Frequently Asked Questions

Bipolar 101:Talk Therapy vs. Drugs

Can I treat bipolar disorder with talk therapy, and not take drugs?

Answered by:

Tanveer Padder, M.D.

Diplomate, American Board of Psychiatry and Neurology

There are many safe, effective treatments for bipolar disorder. People with this illness usually are helped by three things: medication, counseling (talk therapy) and support from people such as a DBSA group. But medications alone or the talk therapy alone is not sufficient, especially for somebody with recurrent episodes. Along with medication, ongoing talk therapy, is an important part of treatment for bipolar disorder. During therapy, you can discuss feelings, thoughts, and behaviors that cause you problems. Talk therapy can help you understand and hopefully master any problems that hurt your ability to function well in life. It also helps you stay on your medication--and helps you deal with effects of bipolar disorder on your social life and career. It can help you maintain a positive self-image.

Types of psychotherapy used to treat bipolar disorder include:

  • Behavioral therapy. This focuses on behaviors that decrease stress.
  • Cognitive therapy. This type of approach involves learning to identify and modify the patterns of thinking that accompany mood shifts.
  • Interpersonal therapy. This involves relationships and aims to reduce strains that the illness may place upon them.
  • Social rhythm therapy. This helps you develop and maintain daily routines.
Medications are the cornerstone for treatment during the acute episodes of mania or depression as patients may not be able to engage in talk therapy that time, Once patients are somewhat stabilized talk therapy can be very useful but can’t tale the place of medications. Medications called antidepressants are prescribed for depression and mood stabilizers are used to treat bipolar disorder. These medications do not cause “highs” or artificial happiness, do not change your personality, are not habit forming and don’t “space people out.” They help return you to a stable, comfortable mood. They help you be you. Sometimes people have to try more than one treatment before they find the right one. It may take a combination of medications to help you feel better. Don’t get discouraged. You and your doctor will find the treatment that’s right for you.

Dr. Padder is a diplomate of the American Board of Psychiatry and Neurology. He is currently medical director of two mental health clinics in Columbia, Maryland, and a consulting psychiatrist at Howard County General Hopsital, an affiliate of Johns Hopkins Medicine. Write to Dr. Padder at tanveerpadder@gmail.com.

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