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Other Treatments for Bipolar Disorder

In addition to medication, psychosocial treatments are helpful in providing treatment, support, education, and guidance to you and your family. If medications and psychosocial treatments are not effective, there is also the option of electroconvulsive therapy.
Studies have shown that psychosocial interventions can lead to increased mood stability, fewer hospitalizations, and improved functioning in several areas. A licensed psychologist, social worker, or counselor typically provides these therapies and often works with your psychiatrist to monitor your progress. The number, frequency, and type of sessions should be based on your individual treatment needs.
Some psychosocial interventions more commonly used for bipolar disorder are cognitive behavioral therapy , psychoeducation, family therapy, and interpersonal and social rhythm therapy.
Cognitive behavioral therapy helps you learn to change inappropriate or negative thought patterns and behaviors associated with bipolar disorder. You will examine your feelings and thought patterns, learn to interpret them in a more realistic way, and apply coping techniques to various situations.
Psychoeducation involves teaching you about your illness and its treatment. You will learn how to recognize signs of relapse so that early intervention can be sought before a full-blown episode occurs. Psychoeducation may also be helpful for your family members.
Family therapy uses strategies to reduce the level of distress within your family that may either contribute to or result from your symptoms.
Family-focused therapy is for you and all family members who will participate. It includes psychoeducation and teaches you better communication and problem-solving skills.
Interpersonal and social rhythm therapy helps you to improve interpersonal relationships and to stabilize your daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
In situations where medication, psychosocial treatment, and the combination of these interventions are ineffective, or work too slowly to relieve severe symptoms (such as psychosis and/or suicidal behavior), electroconvulsive therapy (ECT) may be considered. ECT may also be used to treat acute episodes when medical conditions, including pregnancy, make the use of medications too risky.
ECT is a highly effective treatment for severe depressive, manic, and/or mixed episodes. The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, you should discuss the potential benefits and risks of ECT with your doctor and with family or friends.
Hospitalization is not required for ECT. You will be given a muscle relaxant and an anesthetic. You will be carefully monitored throughout the procedure. A small amount of electric current will be sent to your brain. You may receive a number of these treatments over the course of several days, weeks, or months, depending on your condition.
Side effects of ECT may include:
  • Headache
  • Muscle soreness
  • Heart disturbances
  • Short-term confusion
  • Memory lapses
The data supporting the addition of complementary and alternative therapies to medications for bipolar disorders is limited.

References

Bipolar disorder. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated August 15, 2013. Accessed September 5, 2013.

Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml . Accessed September 5, 2013.

Estevez RF, Suppes T. Maintenance treatment in bipolar I disorder. In: Yatham LN, Kusumakar V, eds. Bipolar Disorder: A Clinician’s Guide to Biological Treatments . New York, NY: Taylor & Francis Group, LLC.; 2009: 107-152.

Hirschfeld RMA. Guideline Watch: Practice Guideline for the Treatment of Patients with Bipolar Disorder . 2nd ed. Arlington, VA: American Psychiatric Association; 2005.

Miklowitz DJ, Scott J. Psychosocial treatments for bipolar disorder: cost effectiveness, mediating mechanisms, and future directions. Bipolar Disord. 2009;11 Suppl 2:110-22.

Price AL, Marzani-Nissen GR. Bipolar disorders: a review. Am Fam Physician. 2012;85:483-93.

Ravindran AV, da Silva TL. Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: a systematic review. J Affect Disord. 2013;150(3):797-719.

Salvadore G, Drevets WC, Henter ID, Zarate CA, Manji HK. Early intervention in Bipolar Disorder, Part II: Therapeutics. Early Interv Psychiatry. 2008;2(3):136-146.

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