Psychotherapy Treatment
The role of psychotherapy in the treatment of people with mood disorders has, until recently, been neglected. We think that good psychotherapy is an important component of treatment for people with all mood disorders, including those with “biologically based” disorders like bipolar disorder and recurrent depression. It turns out that psychotherapy affects the brain, and functional brain scans demonstrate that psychological treatment affects biology.
One way of thinking about this is to consider a simplistic model of how the brain functions in depression. Brain scans demonstrate that there are two important areas involved in depression: the frontal cortex and the limbic, or emotional brain. The frontal cortex is the more advanced part of the brain, where we do our conscious thinking, whereas the limbic brain is the more primitive part of the brain that regulates emotion. There are powerful connections between the two. Thoughts affect emotions and vice versa. Medications seem to work primarily on the limbic brain and therapy on the frontal cortex.
For many people that we see we are able to treat a “treatment resistant” depression because we use treatments that affect both aspects of depression.
Our approach to therapy, like our approach to psychopharmacology, begins by applying the results of well designed clinical research. We try to use “evidence based” treatments as much as possible: therapies that have been shown to work.
Some of these evidence based psychotherapies include:
- Interpersonal Social Rhythm Therapy (IPSRT)
- Cognitive Behavioral Therapy (CBT)
- Interpersonal Therapy (IPT)
- Cognitive Behavioral Assessment System of Psychotherapy (CBASP)
We also know that there are many people with mood disorders who also have problems with substance use (as many as half of those with bipolar disorder have a substance use disorder). So we make sure to provide therapies (and medications) that can help minimize the adverse effects of substance use.
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