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Also known as manic depression, bipolar disorder is a mental ailment that occurs due to several factors like biological, neurological, environmental and emotional. It is featured by very frequent mood swings or cycling among extreme emotions like mania, depression, and normal behavior of the patient.
While there are several treatment options available for bipolar disorder, the most commonly used option is a combination of therapy & medication.
However, not all patients can be put under the same drill. The cases that involve a history of drug abuses, cannot be put to medication, else it could land up in a great risk. Also, it is hard to find that mood swings occurred due to bipolar disorder or drugs and say if the extent o bipolar disorder was not too much in the body, the medications would end up harming the patient quite severely. Also as a basic fact the patients move to medication only when no other resort is found.
In such special cases where medications are not the right choice, CBT comes in to being. The Cognitive Behavioral Therapy popularly known as or CBT is a sort of a therapy that is used to assist the patients in recognizing the exact triggers & causes of their depressive & manic states. Then the patients are made to learn the techniques so as to avoid the triggers & henceforth and cope up with the symptoms during the episodes. 70% of bipolar I disorder patients are made to undergo the CBT experience, especially those when one or a few episodes have taken place with in 4 years of initiating the CBT treatment.
CBT treatment to cope with bipolar disorder is used to accomplish two major goals. These are:
i. To recognize the manic episodes prior to their becoming uncontrollable & making a conscious change in how one reacts to these episodes.
ii. To learn the techniques, thoughts, reactions & behaviors that would help them offset the depression.
With the various activities & techniques prescribed by the expert therapists, these goals are achieved quite effectively.
Under CBT, the effectiveness of the treatment of the bipolar disorder mainly rests in the hands of the patient, as he/she is allotted homework like – performing some exercises, reading, etc. These are focused on helping the patient understand his/her condition and to help them learn the methods to cope with the situation.
The steps to conduct CBT are as follows:
1. Making a Contract with the Patient
Initializing CBT, you need to make a treatment contract with your patient. In this treatment you draw a definite plan of treatment for the patient and he/she agrees to follow the same. This also includes the patient's promise to do all his homework complete taking all assignments seriously. The patient in this contract also ensures that he/she would take any & all the prescribed medication just as directed. This is a crucial step towards CBT as this process largely depends on the patient's desire to cope with the bipolar disorder and his/her sense of responsibility towards the same.
2. Recording the Mood Swings
In the second step, CBT involves monitoring and grading the moods of the patient. For this the doctor gives the patients several worksheets that the patient fills in regularly. In these sheets the patient records his/her moods for the day. They also file the other important details like for how many hours did they sleep, the level of anxiety, & the level of irritability they felt. Especially the patients of Bipolar II Disorder must record all these details daily as in that case the mood cycles very frequently.
3. Patient does the Homework
Once the therapist is able to understand the mood cycles of the patient of bipolar disorder, the next step in CBT is for the patient. Here the therapist gives some reading material to the patient for him/her to understand exactly how our thoughts effect our emotions. This is done by the patient filling in the worksheets and once he/she understands the drill, they would be able to practice through altering their thoughts in far more rational way. Their emotions then become very rational, thereby decreasing the number & severity of the depressive & manic episodes.
4. Recognizing the Triggers
Further, you must be able to know the triggers in the case you are curing. Triggers are the basically any emotional or physical clicks that arouse a depressive or a manic episode like emotions, thoughts, times of the year, situations, environments, events, etc. Once the patient starts understanding and recognizing their triggers, he/she would then be able to learn to avoid them entirely, henceforth decreasing the severity & number of the depressive & manic episodes.
All in all, CBT is quite an effective method of treatment for the bipolar disorder patients. In case you think that you need this therapy, contact your doctor or therapist before it gets too late!
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