Bipolar Disorder Treatment
- What is bipolar disorder and what are the symptoms of bipolar disorder?
- Why consider residential treatment for bipolar disorder?
- What benefits does a therapeutic community provide in the treatment of bipolar disorder?
- How does an integrated treatment team approach work in treating bipolar disorder?
- How does psychiatric treatment in an open setting work?
- How does our comprehensive treatment prepare patients to return to a world beyond Riggs?
- Additional resources on bipolar disorder.
What is bipolar disorder and what are the symptoms of bipolar disorder?
Patients struggling with bipolar disorder struggle with manic, hypomanic and/or depressive episodes that typically affect their social and work lives. After such episodes it is not uncommon to feel deeply ashamed or humiliated by the behavior exhibited during one of these episodes and to lose confidence and trust in oneself. Self-loathing, sleep disturbance, weight fluctuation and/or concentration issues can develop, and some individuals will self-medicate with substances to control their symptoms. In addition to substance use disorders, patients with bipolar disorder often struggle with other comorbid conditions, like personality disorders. Those with bipolar disorder comorbid with other disorders often pose serious treatment challenges, and carry a higher risk of suicide than other bipolar patients. Bipolar disorder is also one of the most over-diagnosed disorders in contemporary psychiatry. Careful diagnosis is crucial, and Riggs attends carefully to confirming or changing the diagnosis.
Why consider residential treatment for bipolar disorder?
Immersion in our treatment program helps patients who do have bipolar disorder:
- develop better emotional regulation and ability to tolerate previously overwhelming feelings;
- come to grips with the emotional impact of having this kind of disorder, including the potential benefits—and risks—of a medication regimen;
- improve their ability to understand the meaning of their symptoms and behaviors;
- develop an awareness for the context of their troubles;
- face the reality that they may be coping with a chronic problem;
- learn to adapt to circumstances;
- understand that their behavior affects others;
- communicate in words instead of behavior;
- make better life choices grounded in better understanding of themselves and their motivations; and
- discover a life worth living.
Successful treatment of people with bipolar disorder is complex and multi-layered. State-of-the-art psychopharmacological intervention is key in helping patients with significant mood disturbance. However, it is well established that most people with bipolar disorder need more than medications alone. In one study, known as the STEP-BD, only 58% of bipolar patients recovered from their mood episode within six months of beginning treatment, and half of these relapsed within two years. Other research has suggested that psychosocial treatment, in addition to medications, is associated with better outcomes in bipolar disorder. When a person feels emotionally unstable, has significant interpersonal difficulties and has been unable to function adaptively, it can be challenging to find treatment that is comprehensive, integrated and multi-faceted—with both medication and psychosocial components. Patients with bipolar disorder who have not been helped sufficiently in other settings often benefit from the integrated, comprehensive, psychodynamically focused psychosocial treatment and evaluation program that Riggs provides.
What benefits does a therapeutic community provide in the treatment of bipolar disorder?
Exploring Different Roles with the Clinical Staff and the Therapeutic Community
At the Austen Riggs Center we have substantial clinical expertise and experience working with patients who have bipolar disorder. Our treatment program is intensive, including psychodynamic psychotherapy four times a week with a psychiatrist or clinical psychologist and embedded in a therapeutic community. The psychotherapists are all doctors (MDs, DOs, PhDs and PsyDs) who recognize the specific treatment dilemmas involved in working with someone with bipolar disorder. Our psychiatrists are well versed in medications that are effective in treatment of the targeted symptoms of bipolar disorder.
Patients have rich opportunities to learn about themselves within the therapeutic community. They learn how others affect them, how they affect others, and are often able to shed habitual unproductive roles. As a result of successful treatment at Riggs patients develop greater confidence and more adaptive coping skills. The goal of this comprehensive approach is to help patients develop ways of facing their future with greater competence.
How does an integrated treatment team approach work in treating bipolar disorder?
An Integrated, Multidisciplinary Treatment Team Works with the Patient
Each patient works with a multidisciplinary team that develops with them a treatment plan. Members of the team include clinical psychologists, at least one psychopharmacologist (who may also be the therapist to some patients), team nurses, and a substance use disorder counselor. A therapeutic community staff member helps patients find their way into the formal groups and informal leisure activities within the Therapeutic Community Program. A clinical social worker, also part of the team, provides liaison contact with the patient’s family, convenes family meetings, and helps with practical concerns such as getting a driver’s license, applying to school, preparing for job interviews, and making plans to transition to life outside of Riggs. The same multidisciplinary team of clinicians generally works with a patient throughout their entire treatment at Riggs.
How does psychiatric treatment in an open setting work?
Beyond Bipolar Disorder -- Exploring the Open Setting
One of the distinguishing features of the Austen Riggs Center is the open setting. In this setting, patients have complete freedom, but in return take responsibility for their safety. There are no locked units or physical restraints and no privilege system. All admissions are voluntary; after a thorough admissions consultation, a person must decide whether to accept an offer of admission. Throughout one’s time at Riggs, there is ample opportunity for staff input and recommendations, but also an emphasis on developing a partnership between patients and staff that keeps in mind the each person’s developmental needs and goals.
How does our comprehensive treatment prepare patients to return to a world beyond Riggs?
Patients Can Take On New Roles and Responsibilities During Their Stay
As patients move through our treatment program, they may take on new responsibilities, learn new skills, and build confidence by accepting a position of leadership within the patient community. All of these efforts are designed to enable someone to develop greater skills in preparation for the transition to life after Riggs. As patients progress, they may step down to a lower level of care, increasing their involvement in the world beyond Riggs as they taper their participation in the therapeutic community.