Bipolar disorder: Treatment with psychotherapy and lifestyle changes

If your child is diagnosed with bipolar disorder, medications will be an important part of their treatment. Your child's doctor may also recommend psychotherapy and lifestyle changes to manage symptoms.

Psychotherapy for bipolar disorder

Psychotherapy, also known as "talk therapy", involves a trained therapist working with an individual or a group of people on common objectives. Depending on the type of psychotherapy, the therapist can offer support, teach coping skills or help the patient(s) explore relationships.

Some psychotherapy treatments for bipolar disorder include:

• cognitive behavioural therapy (CBT)
• interpersonal and social rhythms therapy (IPSRT)
• family-focused therapy (FFT)
• dialectical behavioural therapy (DBT)

Cognitive behavioural therapy (CBT)

CBT has been well studied in children and teens with depression, and is particularly helpful for the depressive episodes in bipolar disorder.

Interpersonal and social rhythms therapy (IPSRT)

This type of psychotherapy originated from interpersonal therapy for depression, and was adapted for bipolar disorder.

IPSRT helps children and teens work on improving their relationships and managing their daily routines by using charts. Regular routines and sleep schedules may help prevent manic or hypomanic episodes or lengthen the time between them.

Family-focused therapy (FFT)

FFT involves a child's family and focuses on enhancing the family's ability to cope with a depressive or manic/hypomanic episode and recognizing new episodes earlier. FFT helps to improve communication and problem solving in the family.

Dialectical behavioural therapy (DBT)

DBT is a therapy that teaches teens skills to help them regulate their emotions and change any maladaptive (unhelpful) behaviour.

Importance of patient/therapist relationship

Psychotherapy is more helpful when there is a good relationship between the therapist and the child. If there is a poor fit, you may need to talk to the therapist or switch to another therapist.

Lifestyle changes and general support

Children and teens with bipolar disorder may see their symptoms improve by following some general healthy routines.

These include:

• getting eight to ten hours of sleep a night
• eating a balanced diet, following Canada's Food Guide
• doing regular exercise in line with the physical activity guidelines for children and youth​
• obtaining peer support, where they can talk to others their age about how they are feeling (your child's doctor may be able to recommend a group)
• spending time doing healthy activities they enjoy
• taking time to see how they can reduce or remove any unnecessary stressors

If your child's symptoms prevent them from following any of these suggestions, your paediatrician or family doctor can offer advice.

Further information

For more information on bipolar disorder, please see the following pages:

Bipolar disorder: Overview

Bipolar disorder: Signs and symptoms

Bipolar disorder: Treatment with medications