Bipolar Patients Need More Talk Therapy

Experts Say Psychological Treatment Boosts Drug Effectiveness, But Short On Therapists

(AP)  Psychological therapy can greatly boost the effectiveness of drugs in treating bipolar disorder, but these specialized talk therapies aren't as widely available as they should be, experts say.

"There are probably several dozen places in the country where you can get these treatments," said Dr. Holly Swartz, an assistant professor of psychiatry at the University of Pittsburgh. "It's not available in the majority of the country."

Much of the problem is lack of training in the specialized techniques for psychologists, psychiatrists and social workers, said David Miklowitz, a professor of psychology and psychiatry at the University of Colorado at Boulder. The techniques should become part of the regular curriculum for them, he said.

And just as drug companies trumpet the effectiveness of their drugs, advocates for talk therapy have to advertise the impact of their techniques, Miklowitz said.

"There's a lot of work that needs to be done to get these treatments into day-to-day use in community practice," he said.

Basically, the talk therapies work by helping patients deal with stress, function socially and stick with their medications, he said.

They come in three styles:

Family-focused therapy includes the patient's family and deals with their relationships. Goals include improving communication and problem-solving and providing for family intervention at the earliest signs of relapse.

Cognitive-behavioral therapy is done with the patient alone. It helps patients change harmful thinking patterns of depression and mania, and teaches them to recognize their early warning signs of relapse to either extreme of the illness.

Interpersonal and social rhythm therapy addresses ways to deal with interpersonal issues like marriage problems, and promotes a regular daily schedule of sleeping, waking, eating and other activities. Sticking to a regular schedule is thought to help stabilize and prevent bipolar symptoms.

Miklowitz is studying whether family-focused therapy can delay the first appearance of bipolar disorder or reduce its severity in children at risk. Those children have suggestive symptoms and a family history of bipolar disorder but do not yet have the full-blown condition.

© MMVII The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Add a Comment

by markrla September 5, 2007 3:16 AM EDT

To brianbwb: If bipolar disorder could be cured with a switch, you never had it in the first place.

To maedean: Are you a doctor? What research have you done to "know that bipolar does not exist"? I bet I know the answer to both questions; no and none!
You are a complete idiot!

Reply to this comment

by brianbwb-2009 September 4, 2007 8:03 AM EDT

One might be surprised at how many cases of BPD were cured in days past with a good old apple tree switch, or Dad''s belt. A few well placed and timely applications of aversion therapy the old fashioned way usually did the trick by the age of puberty.

Reply to this comment

by maedean September 4, 2007 2:10 AM EDT

It is a bunch of bullpolar !!! Just a waste of insurance money and state money. A way for a doctor to get rich off something that does not exist... Just like ADHD every kid in school now has it. The goverment should not pay for this no way. But the sad thing is they give social security for this *** and there are plenty parents collecting from our goverment for this bullpolar ***. Then we wonder why social security is going broke ?????

Reply to this comment

by markrla September 3, 2007 8:26 PM EDT

to tucanofulano:

Are you bipolar?

I have been bipolar for 24 years and talk therapy is highly effective.

You do not know what you are talking about.

Reply to this comment

by markrla September 3, 2007 8:20 PM EDT

to tucanofulano:

Are you bipolar?

I have been bipolar for 24 years and talk therapy is highly effective.

You do not know what you are talking about.

Reply to this comment

by tucano2 September 3, 2007 4:40 PM EDT

This is a lot of babbletalk from shrinks who are trying to drum up more revenue. Everyone has known for decades manic-depressives ("bi-polar") need peace and quiet, not a lot of talking. More "junk science" being promoted here.

Reply to this comment

by sandy19731 September 3, 2007 3:42 PM EDT

The article fails to mention Licensed Professional Counselors.

Visit the American Counseling Association''s website to find one near you.

