Skip to main content

Cognitive Behavioral-Based Treatments for Bipolar Disorder

  • Chapter
  • First Online:
The Massachusetts General Hospital Handbook of Cognitive Behavioral Therapy

Part of the book series: Current Clinical Psychiatry ((CCPSY))

  • 812 Accesses

Abstract

Bipolar disorder is a mood disorder characterized by recurrent hypomanic/manic and/or depressive mood episodes. Although mood-stabilizing medication is the first line of treatment for bipolar disorder, the beneficial effects of empirically supported, cognitive behavioral-based psychosocial treatments have been recognized. In this chapter, we review the clinical presentation and diagnosis of bipolar disorder, as well as its assessment and treatment. We describe cognitive behavioral strategies that can be used independently or in tandem with medications to treat the different phases of the illness and review the empirical support for cognitive behavioral treatments for bipolar disorder. We conclude with a case vignette to illustrate how cognitive behavioral-based psychosocial treatments can be used in the treatment of bipolar disorder.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Pub; 2013.

    Google Scholar 

  2. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64(5):543–52.

    PubMed  PubMed Central  Google Scholar 

  3. Judd LL, Akiskal HS, Schettler PJ, Endicott J, Maser J, Solomon DA, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002;59(6):530–7.

    PubMed  Google Scholar 

  4. Perlis RH, Ostacher MJ, Patel JK, Marangell LB, Zhang H, Wisniewski SR, et al. Predictors of recurrence in bipolar disorder: primary outcomes from the systematic treatment enhancement program for bipolar disorder (STEP-BD). Am J Psychiatry. 2006;163(2):217–24.

    PubMed  Google Scholar 

  5. Miklowitz DJ, Efthimiou O, Furukawa TA, Scott J, McLaren R, Geddes JR, et al. Adjunctive psychotherapy for bipolar disorder: a systematic review and component network meta-analysis. JAMA Psychiatry. 2021;78(2):141–50.

    PubMed  Google Scholar 

  6. Salcedo S, Gold AK, Sheikh S, Marcus PH, Nierenberg AA, Deckersbach T, et al. Empirically supported psychosocial interventions for bipolar disorder: current state of the research. J Affect Disord. 2016;201:203–14.

    PubMed  Google Scholar 

  7. Sachs GS, Thase ME, Otto MW, Bauer M, Miklowitz D, Wisniewski SR, et al. Rationale, design, and methods of the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biol Psychiatry. 2003;53(11):1028–42.

    PubMed  Google Scholar 

  8. First MB, Spitzer RL, Gibbon M, Williams JB. Structured clinical interview for DSM-IV axis I disorders-patient edition (SCID-I/P, version 2.0). New York, NY: Biometrics Research Department, New York State Psychiatric Institute; 1995. p. 722.

    Google Scholar 

  9. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33;quiz 4–57.

    PubMed  Google Scholar 

  10. Miklowitz DJ, Johnson SL. The psychopathology and treatment of bipolar disorder. Annu Rev Clin Psychol. 2006;2:199–235.

    PubMed  PubMed Central  Google Scholar 

  11. Beck JS. Cognitive behavior therapy: basics and beyond. 2nd ed. New York, NY: Guilford Press; 2011.

    Google Scholar 

  12. Otto M, Reilly-Harrington N, Kogan JN, Henin A, Knauz RO, Sachs GS. Managing bipolar disorder: a cognitive behavior treatment program therapist guide. New York, NY: Oxford University Press; 2008.

    Google Scholar 

  13. Swann AC. Impulsivity in mania. Curr Psychiatry Rep. 2009;11(6):481–7.

    PubMed  Google Scholar 

  14. Newman CF, Leahy RL, Beck AT, Reilly-Harrington NA, Gyulai L. Bipolar disorder: a cognitive therapy approach. Washington, DC: American Psychological Association; 2002.

    Google Scholar 

  15. Tijssen MJ, Van Os J, Wittchen HU, Lieb R, Beesdo K, Wichers M. Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community. Acta Psychiatr Scand. 2010;122(3):255–66.

