Bipolar Disorder: Therapy

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Bipolar Disorder: Therapy
Bipolar Disorder: Therapy
Video: Bipolar Disorder: Therapy
Video: Bipolar disorder (depression & mania) - causes, symptoms, treatment & pathology 2023, February

Bipolar disorder: therapy

In acute treatment, the focus is on relieving depressive or (hypo-) manic symptoms. The long-term goal is to reduce or avoid further symptomatic episodes (phase prophylaxis). Usually drug treatment is combined with psychotherapy. Paying attention to possible warning signals and training their self-awareness can help those affected and their relatives to recognize episodes early and to take countermeasures or help in good time.


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  • Medication
  • psychotherapy
  • Further therapy options
  • Recognize warning signs early on
  • Involvement of relatives
  • Whom can I ask?
  • How are the costs going to be covered?


Which medication is prescribed depends on the course of the disease. Laboratory values ​​that are important for monitoring the course should be collected prior to drug therapy. In this way, side effects of active ingredients can be recognized and reduced in good time. The drug level in the blood is also measured regularly.

The following drug groups are used:

  • Mood stabilizers (also called phase prophylactic drugs): lithium and the antiepileptic drugs carbamazepine, valproic acid, lamotrigine and antipsychotics,
  • Antidepressants: only in connection with mood stabilizers.

Note The use of medication should always be coordinated with the attending physician. Stick to the prescribed therapy plan - even if longer treatment is required. With this you can significantly support your recovery and prevent relapses. Report any side effects to your doctor immediately and let them know if you are taking other medicines (including over-the-counter or "herbal") or hormonal contraceptives, as this can lead to drug interactions.


Psychotherapy complements and supports drug treatment in bipolar disorders. In psychotherapy, specific psychological techniques are used to alleviate or heal a mental illness. The focus is on the relationship, the exchange and the conversation between the psychotherapist and the patient about thoughts, feelings or life stories.

Various exercises - depending on the psychotherapeutic method - can support or consolidate this exchange. So-called psychoeducation is an important part of treatment. This should promote understanding of the disorder and explain the relationship to everyday life. Affected people can learn, among other things, to better understand and observe their behavior, feelings and thinking and to take countermeasures as well as possible when episodes are approaching. For more information, see Psychotherapy.

Further therapy options

The other treatment options include:

  • Electroconvulsion Therapy (ECT): In electroconvulsive therapy, a generalized seizure is artificially generated by electrical excitation of the brain. This is done under controlled conditions under short anesthesia. Electroconvulsive therapy has become a safe and established therapy for severe depressive episodes.
  • Light therapy: This method is used in the event of a depressive episode with a clear return in the winter months. The patient looks into the white light of a fluorescent tube once a day (usually in the morning) once or twice a minute. The duration of a session varies between 30 and 120 minutes - depending on the light intensity. This process continues for several weeks.
  • Waking therapy ("sleep deprivation"): This form of treatment is also suitable for depressive episodes. Two to three waking periods in a week, during which the patient is awake for 36 to 40 hours. Alternatively, the night sleep can be canceled in the second half of the night. If you have a tendency to seizure disorders (epilepsy), severe physical illness or psychotic symptoms, waking therapy is not recommended.
  • Sport / movement therapy: sporting activity or movement seems to have a positive effect on psychological well-being. Above all, distraction from negative thoughts, social interaction or the experience of a positive body feeling can have a positive effect on mood.
  • Relaxation methods: By learning and practicing relaxation techniques, one learns to deal better with stress and to come to rest. Professional guidance - especially when starting with the relaxation methods - has proven its worth.
  • Occupational therapy: By means of occupational therapy, it should be made possible for those affected to participate more in life again. The independence in everyday life (e.g. self-sufficiency, household chores) is promoted and the quality of life is increased.
  • Music therapy: Through music therapy with the aid of music, among other things, the handling of feelings is practiced, emotions are expressed and self-confidence is strengthened.

Mood diaries can also be supportive. The mood, important daily events, therapeutic measures, etc. are recorded in it. In a self-help group, those affected can also exchange ideas and learn from one another.

Recognize warning signs early on

Paying attention to possible warning signals and training their self-awareness can help those affected and their relatives to recognize episodes of illness early and to take countermeasures or help in good time. The following signs should make you particularly prudish:

  • Loss of appetite,
  • Depression,
  • Poor concentration,
  • Anxiety,
  • Sleep disorders / insomnia,
  • inexplicable sadness,
  • Listlessness,
  • "Hyperbole",
  • Flood of thoughts,
  • Irritability,
  • Delusions,
  • Suicidal ideation,
  • incessant flow of speech with leaps of thought,
  • Feeling that nothing can stop you and that you can do anything.

Involvement of relatives

A trialogical approach has proven particularly useful. The "trialogue" describes joint discussions between those affected, relatives and professional helpers on an equal footing. This also makes it possible to better pull together in order to achieve the therapy goals agreed with the patient. Self-help groups for those affected and their relatives also offer opportunities for exchange and help.

Whom can I ask?

The treatment of a bipolar disorder is carried out by a specialist in psychiatry. Specialized child and youth psychiatrists are also available for young people under the age of 18. Other health professions such as psychotherapists or clinical psychologists are usually included in the therapy.

In the event of a psychiatric emergency (e.g. risk of suicide), rapid medical help is essential. In these cases, call the ambulance immediately on 144! If possible, you can also go to the nearest psychiatric outpatient department.

Under Services, Links and Brochures you will find helpful information on looking for a doctor or therapist as well as looking for self-help groups (also for relatives).

How are the costs going to be covered?

The costs for medical treatment are usually covered by the health insurance providers. For more information, see Costs and Deductibles and Prescription Fee & Co: This is how drug costs are covered. Information on costs for a hospital stay can be found under What does a hospital stay cost?

When making use of psychotherapy, full cost coverage is possible in the health insurance institutions' own or contractually bound institutions, as well as in institutions that are subsidized by the public sector. In these cases, however, there is the option of paying a deductible. Otherwise, you have the option of applying for a subsidy from the health insurance company if you are taking advantage of psychotherapy from a resident psychotherapist. If this is approved, the health insurance provider will reimburse you for part of the fee paid to the psychotherapist. However, the health insurance carriers only provide a subsidyif there is a so-called disease-related disorder.

Clinical-psychological diagnosis is a service provided by social health insurance, the costs of which are borne by the health insurance providers. You must bear the costs for treatment or advice from resident clinical psychologists yourself, as this is not a benefit from health insurance

Information on rehabilitation can be found under Rehabilitation & Cure.

You can find out more about reimbursement on the website of the social security agency.

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