Diagnosis: Pills, With a Side of Therapy

In bipolar disorder, depressive episodes are more disabling and last longer than manic ones, so antidepressants are often prescribed alongside mood stabilizers. Yet an NIMH study emphasized that the addition of antidepressants can do more harm than good by causing rapid swings back toward mania. So adding therapy to the mix might help: Another study shows that undergoing psychotherapy while taking mood stabilizers better promotes recovery in relationship and life skills. David Miklowitz, a researcher on both of the large-scale investigations, says intensive psychotherapy works best when it concentrates on the triggers that set off depressive episodes. The catch is that stable improvements usually require many sessions over the course of several months. "It isn't enough to do the McDonald's version," Miklowitz says.

Three Flavors of Therapy

These treatment methods are recommended for bipolar disorder but can help with a wide range of issues.

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  • Family-focused therapy reduces tension at home by teaching relatives how to support the patient as well as each other.
  • Cognitive behavioral therapy consists of exercises to help patients learn to identify self-defeating thoughts and think of proactive solutions, like scheduling social activities.
  • Interpersonal and social rhythm therapy stresses the need for stability in relationships, daily routines, and sleep habits. If the patient has an erratic work schedule and nasty coworkers, she'll be advised to find a new occupation.

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