Kathleen A. Barrow, LMFT, MS

Episodes may be a mixture of both manic and depressive symptoms. In such an episode, individuals with bipolar disorder may feel sad, empty, and hopeless but have a high level of energy at the same time. Sometimes, changes in mood are less dramatic. For example, individuals may feel happy and think everything is fine, but people around them may notice their mood changes. Episodes like this are called hypomania. If an individual is hypomanic and does not receive proper treatment, their condition will likely worsen.

Generally considered a lifetime illness, the disorder begins in the late teen or early adult years. Bipolar disorder has no known cause, but research has shown that it tends to run in families. To diagnose it, a psychiatrist carefully assesses an individual's moods and behavior patterns. They may also be asked to keep a daily record of their moods and other factors that can help with diagnosis and determining the right course of therapy. Counseling is a typical form of treatment, as is a group of medications that can control symptoms, called antipsychotics.

Dialectical behavior therapy was developed when therapists attempting to use CBT techniques on the most seriously ill patients ran into a problem. When they suggested that a patient change their thoughts, these very vulnerable patients would become overwhelmed and turn aggressive or suicidal. DBT was developed to support these patients with acceptance and validation while still guiding them towards changing problematic thoughts. Although also used for suicidal and self-harming patients today, these days, DBT is mainly used to treat borderline personality disorder. It is one of the few effective interventions for this serious illness.

DBT has been shown to be very effective at reducing self-destructive behavior. It can also be used to teach new coping skills and increase a patient's self-esteem and motivation to become healthier.