Formerly called manic depression, treatment for bipolar disorder is complicated because it includes both very high highs and very low lows within the same individual. Most clinicians these days feel that bipolar disorder should be treated using medications regardless of whether there is psychotherapy. I have seen many individuals for whom bipolar medications induced dramatic improvement and helped them to get on with their life.
Psychotherapy is also very important for individuals experiencing mania and depression, because bipolar depression and bipolar mania often represent deep-seated beliefs about a person's self and world. Without changing these beliefs, it is unlikely that an individual suffering from bipolar will be able to comply with their medication regimen, because the medications will be taking away mental states that are deeply valued. Therapy can help bipolar individuals to understand the inner logic of their mood swings, and why they are attracted to express the extreme states of consciousness that they experience.
Psychotherapy for bipolar depression will usually be quite a bit different from other kinds of treatment for depression, because the therapist will have to take into account the difficulty that the patient is having balancing their mental states. In many cases a patient will look depressed, and so the therapist will help them to elevate their mood. The next thing you know, the client's mood is too elevated and they begin to behave irrationally!
This type of therapy is definitely a tightrope act. But, like any psychotherapy, it is a collaborative process. The therapist must walk the tightrope with the client only as long as it takes to help the client learn to walk it on their own. Ultimately the goal of therapy is always for the client to experience better control over his or her mental states. In the case of bipolar disorder treatment, part of this process is learning to select more nuanced mental states that express a better balance between positive and negative emotions.
In the case of bipolar depression, this often involves learning the value of the depressive state. In order to cure this type of depression, it must not be dismissed entirely but rather integrated with other mental states.
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