting research, and success stories of people who practice this therapy.


Psychoeducation refers to the process of providing education and information to those seeking or receiving mental health services, such as people diagnosed with mental health conditions (or life-threatening/terminal illnesses) and their family members. Though the term has been in use for most of the 20th century, it did not gain traction until movements addressing the stigmatization of mental health concerns and working to increase mental health awareness began in earnest.

Psychoeducation, the goal of which is to help people better understand (and become accustomed to living with) mental health conditions, is considered to be an essential aspect of all therapy programs. It is generally known that those who have a thorough understanding of the challenges they are facing as well as knowledge of personal coping ability, internal and external resources, and their own areas of strength are often better able to address difficulties, feel more in control of the condition(s), and have a greater internal capacity to work toward mental and emotional well-being.

Offered in both individual and group formats, psychoeducation can benefit the individual diagnosed, parents and other family members, and caregivers and friends. It is not an approach to treatment in itself but represents an important early step in treatment, as it offers those individuals involved in a person’s care information on both how to offer support and how to maintain their own emotional health and overall well-being and provides them with the opportunity to develop a thorough understanding of the mental health concern(s) affecting their loved one. Participating in psychoeducation may have a positive impact on quality of life.

This website lists the many types of therapies that constitute psychoeducation.

Some people might receive psychoeducation through online or electronic formats such as DVDs, CDs, or other audiovisual materials, though others may choose to participate in sessions with a mental health professional.

In addition to helping those diagnosed with mental health concerns better understand the issues they are addressing, psychoeducation also plays a vital role in the destigmatization of mental health conditions. Organizations like the National Alliance on Mental Illness (NAMI) have advocated for increased psychoeducation for consumers of mental health services and their families.

Family-focused therapy

Family Focused Therapy or FFT is a combination of two forms of psychotherapy. First, it is a variety of psychoeducation. It is also a type of family therapy. Family therapies are different from other forms of therapy because of their attention to family dynamics and relationships as contributing factors that help or hurt illness.

Therapists working from this approach treat the entire unit in front of them (e.g., the entire couple; the entire family) as the patient. The individual members of these groups are seen as parts of that single patient. Families may start therapy by problems that a single individual within the couple or family is having. However, the family systems therapist will tend to view the identified problem as a problem shared by all system members. In this way of doing therapy, a husband’s bipolar disorder is considered, at least in part, as a symptom of something going wrong with the relationship. It is not simply something going wrong with the husband.

This article goes into greater detailed-description of how FFT works.