Therapy for bipolar

The National Institute for Health and Care Excellence (NICE) uses evidence to guide the NHS on effective and safe care. 

NICE recommends that people with bipolar should be offered psychological therapy through their GP (primary care) or mental health team (secondary care). This is also known as ‘talking therapy'. 

This means everyone diagnosed with bipolar is entitled to free therapy.

Is there any evidence that therapy for bipolar works? 

Yes, there is strong evidence to say that therapy can help people with bipolar.

Lots of different studies show that combining therapy with medication often leads to faster recovery, and helps people living with bipolar stay well for longer. 

Psychological therapy doesn’t help everyone with bipolar all the time, though. More research to develop new therapies is urgently needed.

Four tips to help you choose the right type of therapy

1. Find out what’s available near you 

If you’ve never had therapy or it’s been a while, talk to your GP or mental health team about what’s available near you. 

If you’re on medication for bipolar, you should be offered therapy too. If it hasn't been offered, it's worth asking for it.

You can mention the NICE guidelines for bipolar, which say therapy is as important as medication.

2. You have a say in your treatment plan

NICE guidelines recommend that healthcare professionals explain the benefits and risks of different therapies so you can make an informed choice. 

If you need more information, ask for it.

3. If a therapy doesn’t work for you, don’t give up 

Finding the right approach can take time, but it’s worth it to manage your condition effectively.

4. Weigh up the pros and cons of private and NHS therapy

You are entitled to free therapy for bipolar through the NHS, but waiting lists can be long. Private counselling for bipolar is often faster but can be expensive.

When deciding between NHS and private therapy, think about what is best for you. Consider how urgently you need care, what you can afford, and which option feels right for your situation.

If you do choose to pay for private therapy, check your therapist is registered with a trusted professional body, such as the British Association for Counselling and Psychotherapy (BACP) and experienced in supporting people with bipolar.

Your GP or mental health team can help guide you. Or book a call with a member of our friendly Peer Support team here.

Types of therapy for bipolar

As well as prescribing medication, your doctor should offer you talking therapy to match your needs. 

There are several types of therapy for bipolar, including Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), Interpersonal Therapy (IPT), Interpersonal and Social Rhythm Therapy (IPSRT) and Family-Focused Therapy (FFT).

However, the different types are not always available in all areas.

Cognitive Behavioural Therapy (CBT)

What is CBT?

CBT is a talking therapy that helps you understand how you think (cognitive) and act (behavioural). It looks at how your thoughts, feelings, and actions are connected, and teaches you ways to break unhelpful patterns.

CBT is typically delivered in one-to-one sessions by psychologists or registered CBT therapists. People usually have five to 20 sessions.

CBT for bipolar

CBT is a recommended treatment for many different mental health conditions, including bipolar.  

CBT can help people with bipolar: 

• Understand their diagnosis
• Spot triggers and early warning signs for mood swings
•  Recognise unhelpful thoughts that lead to episodes of mania or depression
• Choose activities that improve wellbeing
• Manage their condition and prevent relapse
• Stick to treatment plans, including taking medication

Benefits of CBT for bipolar

CBT can make episodes of mania or depression less severe, shorter and less frequent.

Sessions of this talking therapy can also improve relationships, social skills, and overall quality of life. By helping people stay on treatment plans, CBT can reduce the need for hospital stays.

Things to think about

CBT, like other types of therapy for bipolar, isn’t a quick fix. You may need several sessions before noticing a difference. Be patient and give it time.

Dialectical Behavioural Therapy (DBT)

What is DBT?

DBT is a talking therapy that helps people manage intense emotions. Like CBT, it helps you change unhelpful thoughts and behaviours. However, DBT also focuses on self-acceptance.

The term "dialectical" means balancing two opposites: accepting things as they are while working to make positive changes.

DBT is typically delivered in group sessions , with one-to-one therapy alongside. Learning all the skills can take around six months. 

DBT for bipolar

DBT sessions for bipolar use a combination of techniques for acceptance and change.

Benefits of DBT for bipolar

DBT can help people with bipolar manage intense emotions and replace harmful coping strategies with healthier ones.

Acceptance techniques can help you:

• Understand yourself better
• Make sense of certain behaviours

Change techniques aim to replace harmful behaviours with helpful ones by:

• Challenging unhelpful thoughts
• Finding better ways to cope with distress

Things to think about

Some people find group work helpful for sharing experiences and feeling less alone, but others prefer one-to-one sessions. Unfortunately, individual-only DBT isn’t always an option.

Accessing DBT can be tricky. NHS waiting lists may be long, and it isn’t available everywhere. Private therapy may be an option but is often expensive.

If you’re interested in DBT, talk to your GP or mental health team. They can tell you what’s available in your area and suggest alternatives if needed.

Interpersonal Therapy (IPT)

What is IPT?

IPT is a talking therapy that helps people with depression recognise and improve issues in their relationships with family, partners, and friends.

It’s based on the idea that relationship difficulties can contribute to feelings of depression, and depression can make those relationships even harder to manage.

People usually have 16 to 20 sessions.

Interpersonal and Social Rhythm Therapy (IPSRT)

What is IPSRT?

IPSRT is a psychotherapy that was created specifically to help people with bipolar. It combines elements of IPT and social rhythm therapy (SRT).

IPSRT for bipolar

It’s thought that people with bipolar may be more sensitive to changes in their body’s internal clock, which controls sleep and daily routines. Big life events, good or bad, can affect these routines and lead to symptoms of bipolar.

Benefits of IPSRT for bipolar

By addressing both biological factors (like sleep and routine) and relationship challenges, IPSRT aims to reduce symptoms of bipolar and improve day-to-day emotional stability. By helping create a strong routine, it can also help people with bipolar stay on treatment plans including taking medication consistently. 

Things to think about

Studies have found that people with bipolar who received IPSRT showed significant improvement in their mental health after six months. However, more research is needed to see if it helps prevent relapses in the long term.

Family-Focused Therapy (FFT)

What is FFT?

FFT is a group therapy that helps families communicate better and work together to support their loved one. 

FFT for bipolar

FFT can help the family of someone living with bipolar learn more about the condition, including its causes, risks, symptoms and treatment. It can help everyone involved feel more informed and prepared.

Benefits of FFT for bipolar

FFT can strengthen family connections by building a shared understanding of bipolar. It can also help families:

• Develop skills to cope with the challenges of bipolar
• Create strategies for managing difficult situations
• Spot early signs of mood episodes
• Understand risks and triggers for mood episodes
• Learn how to best support their loved one

Things to think about

Family therapy for bipolar can sometimes feel challenging or uncomfortable, but it helps families better understand the condition and separate their loved one's behaviours from who they are as a person.