Saturday, 10 March 2012

CBT/REBT for Bipolar Disorder

Bipolar disorder – warning signs and treatments.
By Meir Stolear, BA (Hons.), MSc (London) - 2012

Bipolar disorder is a condition in which people’s moods swing between short periods of high sprits or restlessness and an extremely low mood or depression. The disorder affects men and women equally and is usually first diagnosed at ages 15 – 25. The exact cause of the disorder is unknown but it is assumed to be either genetically transmitted or learned behaviour, or possibly a combination of both.
There are three different known types of bipolar disorder, which are:
1    People who have had at least one hyper episode and prolonged periods of severe depression.
    People who are experiencing periods of high energy levels and impulsiveness and are engaged in risky or unusual behaviour. These high-energy periods alternate with periods of deep depression.
    People who are experiencing less extreme mood swings and are often, wrongly, diagnosed with depression disorder rather than bipolar disorder.
 For most people with bipolar there does not seem to be a clear or known trigger that brings on manic or depressive episodes. However, the following events seem to act as a trigger of a manic episode for some or many bipolar sufferers:
    Life changes such as childbirth, getting promotion at work, winning some money, etc.
    Medications such as antidepressants or steroids.
    Periods of sleepless nights.
    Moderate to heavy use of illegal drugs.

Some of the symptoms to look for when one get too high:
         Poor ability to concentrate.
         Inability to sleep.
         Making poor decisions, reckless behaviour, having sex with many partners.
         Impulsive behaviour and quick loss of temper.
         Hyperactivity, high energy and racing thoughts.
         Talking a lot and false beliefs about oneself or one’s abilities.
         Easily getting upset agitated or irritated.

Some of the symptoms to look for when getting depressed:
    Loss of concentration, memory and ability to make decisions.
    Loss of appetite and weight loss or binging on food and weight gain.
    Fatigue and very low energy.
    Thinking of oneself as worthless, hopeless, or a loser.
    No pleasure in normally enjoyable activities.
    Recurrent thoughts about death and/or suicide
    Social isolation and self-imposed loneliness.

Treatments and treatment goals:
Medical treatments:
Medical doctors such as psychiatrists commonly prescribe mood stabilizer drugs, such as Carbamazepine, Lamotrigine, Litmus and Valproate. Some doctors may also use anti-anxiety and/or antidepressant drugs.
Electroconvulsive therapy (ECT) may also be used if the patient does not respond to medication. Transcranial magnetic stimulation (TMS) is often used after ECT treatment.
Patients who are in the middle of manic or depressive episodes and cannot deal with their lives independently may need to stay in a hospital until their mood is stable and their behaviour is under their own control.

CBT/REBT treatment:
Most treatments for bipolar disorder involve either medical or psychological interventions. However, evidence has shown that a combination of the two has achieved superior results. Evidence has also shown that treatment for bipolar based on medical intervention and Cognitive Behaviour Therapies (CBT) intervention is the most effective and efficient form of treatment known at present ( Whereas the medication (discussed above) starts stabilizing the patient’s moods and behaviour, CBT on the other hand teaches patients a long-term strategy for managing their disorders effectively and efficiently. CBT and Rational Emotive Behavior Therapy (REBT is a primary CBT model of treatment) specifically teach patients how to shift their attention from their irrational belief system to a rational one. Also, CBT and REBT ( motivate patients to adopt healthy behaviour, identify and achieve personal goals, create new meanings in their lives and teach them unconditional self-acceptance and unconditional emotional and behavioural responsibility. Moreover, these treatments help to develop new life strategies and bipolar management skills, so as to prevent lapses and relapses. The main aim of such intervention is to help the patient develop a healthy balance between self-reliance and compliance with the medical intervention, which the patients may have to stay on for much of their lives.
Websites links to visit:
Association for Rational Emotive Behaviour Therapy (AREBT):
British Association for Behavioural Cognitive Psychotherapies (BABCP):
International Bipolar Foundation: