CBT Psychotherapy for Bipolar Disorder
Clinically reviewed by Emily Mendez, M.S., EdS.
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Psychotherapy is more than just a place where you talk about and reflect on your feelings. For people living with bipolar disorder, it’s a tool that helps life feel more manageable between episodes. Bipolar psychotherapy can help your life feel less chaotic and enable you to accomplish your goals.
One of the most well-known bipolar disorder psychotherapy approaches is cognitive behavioral therapy, or CBT. The reason behind its high recommendation is the structure and availability it offers. It also has decades of solid research behind it.
At the same time, like any other psychotherapeutic approach, it has its limitations. Let’s take a closer look at this bipolar disorder psychotherapy.
What Is CBT?
Cognitive Behavioral Therapy (CBT) is a structured and goal-oriented psychotherapy that focuses on negative patterns of thinking and behaving, providing you with practical skills that you can carry with you outside of therapy and use in your daily life.
It’s often described as the gold standard of psychotherapy due to the extensive research that supports its effectiveness in the treatment of many conditions, including bipolar disorder, anxiety, depression, trauma, and substance use.
While CBT can support coping and daily functioning in the treatment of bipolar disorder, it can’t target the biological side of bipolar disorder, which is how your brain regulates your sleep, mood, and energy. Therefore, it requires a combination of other therapeutic approaches and bipolar medications.
How CBT Supports Daily Stability in Bipolar Disorder
There are several reasons why CBT is helpful for those living with bipolar disorder.
Builds Habits That Support Stability
The main focus of CBT in the treatment of bipolar disorder is on building habits that support stability between episodes, allowing you to focus on and accomplish goals that are meaningful to you.
For instance, you might learn how to notice, evaluate, and respond to thoughts like “I’m hopeless” or “nothing is going to change” during a depressive episode. CBT can teach you how to look for evidence behind those thinking patterns instead of automatically treating them as facts.
Supports a More Stable Daily Routine
Along with thought awareness, you can work with your therapist on building and maintaining a structured daily routine. This can look like scheduling activities and reducing avoidance by breaking down difficult activities into smaller, manageable steps.
Helps With Emotional Regulation
Another thing CBT helps with is emotional regulation. You will learn ways to cope with stress, solve problems and manage interpersonal conflicts that might come up during episodes.
Where CBT Falls Short in Bipolar Disorder Treatment
CBT can be helpful as a psychotherapy for bipolar disorder. However, there are some drawbacks with CBT for bipolar disorder specifically.
Doesn’t Help Much During Periods of Acute Mania
While it supports awareness, building and maintaining routines, and emotional regulation, it can’t help with providing stability during episodes of mania.
Can’t Replace Medication
It also can’t replace medication. Mood stabilizers and antipsychotics remain vital in the management of mood during episodes and protecting long-term stability.
Doesn’t Regulate the Internal Clock
Another area CBT can’t help with is the body's internal clock. Bipolar disorder is tightly connected to circadian rhythms, which means that changes in sleep, routines, light exposure, or social rhythms can trigger episodes.
While CBT can help encourage healthier routines, it isn’t designed to provide the kind of rhythm‑based stability that’s needed during episodes of mania.
That is why CBT is commonly used in combination with another therapy, called Interpersonal and Social Rhythm Therapy (IPSRT). While CBT helps with the areas of thoughts and behavior, IPSRT helps protect and stabilize circadian rhythms, filling in the support to the areas where CBT lacks.
Can Online CBT Therapy Platforms Be Helpful for Bipolar Disorder Psychotherapy?
Despite the limitations, the answer is Yes!
With the use of technology growing, online mental health treatment options are becoming more frequent as well. Some mental health platforms, such as Online-Therapy.com, focus exclusively on CBT. This platform offers structured CBT tools that focus on negative thinking patterns, daily routines, sleep, and anxiety. It is a great option for online CBT.
Talkspace is a good option for bipolar disorder psychotherapy because you can choose both meditation management and CBT.
If you're interested in CBT, you can explore Talkspace here.
Using online platforms can have its advantages by making support more accessible, especially if you are experiencing issues with transportation, availability, or stigma that make in-person therapy difficult.
That said, online CBT platforms are a helpful tool if used to support other treatment approaches rather than being used as a stand-alone solution. Although they can support self-management, psychoeducation and relapse awareness during stable periods, they can't treat severe episodes, provide medication management, and crisis support.
Takeaway
Cognitive Behavioral Therapy can be a very valuable part of a bipolar disorder psychotherapy plan, especially when it comes to creating coping skills, regulating emotions, and building and maintaining daily routines.
At the same time, CBT doesn’t replace medication, and it doesn’t properly stabilize the circadian rhythm. Therefore, it’s best used in combination with other approaches that are important in the treatment of bipolar disorder, such as IPSRT, mood tracking, and medication.
FAQs
How much does cognitive behavioral therapy for bipolar cost?
The cost can vary, but many online platforms are very affordable.
What type of psychotherapy is best for bipolar disorder?
Some of the best types of therapy for bipolar disorder include interpersonal and social rhythm therapy (IPRST), cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT). Explore bipolar disorder therapy options.
How effective is psychotherapy for bipolar disorder?
Numerous studies have shown that psychotherapy is a highly effective part of bipolar disorder psychotherapy, especially when combined with medication. It reduces the risk of relapse significantly.
How does psychotherapy help bipolar disorder?
This is a common question that many people have. It provides you with simple, practical tools needed to manage bipolar disorder. CBT helps you challenge unhelpful thought patterns. Approaches like IPRST help you maintain consistent routines, which is key in stability, as well.
