University of Colorado study shows intensive therapy helps in battle against bipolar disorder

April 02, 2007

New results from the largest federally funded bipolar study ever conducted show that patients who receive psychotherapy in addition to medication get better faster from bipolar disorder's debilitating depression and stay better longer, according to a University of Colorado at Boulder researcher involved in the study.

Part of a $26.8 million effort, the study found that adding intensive psychotherapy to a bipolar patient's medication treatment made them one and a half times more likely to be clinically well during any month of the study year, compared with a group that didn't receive intensive therapy, according to CU-Boulder psychology Professor David Miklowitz, the principal author of the study.

"The take home message here is that psychotherapy is a vital part of the effort to stabilize episodes of depression in people suffering from bipolar disorder," Miklowitz said. "If you get regular intensive therapy, the outcome for depression is going to be better than if you just take medications and have a couple of case management sessions."

The results of the study were published today in the April edition of the journal Archives of General Psychiatry.

Medication is the first line of defense against the disease, also called manic depression. Bipolar disorder is inherited and caused by a biochemical imbalance in the brain. It affects an estimated 5.7 million Americans, many of whom develop the disorder in their teens or as young adults.

While psychotherapy is routinely used to treat bipolar disorder, its effectiveness up until now has been unclear, according to Miklowitz. The seven-year study involved 293 people suffering from bipolar depression who were already taking medication. The participants, who were treated in 15 sites across the country, were randomly assigned to one of three types of standardized, intensive, nine-month psychotherapies, or to a control group that received a brief psychotherapy program that involved three sessions of education about the disorder.

The three types of intensive therapies included a family-focused therapy that involves participants' family members and focuses on family coping, communication and problem-solving; cognitive behavioral therapy that focuses on helping the patient understand and cope with distortions in thinking and activity; and interpersonal and social rhythm therapy that focuses on stabilizing daily and nightly routines and solving key relationship problems.

After one year, 64 percent of those in the intensive psychotherapy groups had recovered from the episode of depression that brought them into treatment, compared with 52 percent in the control group. Patients in intensive psychotherapy also recovered an average of 110 days faster than those in the control group. None of the three therapies appeared to be significantly more effective than the others, although rates of recovery from depression were highest among those in family-focused therapy, Miklowitz said.

While fully controlling the ups and downs of bipolar disorder is not possible, doctors can delay patients' relapses into debilitating periods of depression and manic behavior. Relapses of the disorder can split up marriages, cause job loss and even lead to suicide, according to Miklowitz.

"You need drugs like lithium as a first-line offense against depression, but then the question becomes 'What if the person is not responding right away?' " Miklowitz said. "That's when therapy may be the missing ingredient. We're not saying you should get therapy instead of medication. It's therapy on top of medication."

Getting the treatments into the community will be a challenging task. "There also has to be a consciousness among clinicians that bipolar people benefit most from learning skills to cope with the disorder, rather than just generic counseling," he said. "Teaching patients and family members how to immediately recognize and get treatment for emerging symptoms is essential."
Miklowitz' study was part of the Systematic Treatment Enhancement Program for Bipolar Disorder study funded by the National Institutes of Health's National Institute of Mental Health.

Researchers at CU-Boulder and the University of Colorado at Denver and Health Sciences Center were also involved in a paired study that found that treatment of bipolar patients with mood stabilizers in conjunction with an antidepressant did not provide any benefit and had similar outcomes to treatment with just a mood stabilizer and a placebo pill. That study was published online in the New England Journal of Medicine on March 28.

University of Colorado at Boulder

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to