Comparing Therapies for Bipolar

There are many therapy options out there for bipolar disorder, but is one more effective than another?

A recent study compared cognitive behavioral therapy (CBT) to supportive therapy for the treatment of bipolar disorder.

They found that both treatments were effective for treating the symptoms of bipolar disorder.

Researchers, led by Thomas D. Meyer, PhD, of the Department of Clinical and Developmental Psychology at Eberhard Karls Universität in Tübingen, Germany, sought to fill a gap in understanding the treatments available for bipolar disorder. 

Previous studies have shown that CBT was effective for treating bipolar disorder, but these studies did not compare CBT to other treatments.

Dr. Meyer’s randomized controlled trial included 76 patients with bipolar I or bipolar II. Patients were assigned to either CBT or supportive therapy for 20 sessions over nine months. Then, patients were followed for up to 2 years.

Both CBT and supportive therapy are psychoanalytic therapies that aim to increase healthy thought processes and behaviors while decreasing distressing thoughts and behaviors. CBT uses systematic goals to achieve these aims, whereas supportive therapy reinforces and supports the positive, healthy thoughts and behaviors.

The study found that the patients showed equal amounts of symptom improvement regardless of the type of treatment. Relapse of symptoms was also similar for people in both therapy types.

During the 33 months of the study, 64.5 percent of the people relapsed regardless of the type of therapy they received. Relapsing was linked to having bipolar II, the number of previous episodes, and the number of sessions attended prior to the relapse.

The authors concluded that both therapies share some characteristics like mood monitoring and educational components.  These aspects might explain the overall benefits of these types of treatments and why they had equally good effects.

This study was published in the July issue of Psychological Medicine. The authors reported no conflicts of interest.

Over 5 million people in the United States suffer from bipolar disorder, about 1.6% of the population. Bipolar disorder is a mental illness that causes patients to have extreme and abnormal mood swings, from manic highs to potentially dangerous low depression.

The mood changes are severe enough to cause disruption in the patient's day to day life, limiting his or her ability to work, maintain relationships, and sometimes can result in suicide. During a manic episode, patients will sleep little, set unrealistic goals, and 'feel invincible', often while engaging in risky sexual or financial behavior. A depressive episode can be a crushingly low and hopeless state of mind, with thoughts of suicide. It is the sixth leading cause of disability worldwide, and causes significant stress on families and relationships.

Treatment is necessary as it is a chronic condition, with the first line of treatment being mood stabilizing medications like lithium, anti-psychotic medications (Zyprexa, Abilify, Seroquel), or anti-convulsant medications (Depakote, Lamictal). Anti-depressants (Prozac, Zoloft, Lexapro, Paxil, Celexa) and psychotherapy also play an effective and often necessary role in providing treatment.

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