Nondrug Treatments for Bipolar Disorder

Along with medication, ongoing psychotherapy, or "talk" therapy, is an important part of treatment for bipolar disorder. During therapy, you can discuss feelings, thoughts, and behaviors that cause you problems. Talk therapy can help you understand and ultimately master any problems that hurt your ability to function well in life. It also helps you stay on your medication -- and helps you deal with effects of bipolar disorder on your social and work life. It can help you maintain a positive self-image.

Types of psychotherapy used to treat bipolar disorder include:

• Behavioral therapy. This focuses on behaviors that decrease stress.
• Cognitive therapy. This type of approach involves learning to identify and modify the patterns of thinking that accompany mood shifts.
• Interpersonal therapy. This involves relationships and aims to reduce strains that the illness may place upon them.
• Social rhythm therapy. This helps you develop and maintain daily routines.

Support groups also help people with bipolar disorder. You receive encouragement, learn coping skills, and share concerns. You may feel less isolated as a result. Family members and friends may also benefit from a support group. They can gain a better understanding of the illness, share their concerns, and learn how to best support loved ones with bipolar disorder.

Education is another integral part of treatment for you and your family. People with bipolar disorder (and their families) often benefit from learning about the disorder -- its symptoms, early signs of an episode, and types of treatment.

Also, taking these steps will help:

• Establish routines. Regular sleep, eating, and activity appear to help people with bipolar disorder control their moods.
• Identify symptoms. Even though the early warning signs of an approaching episode vary from person to person, together with a psychiatrist you can identify what behavior changes signal the onset of an episode for you. It may be insomnia, shopping sprees, or becoming suddenly involved in religion.
• Adapt. This can help you avoid embarrassing behavior during manic episodes and set realistic goals for treatment. Your doctor can help you prepare for future episodes and manage fear about having more. A key part of adapting is to understand the types of stress that can cause episodes and the lifestyle changes that can reduce them.
• Maintain a regular sleep pattern. Go to bed and wake up around the same times each day. Changes in sleep can cause chemical changes in the brain, potentially triggering mood episodes.
• Do not use alcohol or drugs. These substances can trigger mood episodes. They can also interfere with the effectiveness of medication. About 40% of people with untreated bipolar illness will abuse alcohol or drugs.

Special Problems

For many people with bipolar disorder, there is risk of having a second illness. Typically, these are alcohol and drug abuse, seasonal affective disorder (SAD), or an anxiety disorder.

An estimated 60% of all people with bipolar disorder have drug or alcohol problems -- the result of reckless manic episodes. Abuse can happen when people drink or take drugs to control their mood swings.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.