How We Treat Bipolar Disorder
The Arroyos approaches the treatment of bipolar disorder from an interdisciplinary team approach. We start with a thorough evaluation of your bipolar disorder to make sure we understand your symptoms to make an accurate diagnosis. We also carefully assess for any co-occurring psychological and medical conditions. It is common for bipolar patients also to have anxiety disorders, ADHD, trauma, eating disorders, substance use disorders, migraine headaches, and other medical problems.
Scientific research indicates that the best treatment for most bipolar patients is the combination of bipolar-specific psychotherapy plus medications. The Arroyos treatment is ideally qualified to help you with your bipolar disorder as we offer a full range of evidence-based treatments for bipolar disorder integrated with psychiatric mediation management in the same practice. Our professionals work closely together to coordinate your psychotherapy and medications within one clinical team.
Diagnosing Bipolar Disorder
Bipolar disorder is a spectrum of conditions with cycling mood as a key feature. Cycling mood means that the individual has had at least one episode of mania in their lifetime in addition to bouts of depression.
A manic episode consists of a discrete period during which the person’s mood is more cheerful, euphoric, or irritable than normal. This change in mood is not caused by drugs, alcohol, or external life circumstances. This altered mood state must last for several days and cause clinically significant disruption in the person’s functioning. Also, the person must experience some of these other symptoms:
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Diagnosing bipolar disorder is complex and must be done by a qualified licensed mental health professional.
Types of Bipolar Disorder
The main types of bipolar disorder are:
Bipolar I Disorder. At least one lifetime manic episode with elevated or irritable mood lasting at least one week accompanied by several of the other symptoms listed in the Diagnosing Bipolar Disorder section. Also, the person has serious impairment in social or occupational functioning, may have psychotic symptoms, and may need hospitalization.
Bipolar II Disorder. At least one lifetime hypomanic episode with elevated or irritable mood lasting at least four days accompanied by several of the other symptoms listed in the Diagnosing Bipolar Disorder section. The symptoms do not cause serious impairment in social or occupational functioning and never have psychotic symptoms or require hospitalization.
Cyclothymic Disorder. At least two years during which symptoms of hypomania and depression are present the majority of the time, but are not severe enough to be diagnosed as a more severe bipolar disorder or as a major depressive disorder.
Other Bipolar Disorders. Cycling mood disorders that do not fit the criteria for the above three disorders.
Psychotherapy for Bipolar Disorder
The Arroyos offers a variety of evidence-based (science-based) psychotherapies that are very effective in treating bipolar disorders. All of these bipolar therapies include psychoeducation about bipolar disorder and medications to treat bipolar disorder:
Cognitive Behavior Therapy (CBT) for Bipolar Disorder. Individual therapy designed to change negative thoughts, emotions, and behaviors associated with bipolar disorder. CBT also works to help create new healthy patterns of behavior and routines and improve social skills.
Interpersonal and Social Rhythm Therapy (IPSRT). Individual therapy designed to reduce and resolve interpersonal stress and stabilize circadian rhythms (24-hour sleep-wake cycles). IPSRT identifies one or more areas of interpersonal conflict and helps develop healthy ways of coping with the conflict. ISPRT also helps stabilize daily routines.
Family Focused Therapy (FFT). Family therapy designed to improve family communication and problem-solving skills when dealing with a family member with bipolar disorder. Family members work with the patient to understand their condition better, support treatment, and develop an early response strategy for relapses.
Medications for Bipolar Disorder
There are several highly effective medications for the treatment of bipolar disorder. The choice of which class of medication, brand, and dose is made between you and your psychiatrist. Your psychiatrist may recommend that you complete pharmacogenomic testing through The Arroyos laboratory service to better match your medications with your genetic profile.
Standard medications to treat bipolar mania include lithium, valproic acid, and mood stabilizers. The treatment of bipolar depression requires careful management. The use of traditional antidepressants such as SSRIs and SNRIs, particularly when used alone, can switch some depressed bipolar patients into mania. Standard medications for bipolar depression are lamotrigine, mood stabilizers, and lithium.
How to Help a Loved One
If you have a loved one who is suffering from bipolar disorder, it is important to talk with them right away about your concerns. They may be embarrassed about their condition, have difficulty putting their feelings into words, feel hopeless or worthless, or be preoccupied with feelings of guilt or even suicidal thoughts. Let them know that you care and that you are confident that they can feel better if they speak to a trained professional. Please call us if they are willing to schedule an intake appointment. If they are unwilling or unable to get help, they may need to be hospitalized. If they are expressing thoughts of hurting themselves or someone else, this is an emergency. Call 911 or take them to the nearest emergency room.