    CAS  PubMed  Google Scholar 

  16. Colom F, Vieta E, Tacchi MJ, Sánchez-Moreno J, Scott J. Identifying and improving non-adherence in bipolar disorders. Bipolar Disord. 2005;7(Suppl 5):24–31.

    PubMed  Google Scholar 

  17. Keck PE Jr, McElroy SL, Strakowski SM, West SA, Sax KW, Hawkins JM, et al. 12-month outcome of patients with bipolar disorder following hospitalization for a manic or mixed episode. Am J Psychiatry. 1998;155(5):646–52.

    PubMed  Google Scholar 

  18. Scott J, Pope M. Self-reported adherence to treatment with mood stabilizers, plasma levels, and psychiatric hospitalization. Am J Psychiatry. 2002;159(11):1927–9.

    PubMed  Google Scholar 

  19. Sajatovic M, Levin J, Fuentes-Casiano E, Cassidy KA, Tatsuoka C, Jenkins JH. Illness experience and reasons for nonadherence among individuals with bipolar disorder who are poorly adherent with medication. Compr Psychiatry. 2011;52(3):280–7.

    PubMed  Google Scholar 

  20. Kleindienst N, Greil W. Are illness concepts a powerful predictor of adherence to prophylactic treatment in bipolar disorder? J Clin Psychiatry. 2004;65(7):966–74.

    PubMed  Google Scholar 

  21. Miklowitz DJ, Chung B. Family-focused therapy for bipolar disorder: reflections on 30 years of research. Fam Process. 2016;55(3):483–99.

    PubMed  PubMed Central  Google Scholar 

  22. Deckersbach T, Holzel B, Eisner L, Lazar SW, Nierenberg AA. Mindfulness-based cognitive therapy for bipolar disorder. New York, NY: Guilford Press; 2014.

    Google Scholar 

  23. Lovas DA, Schuman-Olivier Z. Mindfulness-based cognitive therapy for bipolar disorder: a systematic review. J Affect Disord. 2018;240:247–61.

    PubMed  PubMed Central  Google Scholar 

  24. Xuan R, Li X, Qiao Y, Guo Q, Liu X, Deng W, et al. Mindfulness-based cognitive therapy for bipolar disorder: a systematic review and meta-analysis. Psychiatry Res. 2020;290:113116.

    PubMed  Google Scholar 

  25. Linehan M. DBT skills training manual. New York, NY: Guilford Publications; 2014.

    Google Scholar 

  26. DiRocco A, Liu L, Burrets M. Enhancing dialectical behavior therapy for the treatment of bipolar disorder. Psychiatry Q. 2020;91(3):629–54.

    Google Scholar 

  27. Van Dijk S, Jeffrey J, Katz MR. A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder. J Affect Disord. 2013;145(3):386–93.

    PubMed  Google Scholar 

  28. Eisner L, Eddie D, Harley R, Jacobo M, Nierenberg AA, Deckersbach T. Dialectical behavior therapy group skills training for bipolar disorder. Behav Ther. 2017;48(4):557–66.

    PubMed  PubMed Central  Google Scholar 

  29. Afshari B, Omidi A, Ahmadvand A. Effects of dialectical behavior therapy on executive functions, emotion regulation, and mindfulness in bipolar disorder. J Contemp Psychother. 2019;50:1–9.

    Google Scholar 

  30. Chan S, Li L, Torous J, Gratzer D, Yellowlees PM. Review of use of asynchronous technologies incorporated in mental health care. Curr Psychiatry Rep. 2018;20(10):85.

    PubMed  Google Scholar 

  31. Liu JY, Xu KK, Zhu GL, Zhang QQ, Li XM. Effects of smartphone-based interventions and monitoring on bipolar disorder: a systematic review and meta-analysis. World J Psychiatry. 2020;10(11):272–85.

    PubMed  PubMed Central  Google Scholar 

  32. Depp CA, Ceglowski J, Wang VC, Yaghouti F, Mausbach BT, Thompson WK, et al. Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial. J Affect Disord. 2015;174:23–30.

