You're watching Bipolar in Focus. I'm Jane Pauley.
Therapy has been proven to be an indispensable component to wellness, a place where people with bipolar can learn to understand the disease, to cope with it and lead productive lives.
Here to discuss Cognitive Behavior Therapy is Dr. Robert Leahy, the Director of the American Institute for Cognitive Therapy. Welcome.
Thanks for having me, Jane.
What is the cognitive part? What is the behavior part?
The cognitive part is the biases in thinking that you have when you're depressed or when you're manic.
And so what we do is we help patients examine their thoughts. The patient may have the thought "I'm a total loser" for example and we categorize these thoughts.
This is labeling, this is kind of all or nothing thinking. Maybe you're discounting your positives. Maybe you're using perfectionist standards. What is the evidence for and against this thought?
So there are a lot of different techniques that we use in cognitive therapy to help test out the thoughts.
So we look at the assumptions that people have or the rule books that they have that are overly demanding when they're depressed.
When is the appropriate time for cognitive behavior therapy and who is the candidate?
Well, anybody who has a history of being depressed or manic or anxious is a good candidate for cognitive therapy.
And so far as bipolar disorder -- and we find that the best time to kind of intervene for people who are bipolar is in between the episodes.
Once their mania has been reduced to some extent and they are able to reflect, we then try to get them to use some cognitive behavioral techniques.
Well, let's talk about the techniques. How does it work? What techniques do you teach?
There are two parts to cognitive behavioral therapy. The behavioral part is the activities, the scheduling, the communication, rewarding yourself.
The cognitive part is trying to convince you to do these things. Examining your thoughts, looking at the evidence for and against,
thinking about what advice would you give a friend who thought that they were a total loser or a failure, that nothing would work out, you know putting things in perspective.
Are you looking at things in an all or nothing way? There are so many different things that we can do to help people with these biases in thinking.
What's the homework about?
Homework is actually, it's like if you had a personal trainer who came to your house -- once a week and said, "These are the exercises that you should do."
That would be great if you did them once a week but it would be much better if you did them seven days a week.
So the homework is actually practicing the habits of challenging your thoughts, monitoring your thoughts, changing your behavior, improving your communication, you know building hope.
Practicing new habits strengthens your ability to cope with manic-depressive illness for bipolar disorder.
So, cognitive behavior therapy is done in concert with medication?
Absolutely! The cognitive therapy is part of a full range of interventions that can be used and all of patients that we see who have bipolar disorder have to be on medications.
Enumerate the potential long-term benefits.
Well, there are long-term benefits of the cognitive behavior therapy. One is that the patient is much more likely to stay on medication with cognitive behavior therapy.
It reduces the risk of hospitalization, reduces the risk of suicide, improving functioning at work, improving functioning in the family.
Thank you, Dr. Leahy. And thank you for watching Bipolar in Focus.