View Full Version : Is psychotherapy enough to treat BP?


Fuzzy12
03-22-13, 07:56 AM
So one of my relatives is a psychiatrist. She said that BP can be managed by psychotherapy alone and that most people don't need medication. She said BP isn't any worse than having the flu. You can't avoid it but you can manage the symptoms using certain cognitive strategies. She said lots of her patients have been successful in managing both depression and BP just using psychotherapy. Is that possible?

I'm sure psychotherapy helps. But is it enough? Is it sufficient for at least mild cases or BP II? Nothing ever helped me with depression. I can't seem to fight the onslaught of negative emotions though I am aware of when exactly I start sinking. With the right strategies can you think yourself out of a depressive episode?

dogluver358
03-22-13, 08:29 AM
I think it's helpful, but for me personally, I couldn't manage without medicine. And mine is far worse than having the flu. You treat the flu with medication, so why not bipolar? You can't "think" or "talk" yourself out of the flu. I don't like that analogy. And for some people the flu can be pretty severe to the point of hospitalization, and that goes for bipolar as well.

There's no reason, cognitively speaking, that causes me to have episodes. I can't "think" myself into or especially 'out of' a severe manic or mixed episode and don't see how therapy would help me get out of it. Last time, I ended up in the hospital so nutty they had me on some absurd amount of Ativan, and even then, some nights I required the "cocktail" to get to sleep.

However, that said. Therapy can be important, especially with learning how to cope with things, recognizing signs of when things are going wrong, and those negative thoughts that plague me when I'm down. I sometimes ask my doctor if I can stop my meds, and the answer I get is... "Hell no".

But do I think it can only be treated with therapy? Probably not, at least not for me. It's not a personality disorder. It's primarily treated with medication. I guess if you consider cyclothymia where the depression is mild and the hypomania is mild one could make a case for that, but even then, unless negative thoughts are causing the depression, I don't know how you'd treat that just with therapy.

That just doesn't make sense to me at all.

Last manic episode I bought a car...and when I was so depressed nothing-therapy, meds, etc-were not helping and I had to have ECT. I'm so dependent on my meds right now just to stay somewhere around "normal". I was out of control when I was without medicine.

dogluver358
03-22-13, 08:33 AM
Once in a while I'll ask my doctor if I can stop my meds, and the answer I usually get is.... "H3LL NO!"

Fuzzy12
03-22-13, 08:38 AM
I think it's helpful, but for me personally, I couldn't manage without medicine. And mine is far worse than having the flu. You treat the flu with medication, so why not bipolar? You can't "think" or "talk" yourself out of the flu. I don't like that analogy. And for some people the flu can be pretty severe to the point of hospitalization, and that goes for bipolar as well.

There's no reason, cognitively speaking, that causes me to have episodes. I can't "think" myself into or especially 'out of' a severe manic or mixed episode and don't see how therapy would help me get out of it. Last time, I ended up in the hospital so nutty they had me on some absurd amount of Ativan, and even then, some nights I required the "cocktail" to get to sleep.

.

I thought exactly the same. I can't think myself out of an episode, even not when I know I'm sinking. But I'm wondering if there maybe are some strategies that I haven't tried yet that make this possible.

Also, my depression isn't always caused by negative triggers or negative thoughts. It's so frustrating because usually I know that there is no reason at all to feel bad but my thoughts don't make a difference to how I feel at all.

I don't get severe hypomanias but the depression isn't mild. I guess, psychotherapy is a worth a try but I'm really scared to stop anti depressants. I don't want to fall back into that hole again. I doubt any amount of thinking or techniques could get me out of that but who knows??

Abi
03-22-13, 09:08 AM
She is full of sh**. Fire her.

SquarePeg
03-22-13, 09:16 AM
She actually said itīs no worse that flu??? really, this is very worrying that she can say this, but my friendīs sister is a p.doc and she comes out with total sh*t at times and I challenge her.

I think pyschotherapy can help to learn to accept and manage bi polar, it can help to repair your self esteem and come to terms with some negative aspects, but I doubt very much it can be the only treatment.

Iīm still reeling over the flu comment!

Fuzzy how are you doing with your new treatment? xx

sarahsweets
03-22-13, 10:23 AM
When I have a manic episode...at least now in days its usually related to a lapse in my meds...I forget to take them a few days or fill my pill case wrong and all hell breaks loose. There are a few members here who have had the unfortunate experience of dealing with me in a manic state. The depressive part of my BPII seems to happen whether my meds are straight or not...I would love to find the therapist who can manage that sh*t. The chemical inbalance in my brain affects my moods,state of mind emotions,rage etc. I can become irrational, paranoid,depressed raged filled or blah..it sucks the big one. I believe if medication for bipolar was just like a performance enhancer then people would be running to the doctor's office to get some because hey, it works for everyone right? Since you dont NEED meds to treat it only therapy, then their must be some gain in taking meds...ha. I have never met a single person Jonesing for some cymbalta or lamictal...

btw fuzzy...that psyche should F**K off.

dvdnvwls
03-22-13, 02:28 PM
If I really had the flu every day for the rest of my life, it would be pretty bad. Just saying.

Lunacie
03-22-13, 02:37 PM
If I really had the flu every day for the rest of my life, it would be pretty bad. Just saying.

^ That's a good point.

dvdnvwls
03-22-13, 03:07 PM
(Flu is still serious today, but it used to be a relatively common cause of death. We're privileged that we no longer need to fear for our lives every time we feel it starting.)

Anyway, saying BP is no worse than the flu doesn't make much sense, because the reality for us is that you catch the flu and then you get over it in a week or two; but saying it shares some characteristics (unavoidable, incurable, but able to be worked around without drugs) does not sound bat-s**t-crazy to me. Maybe inaccurate, maybe even 100% wrong; but if it's wrong then it's simply a worthwhile argument that happens to be wrong, not some crackpot theory or something.

Fuzzy12
03-22-13, 04:14 PM
i think that's how she meant it. You can't avoid the flu or catching a virus and you can't really cure it with meds like antibiotics. You can just manage the symptoms.

deadmau5
03-22-13, 04:40 PM
I doubt psychotherapy is enough on its own.

keliza
03-22-13, 05:56 PM
I don't mean to insult your relative, but I think she is the batsh*t crazypants. I'm choosing to describe her that way instead of the million and one other reactions that first jumped into my brain when I read what she said about bipolar disorder being like the flu, all of which were far less PG.

I've been in therapy consistently since my diagnosis, and YEARS of it has not stopped my episodes from happening. It almost sounds like your relative is espousing the idea that people with bipolar disorder can "get over it" if they just "try hard enough" which is the kind of toxic thinking that makes people's mental illnesses WORSE, not better.

Am I doing much better now than I was at the beginning of therapy? Absolutely. Would I have made it this far without therapy? Definitely not. It's an integral part of my treatment. But the same can be said about my medication, too. Before I found the proper doses of the proper medications, I had virtually NO measurable control over when my episodes came and went. Therapy helped with restructuring my cognitive schemas, but when you're dealing with a biological illness you can't just rethink your brain chemistry.

Also, when I'm psychotic or screamingly manic, there is no thinking your way out of that... you really aren't thinking at all anymore.

I am sure there are some people out there who have been able to manage their bipolar episodes with therapy alone. But that is generally the exception, not the rule, and it is not the recommended course of action of any reputable medical or mental health organization.