Written by: Kristin McConaughy

Worldwide statistics indicate that BP-I affects around 1% population. In comparison, 2.9% are affected by BP-II (Kessler et al., 2005), and another 4.2% appear to be affected by severe mood swings, i.e., cyclothymia (Regeer et al., 2004).

 Over the years, several treatments like psychotherapy, psychoeducation, cognitive-behavioral therapy (CBT) (Hilty et al., 2006), family therapy, interpersonal and social rhythm therapy, and online therapy (Lauder et al., 2010), have been tried and tested. Besides these psychological treatments, medicinal, or drugs based treatments treat Bipolar disorders. Moreover, the combination of the two; ( pharmacotherapy) might effectively manage this complex disorder. 

 The critical treatment parameters for treating Bipolar disorder is (i) hypomanic pole (ii) depression pole and (iii) cyclothymia or extreme mood swings. The relapse in the above three parameters is in characterizing the effectiveness of a treatment method.

 An in-depth examination of psychological treatment reveals that medicines alone are insufficient to avoid relapse occurrences and reduce illness episodes (Lauder et al., 2010). On the other hand, the depression poles are far better through CBT. In such cases, (Chiang et al., 2017) reported that sessions with duration ≥90min effectively reduced depression pole and resulted in improved social-functionality.

Few groups with counseling sessions over 90 min extending up to 120 min have reduced depression levels and controlled maniac severity(Chiang et al., 2017). However, in such cases, the patient and therapist relationship was found to be a dominant factor. However, these approaches tend to be limited in the sense that these suffer from recurrences. The viability of an alternative system known as family therapy was reported by (Swartz and Swanson, 2014).

Their studies involved 92 subjects, out of which 53 recovered without any recurrence. Similar positive results in terms of faster recovery periods (Miklowitz et al., 2013), and immunity against recurrences were also reported (Rea et al., 2003; Miklowitz et al., 2013). An insight into understanding the reasons as to why the recurrences occur was deciphered by (Frank, 2007).

They concluded that specifically, positive and negative events in further years, post-treatment can shift the balance and increase vulnerability to possible recurrences. Overall, there is no conclusive evidence that indicates the superiority of any psychological approach; this provides a baseline for assessing the patient’s mental progression and determining future therapy combination with medicine. 

 References

 Chiang, K. J. et al. (2017) ‘Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials,’ PLoS ONE, 12(5), pp. 1–19. DOI: 10.1371/journal.pone.0176849.

 Frank, E. (2007) ‘Interpersonal and social rhythm therapy: a means of improving depression and preventing relapse in bipolar disorder,’ Journal of Clinical Psychology, 63(5), pp. 463–473. DOI: 10.1002/jclp.20371.

 Hilty, D. M. et al. (2006) ‘A review of bipolar disorder in adults.’, Psychiatry (Edgmont (Pa. : Township)), 3(9), pp. 43–55. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20975827http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC2963467.

 Kessler, R. C. et al. (2005) ‘Lifetime Prevalence and Age-of-Onset Distributions of,’ Arch Gen Psychiatry, 62(June), pp. 593–602. DOI: 10.1001/archpsyc.62.6.593.

 Lauder, S. D. et al. (2010) ‘The role of psychotherapy in bipolar disorder,’ Medical Journal of Australia, 193(4), pp. 31–35. DOI: 10.5694/j.1326-5377.2010.tb03895.x.

 Miklowitz, D. J. et al. (2013) ‘Psychosocial Treatments for Bipolar Depression: A 1-Year Randomized Trial From the Systematic Treatment Enhancement Program Setting-Fifteen clinics affiliated with the Systematic Treatment Enhancement Program for Bipolar Disorder’, Arch Gen Psychiatry, 64(4), pp. 419–426. DOI: 10.1001/archpsyc.64.4.419.

 Rea, M. M. et al. (2003) ‘Family-focused treatment versus individual treatment for bipolar disorder: Results of a randomized clinical trial,’ Journal of Consulting and Clinical Psychology, 71(3), pp. 482–492. DOI: 10.1037/0022-006X.71.3.482.

 Regeer, E. J. et al. (2004) ‘Prevalence of bipolar disorder in the general population: A Reappraisal Study of the Netherlands Mental Health Survey and Incidence Study,’ Acta Psychiatrica Scandinavica, 110(5), pp. 374–382. DOI: 10.1111/j.1600-0447.2004.00363.x.

 Stratford, H. J. et al. (2015) ‘Psychological therapy for anxiety in bipolar spectrum disorders: A systematic review,’ Clinical Psychology Review. Elsevier B.V., 35, pp. 19–34. DOI: 10.1016/j.cpr.2014.11.002.

 Swartz, H. A., and Swanson, J. (2014) ‘Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence,’ Focus, 12(3), pp. 251–266. DOI: 10.1176/appi.focus.12.3.251.