Clients with bipolar disorder often are assigned to our Cognitive Behavioral Therapy (CBT) specialized recovery community.

Cognitive behavioral therapy, or CBT, is an evidence-based therapy proven to be effective in treating bipolar disorder. CBT therapy focuses on understanding how your thoughts, behaviors, and mood are connected. Patients who engage in CBT learn strategies to improve their mood – how they feel – by changing their thought and behavior patterns.

CBT therapy can help people recognize thoughts and behaviors that may signal that an episode of depression or mania is developing. CBT empowers clients to use learned skills and strategies to prevent or mitigate the mood episode. Through CBT, people also often are able to identify strengths and personal assets they can use to navigate mood episodes and prevent relapse or hospitalizations.

Clients with co-occurring borderline personality disorder may be assigned to the dialectical behavior therapy (DBT) recovery community. DBT also may be appropriate for clients with bipolar disorder who struggle with emotion regulation, self-harm, or frequent suicide attempts.

DBT progresses through four key modules: emotion regulation, interpersonal effectiveness, mindfulness, and distress tolerance.

DBT helps clients learn skills to manage intense emotions, stress, and challenging situations to live a "life worth living."

Some people who have bipolar disorder also experience psychosis. Young adults may experience a first episode of psychosis (FEP) as part of a manic episode. Medication is critically important for psychosis because everything gets worse every next day someone lives with untreated psychosis.

Clients experiencing psychosis as part of bipolar disorder likely will enter the cognition and first episode (CAFE) recovery community. Once the psychosis is resolved through medications and therapy, clients may transition to the cognitive behavioral therapy (CBT) recovery community if clinically appropriate.

All clients experiencing psychosis participate in computer-based cognitive training to prevent cognitive decline and improve executive functioning.

Several studies show that more than 40 percent of individuals with a bipolar diagnosis also experience symptoms of substance use disorder. We call this having a dual diagnosis or co-occurring disorders. Co-occurring diagnoses can make recovery more challenging. But research indicates that people who address multiple psychiatric diagnoses simultaneously experience better long-term outcomes than those who try to address each diagnosis separately.

While Skyland Trail clients with bipolar disorder participate in a recovery community focused on their mood disorder or psychosis, clients with co-occurring substance use disorder also participate in the dual diagnosis recovery community. Clients who may have been using alcohol or substances as a coping mechanism to deal with the symptoms of their bipolar depression or mania learn new strategies and skills to regulate their mood, cope with stress, and stay healthy without relying on substances.

Trauma – particularly when experienced in early childhood – is very predictive of developing all mental illnesses, including bipolar disorder. Skyland Trail practices trauma-informed mental health care. Trauma-informed care allows trauma survivors to first address the symptoms of a diagnosed mental illness like bipolar disorder before processing their trauma.

Throughout treatment, care providers acknowledge that the client has experienced trauma and validate the emotions arising from that experience. But the treatment team does not ask the client to describe or re-live the trauma in any way. Treatment strategies are focused on helping the client develop skills to handle difficult emotions and stressful situations in healthy ways.

Completing trauma-informed psychiatric treatment for bipolar disorder allows clients to develop insight, adopt skills, and build a strong foundation for healthy living. Clients who are trauma survivors are then better prepared and equipped to pursue formal trauma treatment with a specialized mental health provider.

Some clients with a history of trauma may be assigned to additional groups focused on addressing "stuck points" related to their trauma that are preventing them from making progress in therapy. These groups use an evidence-based approach called Cognitive Processing Therapy (CPT), which is a type of CBT.