Research regarding psychosocial therapy for bipolar disorder points out that it has a task in the adjuvant treatment of the condition. Advances that have been affirmed to be the most successful encompass family therapy, cognitive behavior therapy, and psychoeducation. The effectiveness of the interventions might considerably lie in their joint aspects. The dissimilar psychosocial interventions all have several overlying patterns; for instance, psychoeducation has been established to be strongly associated with cognitive behavior therapy.
Diverse psychotherapy approaches have their exceptional significance, but share some approaches, for instance, major concerns of the therapeutic alliance, timely recognition of prodroma, enhanced awareness, facilitation of adherence, understanding of disorder prompts, and advancement of policies such as relapse avoidance and management skills. Different psychotherapy approaches have been successful in the management of the bipolar disorder.
Bipolar disorder signifies a mental health condition that causes periods of depression and results in abnormal swings in mood, activity levels, and the capacity to undertake daily tasks. The causes of the disorder are not fully understood although they often seem to be inherited. Though medication represents a key treatment factor, it cannot alone successfully handle the many problems associated with the condition such as constant sub-threshold depression, poor adherence to medication, and low social and occupational performance. Psychotherapy has shown mounting evidence, which presents an effective pharmacotherapy way of managing this intricate disorder (Duffy, 2014).
Hindrances to successful care could arise in different ways associated with systems and services, where greater impediments are linked to non-adherence to medication. Concerns of access, convenience, and outlay influence commitment to treatment. It is affirmed that comorbid substance abuse predicts non-adherence and is linked to worsening of health and a greater risk of suicide.
Signs and Symptoms
Under the manic condition of bipolar disorder, the patient is likely to experience sentiments of increased energy, euphoria, and inventiveness. People who have a manic episode might talk too much, sleep for a short time, and express hyperactivity. They may also develop feelings of being excessively powerful, unshakable, or destined for prominence. Though mania may initially present good feelings, it tends to spin out of control later.
The patient may act carelessly in the course of the manic episode, for instance, through misusing all the savings, taking part in improper sexual behavior, or getting into foolish business deals. People with bipolar disorder might also become unjustifiably angry, hostile, and ill-tempered, which could lead to picking fights, attacking individuals who do not get along with the preferred plans, and censuring every person who condemns their behavior. Other patients turn out to be delusional and may start to ‘hear’ strange voices (Rennes, Regeer, van der Voort, Nolen, & Kupka, 2014).
Bipolar disorder has been found to become chronic gradually and result in numerous treatment difficulties since it is characterized by depression and mood fluctuation. Studies regarding bipolar disorder affirm that a strong aspect of poor adherence is the failure to remember to take medicine (Renes et al., 2014). At a poor state of health, psychiatric comorbidities are as well linked to decreased medication adherence and personal aspects of illness recognition, comprehension of the treatment instructions, and dread of the effects of non-adherence.
Bipolar disorder usually starts in the course of late teenage years to young adulthood, mainly at about age 21. The probability of the recurrence of bipolar disorders is almost certain with the vast majority of patients having several episodes.
Though there is significant variability concerning relapse, it has been established that episodes turn out to be more recurrent and shorter with time. Manic incidences characteristically have a sudden onset and develop in a few days whereas depressive occurrences often happen more slowly (Renes et al., 2014). After treatment, recurrence of depression, mixed feelings, or manic disorder last just about three months. The general outcome of the disorder anchored in prospective cohort account is not pleasant since regardless of treatment being successful in the reduction of symptoms and re-emergence, just a handful of patients get significantly well for a long duration.
Studies carried out in a group anchored cognitive behavior therapy (CBT) plan for individuals with bipolar disorder and comorbid drug abuse express promising inclinations in lessening substance use and relapse. Though medications play a critical function in the reduction of relapse, it could happen even with the finest adherence to the medicament. Medication has been proved to offer limited efficiency in dealing with functional impairment involving incidents and has the likelihood of having greater effectiveness in depression as compared to mood swings.
Since depression presents the greatest trouble, it is remarkable that psychotherapy (for instance, cognitive behavior therapy) addresses it significantly. Functional development of the disorder takes noticeably longer when judged against symptomatic recovery (Duffy, 2014). However, even with successful pharmacotherapy, there remain issues in social as well as work-related areas for sixty percent of patients. For example, living alone and work underperformance have a considerable unfavorable effect.
Though the fundamental impact of the majority of psychotherapy interventions has been the reduction of relapse, some adjunctive practices express improvements in functionality. Such interventions have been affirmed to be more successful in facilitating social performance as compared to medication. Even though there are different theoretical advances to the psychosocial management of the bipolar disorder, there is a smudging of borders amid them attributable to several shared factors (Cretu, Culver, Goffin, Shah, & Ketter, 2016).
They mostly vary in their prominence and not their unique aspects. Studies on psychosocial interventions for bipolar disorder articulate no proof of the supremacy of any particular therapeutic advance, possibly because of the comparability of their significance. At a personal level, nevertheless, specific psychosocial requirements ought to be determined and managed as adapted as attainable. No particular psychosocial instrument benefits all patients in the same way.