    PubMed  Google Scholar 

  33. Murray G. What would digital early intervention for bipolar disorder look like? Theoretical and translational considerations for future therapies. Front Psych. 2019;10:599.

    Google Scholar 

  34. Plante DT, Winkelman JW. Sleep disturbance in bipolar disorder: therapeutic implications. Am J Psychiatry. 2008;165(7):830–43.

    PubMed  Google Scholar 

  35. Harvey AG. Sleep and circadian rhythms in bipolar disorder: seeking synchrony, harmony, and regulation. Am J Psychiatry. 2008;165(7):820–9.

    PubMed  Google Scholar 

  36. Grandin LD, Alloy LB, Abramson LY. The social zeitgeber theory, circadian rhythms, and mood disorders: review and evaluation. Clin Psychol Rev. 2006;26(6):679–94.

    PubMed  Google Scholar 

  37. Roehrs T, Roth T. Caffeine: sleep and daytime sleepiness. Sleep Med Rev. 2008;12(2):153–62.

    PubMed  Google Scholar 

  38. Harvey AG, Kaplan KA, Soehner AM. Interventions for sleep disturbance in bipolar disorder. Sleep Med Clin. 2015;10(1):101–5.

    PubMed  PubMed Central  Google Scholar 

  39. Morton E, Murray G. Assessment and treatment of sleep problems in bipolar disorder-a guide for psychologists and clinically focused review. Clin Psychol Psychother. 2020;27(3):364–77.

    PubMed  Google Scholar 

  40. Gold AK, Sylvia LG. The role of sleep in bipolar disorder. Nat Sci Sleep. 2016;8:207–14.

    PubMed  PubMed Central  Google Scholar 

  41. McElroy SL, Altshuler LL, Suppes T, Keck PE Jr, Frye MA, Denicoff KD, et al. Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am J Psychiatry. 2001;158(3):420–6.

    CAS  PubMed  Google Scholar 

  42. Andersson G, Titov N. Advantages and limitations of internet-based interventions for common mental disorders. World Psychiatry. 2014;13(1):4–11.

    PubMed  PubMed Central  Google Scholar 

  43. Nielsen L, Riddle M, King JW, Aklin WM, Chen W, Clark D, et al. The NIH science of behavior change program: transforming the science through a focus on mechanisms of change. Behav Res Ther. 2018;101:3–11.

    PubMed  Google Scholar 

  44. Elmslie JL, Silverstone JT, Mann JI, Williams SM, Romans SE. Prevalence of overweight and obesity in bipolar patients. J Clin Psychiatry. 2000;61(3):179–84.

    CAS  PubMed  Google Scholar 

  45. Krishnan KR. Psychiatric and medical comorbidities of bipolar disorder. Psychosom Med. 2005;67(1):1–8.

    PubMed  Google Scholar 

  46. Soreca I, Fagiolini A, Frank E, Houck PR, Thompson WK, Kupfer DJ. Relationship of general medical burden, duration of illness and age in patients with bipolar I disorder. J Psychiatr Res. 2008;42(11):956–61.

    PubMed  Google Scholar 

  47. Weintraub MJ, Schneck CD, Miklowitz DJ. Network analysis of mood symptoms in adolescents with or at high risk for bipolar disorder. Bipolar Disord. 2020;22(2):128–38.

    PubMed  Google Scholar 

  48. Manchia M, Pisanu C, Squassina A, Carpiniello B. Challenges and future prospects of precision medicine in psychiatry. Pharmgenomics Pers Med. 2020;13:127–40.

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Douglas Katz .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Katz, D., Gold, A.K., Boccagno, C., Deckersbach, T., Eisner, L., Sylvia, L.G. (2023). Cognitive Behavioral-Based Treatments for Bipolar Disorder. In: Sprich, S.E., Petersen, T., Wilhelm, S. (eds) The Massachusetts General Hospital Handbook of Cognitive Behavioral Therapy. Current Clinical Psychiatry. Humana, Cham. https://doi.org/10.1007/978-3-031-29368-9_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-29368-9_10

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-031-29367-2

  • Online ISBN: 978-3-031-29368-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics