Schema Therapy & Bipolar Disorder

Although I agree that schema therapy is not a primary treatment for bipolar disorder, we have utilized it in 2 ways at our center. The first is to weaken the reactions to stressors that may bring on a bipolar episode. It seems that such episodes are not always "random" but can be set off by life events and circumstances. Schema therapy can sometimes be helpful in examining these triggers -- some of which may be linked to lifelong issues -- and helping to resolve them. We would always insist that the patient simultaneously try out medication for the bipolar illness.

Jim also raised another possibility -- one that we have seen many times at our Center: the misdiagnosis of bipolar disorder when the patient is actually suffering from a personality disorder (usually along the borderline spectrum). The rapid shifts in modes/moods in borderline patients can sometimes be confused with bipolar disorder. I personally like to see clear evidence of a major manic episode (Bipolar I) before assuming that the bipolar diagnosis is correct. If the patient is borderline (or similar), schema therapy can be extremely helpful.

For whatever reason, I am pleased to hear that schema therapy was useful with Julie's client.

Replies:

New book on schema therapy, by Jeff Young, 07/24/03

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