The 5 Psychological Treatments For Bipolar Disorder
Bipolar disorder (BD) is a chronic psychological disorder of affectivity, characterized mainly by the experience of phases of hyperarousal and hyperactivity (phases of hypomania or mania) that develop in alternation with other phases of low and inhibited mood (phases of depression). ), as well as with phases in which the patient is emotionally stable (euthymia phase).
Psychological treatments for bipolar disorder have been developed in order to mainly address depressive symptoms and also to improve patient adherence to pharmacological treatment, which aims to treat manic episodes, because at the moment there is not enough scientific evidence. to be able to treat them with psychological treatment in a unique way.
In this article we will see some of those psychological treatments for bipolar disorder that have positive results in terms of their effectiveness for the treatment of the same throughout the different phases of its development.
The most used psychological treatments for bipolar disorder
This is a brief classification of psychological therapies and intervention modalities applied in patients with bipolar disorder.
1. Psychoeducational intervention
One of the psychological treatments for bipolar disorder that has a long history in its treatment is psychoeducational intervention in an individual format; It is also usually carried out in group and family formats..
Psychoeducational intervention involves providing information about bipolar disorder so that people diagnosed with it can achieve deal with it in the best possible way, as well as the possible consequences.
This psychological intervention is made up of the following modules, within the intervention in individual format:
It should be noted that the studies carried out regarding the results regarding the effectiveness of the psychoeducational intervention indicate that It is more effective if applied in a group format over several monthsstarting with this intervention from the moment the diagnosis of bipolar disorder has been made in the patient.
On the other hand, when a patient with bipolar disorder has had several episodes, comorbidity with other disorders or is in an advanced phase of the disorder, psychoeducational intervention would not be the most suitable treatment, so other psychological treatments would have to be resorted to. bipolar disorder that are appropriate in this case.
The Barcelona Group has developed a psychoeducational intervention approach that presents positive scientific guarantees in addressing the symptoms of bipolar disorder. This intervention is carried out over 21 sessions in group format, in which we work with the modules listed previously in this section. In this sense, a clinical trial showed that psychoeducational intervention in group format significantly reduced relapses and hospitalizations in patients with bipolar disorder.
It is noteworthy that the most recent studies recommend the use of psychoeducational intervention combined with psychopharmacological treatment. On the other hand, this intervention is recommended for the treatment of symptoms of depression; On the other hand, there is not enough evidence when it comes to addressing the symptoms of mania. However, psychoeducation is a good alternative because of its low cost compared to other psychological treatments for bipolar disorder (e.g., cognitive behavioral therapy).
2. Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT), when framed within psychological treatments for bipolar disorder, is based on the fact that in All human beings have an interaction between their thoughts, emotions and behaviors, so thoughts directly influence the way we act and feel..
Therefore, the objective of this treatment is to train people with bipolar disorder so that they are able to master, examine and also modify the dysfunctional thoughts they may have, which will have a positive impact on their behaviors and emotions.
This type of psychological therapy for bipolar disorder It can be used both individually and in groups and for a limited time.. Some of the most used techniques in this treatment are problem solving, modification of maladaptive coping styles or cognitive restructuring. Likewise, it should be said that there are specific manuals that explain the approach to bipolar disorder from cognitive-behavioral therapy, among which the manual by Lam and collaborators stands out, which divides the therapy between 12 to 18 sessions, with a weekly frequency. .
It is important to note that cognitive-behavioral therapy includes a psychoeducational intervention component that has been shown to reinforce the effects of both psychological treatments for bipolar disorder, the main benefits being the following: early detection and coping with the prodromal symptoms of the disorder, stabilization of sleep routine, improve medication adherence and help the patient identify possible signs triggering an emotional episode.
The results of extensive studies on cognitive-behavioral therapy, as a treatment for bipolar disorder, have shown that it is a therapy with great solvency and experimental support for this mental disorder; besides, It is the most studied psychological therapy.
3. Family therapy
Psychological treatments for bipolar disorder in a family format present two main modalities: family psychoeducational intervention and family-centered therapy.
These interventions are based on the hypothesis that establishes that there are high levels of hostility, critical attitude or emotional overinvolvement of the family members of the patient with bipolar disorderwhat is known as “high expressed emotion”, with very low results in terms of management and remission of the symptoms of the disorder, as well as a higher rate of relapses in the patient.
Family psychological therapy for bipolar disorder has the main objective of Provide support to the patient and their families, so that they understand bipolar disorder and its treatment in greater depth.as well as training them to develop a series of strategies to face the disorder in an adaptive way that allows its management and also the reduction of the stress produced.
The main components of this class of psychological treatments for bipolar disorder are the following: family psychoeducational intervention, communication skills training, and finally, problem-solving training.
The family intervention for the treatment of bipolar disorder that has been studied the most is the FFT (Family-Focused Therapy) model. or Family-focused therapy, by Miklowitz and Goldstein, which is manualized and consists of 21 therapy sessions distributed over 9 months.
Most treatment guidelines recommend combining family psychological intervention with pharmacological treatment.
4. Interpersonal and social rhythm therapy
Another of the most used psychological treatments for bipolar disorder is interpersonal and social rhythm therapy, which has been developed to improve the mood of people with bipolar disorder by intervening on affective episodes, and also to stabilize the patient’s social and biological rhythms.
Therefore, we intervene so that the patient learns to develop and maintain stable sleep routines, train a series of skills that allow the patient to reduce the quantity and severity of social stressors, which would improve the quality of their sleep. interpersonal relationships and, on the other hand, help the patient develop new habits and skills that allow them to prevent affective episodes that could arise in the future.
You may be interested: “How to generate new healthy habits?”
5. Systematic care
Once we have seen what the main psychological treatments for bipolar disorder are, we are going to learn about a modality that includes various types of intervention (for example, crisis intervention teams, assertive community treatment, etc.). ).
These types of interventions have been developed for those patients with bipolar disorder who present various problems, such as persistent symptoms, functioning problems at different levels and a high history of involuntary hospitalizations, so They need systematic care in which they can rely on various assistive devices (for example, a day hospital, specialized care, etc.).
Assertive community treatment has demonstrated very positive results in the approach to these patients, since significant improvements have been found in terms of the patients’ psychopathology, as well as in their level of functioning, greater adherence to medication and also an improvement in patient satisfaction due to an improvement in their quality of life.
Thus, These types of treatments help significantly reduce health care costssince they help reduce hospitalization rates in addition to improving patients’ symptoms, as well as their levels of functionality.
In Spain, the first assertive community care program was established in the town of Avilés (Asturias), which has more than 20 years of experience.
