Psychosocial Therapy for Bipolar Illness

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Bipolar illness is usually best treated with an educational rather than a psychodynamic approach. This illness seems less dependent on external events and styles of interacting, and more on chemical imbalances. It is also a chronic and recurrent illness that will not disappear, and it requires ongoing treat­ment to help you cope. When you suffer from bipolar illness, at the beginning of an episode you may have little insight that you are ill. The mood distorts your perceptions so that you see the world as all-wonderful or all-terrible, and you cannot be reasoned out of this perception by conventional talking therapy. One of the signs that you are recovering from an episode is an awareness of how ill you have been.

A family-focused approach to education about the illness can be very helpful. Most families don’t know much about bipolar disorder. Intense emotional interactions can make your condi­tion worse. Once your family understands that your illness is caused by chemical imbalances, and not by flaws in the family, they can let go of their guilt and overinvolvement. Lowering the emotional temperature may give you space to calm down. If you have bipolar disorder you may be sensitive to overstimula­tion, and function better with low-key styles of emotional expression, and large doses of approval and attention from your relatives. Family members can be taught to speak warmly, to listen, and to let you know frankly but respectfully when your Behavior upsets them.

They may also be able to help you work against the disorder. When they know that you are currently unable to deal with too many outside events, they can assist you in decreasing your expectations. For example, you may have to settle for less stressful and less challenging work; you may have to forget about long journeys with time changes that upset your sleep patterns. Watching for signs of relapse can become the work of everyone in the family, so that new episodes are treated early. Accepting the illness and the need for long-term treatment often takes a long time, but it’s well worth the effort.

Recently, cognitive Behavioral therapy has been adapted for the treatment of people with bipolar illness.