Bipolar Disorder is a psychiatric disorder characterized by episodes of depression and episodes of mania or hypomania. They present with high energy levels, impulsivity, irritability leading to intense anger, poor life decisions such as starting to take illicit drugs or becoming sexually promiscuous, and other symptoms.
Bipolar Disorder almost always requires mood stabilizing medication. However, talking therapies are also very beneficial for these patients.
Recently, researchers compared Dialectical Behavior Therapy (DBT) with standard of care psychotherapy for adolescent patients with Bipolar Disorder. The patients received either DBT or the alternative therapy for one year. (Goldstein T and colleagues in JAMA Psychiatry January 2024; Volume 81, Number 1).
They found out that DBT reduced suicidal behavior compared to the other therapy. However, there was no difference in depression, mania, or hypomania.
If this research is replicated, it supports using DBT with patients who have Bipolar Disorder because it would reduce the risk of suicidal behavior.
DBT uses concepts and techniques from Cognitive Behavior Therapy (CBT) and adds techniques that address intense negative emotions such as anger. It also places a lot of attention on interpersonal relationships.
DBT was first used for Borderline Personality Disorder and demonstrated significant benefits. Since then, it has been used for several other mental disorders including PTSD, depression, anxiety, and others.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
