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Is Cognitive Behavioural Therapy more effective than Psychodynamic Therapy in thetreatment of Bipolar Disorder?
Introduction
Bipolar disorder is a condition also known as manic depression where your mood can shift from an
episode of mania, where you may experience high amounts of energy, inflated self esteem, decreased
need for sleep and/or become hyperactive, to a depressive episode, featuring feelings of low mood or
lethargic tendencies. It has a lifelong prevalence rate of 1%- 1.5%. This disorder can be treated
through various different ways depending on the severity or complications of the condition, such as
comorbidity.
This study will compare the efficacy of both Cognitive Behavioural Therapy (‘CBT’) and
Psychodynamic Therapy in treating Bipolar disorder. Summarising them both in turn:
● CBT, is a structured, pragmatic form of therapy, aiming to identify specific current problems,
and solve them. What is distinct about CBT is that it does not deal with a patient's past, but
instead addresses issues they are facing at present. It aims to stop negative cycles through
breaking down what makes a person feel bad, anxious or scared, and changing behaviour as a
result, making their problems more manageable. Furthermore, CBT is structured, so the
subject is encouraged to not expel every different quality of their life in great detail, but
alternatively they are expected to keep focused on certain topics to reach the outcome of their
treatment.
● Contrastingly, Psychodynamic Therapy encourages the subject to speak freely about their
memories, problems and even fantasies, to help the therapist understand the patient to a
greater extent. Moreover, Psychodynamic Therapy aims to understand any and all reasoning
behind the subject’s symptoms, relationship issues and or emotional distress. Unlike CBT,
Psychodynamic Therapy sets out to understand how your past experiences, mind sets and
, worries about the future are causing difficulties in your present life. Throughout
Psychodynamic Therapy, the relationship with the therapist would be examined, and indeed
the therapist can use this information as an analytical indicator with regard to how the subject
forms relationships, in both the past and present.
Initially, as a result of these statements, it can be argued that Psychodynamic Therapy offers a more
holistic insight into a subject’s problems, whilst CBT refuses to delve any further past their current
issues. Indeed this has prompted some to suggest as a hypothesis that Psychodynamic Therapy is more
effective than CBT in the treatment of Bipolar Disorder.
What is the difference between Bipolar Disorder Type One and Type Two?
Source: Patricia Oelze - ‘What is the difference between Bipolar 1 and 2?’ Medically reviewed by Mr
Aaron Dutil
Bipolar Type One and Two have overlapping symptoms, but ultimately the main difference between
the two is that a patient with Bipolar Type Two experiences less manic symptoms.
Bipolar Type One:
For a diagnosis of Bipolar Type One, a patient would need to have had a manic period which lasted
more than a week; depression episodes are not necessarily needed for a diagnosis for Bipolar Type
One.
However, a patient would need to have one of the following symptoms to identify their mania:
- Increased racing thoughts
- Higher energy levels
- Increased irresponsible behaviour
- Higher mood levels than usual
- Delusions of grandeur
, - Potential psychotic episodes
- Lack of control of impulse and potentially even hallucinations
As well as this, a patient with Bipolar Disorder Type One would tend to need to have at least three of
the following symptoms for a diagnosis, (this depends contextually on the circumstance of course):
- Irritability / aggressive nature
- A lack of need for sleep
- Over-confidence
- Attention span issues
- Lack of ability to make decisions or concentrate
Bipolar Type Two:
For this type of Bipolar disorder, a patient would usually be expected to have experienced one
hypomanic (a more mild version of mania) period as well as a severe depressive episode lasting at
least 14 days. This would mean that if a patient suffered from Bipolar Disorder Type Two, they would
experience less mania, and more depressive symptoms.
Symptoms of the depressiver aspect of Bipolar Disorder Type Two include:
- Forgetfulness
- Suicidal thoughts
- Reduced energy levels
- Social isolation
- Weight gain or weight loss
- Lack of enjoyment in activities previously enjoyed
- Lack of concentration
For the purposes of this study, both types of disorder will be recognised as similar, and therefore it
will be suggested that the treatment of both types is similar.
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