What proven strategies, in addition to medication, help improve morale for people who live with bipolar disorder?

For most people who live with bipolar disorder, low mood depression is more common than feeling speeded up or manic. Medications can certainly help reduce or prevent depression, but many people still experience low mood despite medication.

Psychotherapy or counseling can certainly help.  Some specific types of psychotherapy have been proven to help reduce depression in bipolar disorder.  Those proven psychotherapies tend to focus on:

  • Learning to identify and manage overly negative or self-critical thoughts. Feeling depressed leads to seeing or interpreting things in a more negative way, and that leads to feeling more depressed. You can learn to break that cycle by recognizing your typical negative thoughts more quickly and then taking away their power—either by actively pushing back or just taking a step back and letting them go. The “brand name” for this is cognitive therapy.
  • Increasing involvement in enjoyable or rewarding activities. Feeling depressed leads to pulling back from things that help you feel better, and that leads to feeling more depressed. You can learn to break that cycle by planning specific positive activities and problem-solving to get past the barriers (internal and external) to actually doing those positive things. The “brand name” for this is behavior therapy or behavioral activation therapy.
  • Increasing positive (and avoiding negative) interactions with other people. You can identify patterns in your important relationships that lead to conflict or dissatisfaction—and take specific steps to avoid old patterns and emphasize new ones. The “brand name” for this is interpersonal therapy.

Developing your personal wellness plan will also help. For most people, a wellness plan includes:

  • Specific things you try to do regularly to help lift your mood and energy—like physical exercise, creative activities, or positive social activities
  • Specific things you try to avoid—like alcohol, street drugs, or disrupting your sleep pattern
  • People who can help you to keep on track with your plan

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist at Washington Permanente Medical Group and senior investigator at Kaiser Permanente Washington Health Research Institute well-known for his extensive research on practical approaches to improving mental health care. He seeks to develop and evaluate effective real-world strategies that support better mental health and wellness.  Current areas of emphasis include identifying and assessing suicide risk, improving care for treatment-resistant depression, and reducing racial and ethnic disparities in mental health care.