Nurses could seek ways of connecting patients and their family members to support groupings, which could assist in the reduction of sentiments of segregation and stigmatization. The lack of adequate supervision may be a problem with some approaches as patients could share unpleasant encounters with unwarranted individuals (Cretu et al., 2016). Mood examination could be adopted as a section of the normal care of patients with bipolar disorder, and act as a major instrument in the longitudinal management of temper, avoidance of the incidence of problems, and improvement of wellbeing to mention a few.
Cognitive Behavior Therapy
Anchored in the management of the disorder, cognitive behavior therapy has been applied as an adjuvant to medication (Sparding et al., 2015). CBT highlights individual skill development with the help of tactical policies to challenge distorted ideas that could result in mood shifts. Behavioral techniques concentrate on reacting to triggers on mood swings, which encompass practices that enhance activity levels when the patient is lethargic and depressed.
They also include strategies that help the patient strive towards reasonable and convenient objectives. Research on personal cognitive therapy presents encouraging results at 1-year follow-up though the benefits decrease with time thus implying the requirement for promoter sessions to uphold the gains. Some studies have tried to evaluate whether cognitive behavior therapy alone could be better or lesser effective when judged against an instance when it is offered together with psychoeducation, though no considerable difference has been established.
The fundamental role of psychoeducation is providing insights and details, which are characteristically offered in an instructive way. The basic elements of psychoeducation encompass information regarding the disorder, and the function of medication, management of biological cycles (for instance, sleep-wake sequence), determination of disorder prompts individual disorder profiles (for instance, detection of prodromes), and relapse avoidance methods. Other components include risk avoidance, with the inclusion of drug abuse, stress management, and analytical policies. Psychoeducation has been established to lessen relapse considerably and boost operation, in addition to enhancing adherence to medication (Geddes & Miklowitz, 2013).
Interpersonal and Social Rhythm Therapy
Anchored in the individual psychotherapy approach and supported by the significance of regular social rhythms in the disorder, this treatment plan investigates causes of relapse, interference with public and circadian models, lack of medication adherence, and traumatic experiences. The pattern implies that positive and negative life experiences can adversely influence circadian patterns, creating a risk of reappearance. It deals with such concerns through the establishment of normal habits, investigating interpersonal differences, and handling concerns about social functions while seeking to have assurance in the handling of bipolar disorder (Sparding et al., 2015).
The interpersonal pressure within the family results in the breakdown of relationships and deficiency of apparent social backing where the greatly articulated emotions could lead to relapse (Päären et al., 2014).
The family-centered treatment has been evident in the reduction of re-emergence when applied as an adjuvant to medication for the disorder. It is commenced when stabilization of mood is influenced following an acute episode and encompasses the patient and at least one considerable member of the family (for instance, partner or parent). The main concentration of family-centered therapy is the provision of education concerning the recent illness incident. This encompasses evaluating likely foundations and the patient’s prompts, discussing the significance of medication, distinguishing the individual and the disorder, and facilitating constructive family connections. Enhanced positive communication emerges as a major method in this plan and studies establish huge benefits in the reduction of depression and mood swings.
Bipolar disorder denotes a mental health problem that leads to periods of depression and irregular swings in mood, activity levels, and the capability to tackle daily tasks. The cause of the bipolar disorder is not clearly understood though it is often believed to be inherited. This study affirms that different psychosocial interventions, for instance, CBT, psychoeducation, and family therapy are important in the effective treatment of the bipolar disorder.
The interventions ought to be employed as a habitual approach of management, and as early as possible following the diagnosis. Future studies should refine the kind of intervention that is the most valuable for specific patients at some given phases of the disorder, and establish the means of handling cognitive shortfalls and comorbid disorders.
Cretu, J. B., Culver, J. L., Goffin, K. C., Shah, S., & Ketter, T. A. (2016). Sleep, residual mood symptoms, and time to relapse in recovered patients with bipolar disorder. Journal of Affective Disorders, 190, 162-166.
Duffy, A. (2014). Toward a comprehensive clinical staging model for bipolar disorder: Integrating the evidence. Canadian Journal of Psychiatry, 59(12), 659-666.
Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The Lancet, 381(9878), 1672-1682.
Päären, A., Bohman, H., von Knorring, L., Olsson, G., von Knorring, A. L., & Jonsson, U. (2014). Early risk factors for adult bipolar disorder in adolescents with mood disorders: A 15-year follow-up of a community sample. BMC Psychiatry, 14(1), 1-29.
Renes, J. W., Regeer, E. J., van der Voort, T. Y., Nolen, W. A., & Kupka, R. W. (2014). Treatment of bipolar disorder in the Netherlands and concordance with treatment guidelines: Study protocol of an observational, longitudinal study on naturalistic treatment of bipolar disorder in everyday clinical practice. BMC Psychiatry, 14(1), 58-64.
Sparding, T., Silander, K., Pålsson, E., Östlind, J., Sellgren, C., Ekman, C. J., & Landén, M. (2015). Cognitive functioning in clinically stable patients with bipolar disorder I and II. PloS One, 10(1), 1-13.