Reply to this comment

by ljb6599 September 3, 2007 2:51 PM EDT

I guess I live in a part of the country where therapy is available.I work as an Occupational Therapist at the University of Minnesota Medical Center,Fairview in Minneapolis Minnesota in what is called an Adult Day Treatment Outpatient Mental Health Program.At this time our program is not full.There are no waiting lists. Access and barriers to treatment seem related to health insurance as it relates to mental health benefits.Many people do not even have insurance to cover outpatient mental health.For those whom do it takes forever to get authorization for treatment and much paperwork.Also Medicare does not pay for long term outpatient mental health treatment which many need.They will cover short-term, acute therapy i.e.(Partial Program) for 2-3 weeks but also require an excessive amount of paperwork.Many people whom are disabled by their mental illness are covered by medicare and they are all not elderly. Many of them are adults in their 40''s and 50''s.Mental Health parity does not exist in this country.Many people do not even know that a bill(HR 1424)the Paul Wellstone Mental Health and Addiction Act is awaiting approval in Congress which will grant greater access to mental health and addiction treatment by barring health insurers from placing discrimatory restrictions on treatment for mental health care. I encourage you all to contact their representative and ask them to support passage of HR 1424.

Reply to this comment

by skyy51 September 3, 2007 12:50 PM EDT

i agree, but many people w/ bipolar are unable to afford insurance or do not even qualify for disability & their options for supposed "therapy" are basically non-existant.

Reply to this comment

by mgum1215 September 3, 2007 9:47 AM EDT

Good article

Reply to this comment

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[markrla]

To brianbwb: If bipolar disorder could be cured with a switch, you never had it in the first place.

To maedean: Are you a doctor? What research have you done to "know that bipolar does not exist"? I bet I know the answer to both questions; no and none!
You are a complete idiot!

[brianbwb-2009]

One might be surprised at how many cases of BPD were cured in days past with a good old apple tree switch, or Dad''s belt. A few well placed and timely applications of aversion therapy the old fashioned way usually did the trick by the age of puberty.

[maedean]

It is a bunch of bullpolar !!! Just a waste of insurance money and state money. A way for a doctor to get rich off something that does not exist... Just like ADHD every kid in school now has it. The goverment should not pay for this no way. But the sad thing is they give social security for this *** and there are plenty parents collecting from our goverment for this bullpolar ***. Then we wonder why social security is going broke ?????

[markrla]

to tucanofulano:

Are you bipolar?

I have been bipolar for 24 years and talk therapy is highly effective.

You do not know what you are talking about.

[markrla]

to tucanofulano:

Are you bipolar?

I have been bipolar for 24 years and talk therapy is highly effective.

You do not know what you are talking about.

[tucano2]

This is a lot of babbletalk from shrinks who are trying to drum up more revenue. Everyone has known for decades manic-depressives ("bi-polar") need peace and quiet, not a lot of talking. More "junk science" being promoted here.

[sandy19731]

The article fails to mention Licensed Professional Counselors.

Visit the American Counseling Association''s website to find one near you.

[ljb6599]

I guess I live in a part of the country where therapy is available.I work as an Occupational Therapist at the University of Minnesota Medical Center,Fairview in Minneapolis Minnesota in what is called an Adult Day Treatment Outpatient Mental Health Program.At this time our program is not full.There are no waiting lists. Access and barriers to treatment seem related to health insurance as it relates to mental health benefits.Many people do not even have insurance to cover outpatient mental health.For those whom do it takes forever to get authorization for treatment and much paperwork.Also Medicare does not pay for long term outpatient mental health treatment which many need.They will cover short-term, acute therapy i.e.(Partial Program) for 2-3 weeks but also require an excessive amount of paperwork.Many people whom are disabled by their mental illness are covered by medicare and they are all not elderly. Many of them are adults in their 40''s and 50''s.Mental Health parity does not exist in this country.Many people do not even know that a bill(HR 1424)the Paul Wellstone Mental Health and Addiction Act is awaiting approval in Congress which will grant greater access to mental health and addiction treatment by barring health insurers from placing discrimatory restrictions on treatment for mental health care. I encourage you all to contact their representative and ask them to support passage of HR 1424.

[skyy51]

i agree, but many people w/ bipolar are unable to afford insurance or do not even qualify for disability & their options for supposed "therapy" are basically non-existant.

[mgum1215]

Good article