More threads by David Baxter PhD

David Baxter PhD

Late Founder
Is Drug Treatment Enough?
by Dan Haupt, M.D.
Tuesday, May 1, 2007

What is the importance of psychotherapy in individuals diagnosed with bipolar disorder? Is drug treatment alone sufficient to treat this condition, or is some form of therapy necessary?

For the majority of people with bipolar disorder, a combination of psychotherapy and medication results in better outcomes. Determining whether or not this is the case in any given person requires communication between the patient, their family, and the physician regarding the response to medication. Some (probably rare) individuals have complete or nearly complete improvement in their symptoms. They may have excellent insight into their illness and the effects it has on themselves and others.

It is more common, however, for an individual to have some kind of partial improvement in their symptoms associated with medication. In these situations, the patient may have ongoing problems with work and relationships, which are often related to the illness.

In these more common situations, it is helpful to receive some kind of individually-tailored psychotherapy. The goals may include things such as educating the patient on the nature of their illness, bringing to their attention related behaviors that may be interfering in various aspects of their lives, and identification of strategies that can be used to adapt successfully to their bipolar symptoms.

In general, our society has come to have unrealistic expectations or medications. For a variety of reasons, many people have come to expect that for any condition, a successful medication treatment is available and preferable to other treatment options. However, and especially regarding the treatment of mental illness, medications are not cures and in many cases do not provide full relief from the symptoms of the illness.

When seeking treatment for bipolar disorder, patients and physicians should be confident that any medication change or addition is truly providing long-term benefit, and remain vigilant for side effects related to the medications. For example, if someone is taking three medications but is still experiencing symptoms that are largely unchanged from taking one or two medications, and is also experiencing additional side effects, consideration should be given to discontinuing, rather than adding medications. In these common situations, psychotherapy can play an essential role in managing the illness.
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