Which Talk Therapies are Most Effective for Mood Disorders?

“I have recently been diagnosed as Bipolar II. In addition to medication, my psychiatrist has recommended talk therapy. I have been told that there are some approaches to talk therapy that are more effective with mood disorders. What do you recommend?”

This is an excellent question. Your psychiatrist has made a sound recommendation. The opportunity to talk out one’s feelings with an understanding mental health professional is a major part in alleviating anxiety and reducing symptoms of all mood disorders. This is especially important in the process of stabilizing on medication.

You are correct; there are a variety of approaches to talk therapy. There are three basic approaches: psychodynamic, examining prior personality development; cognitive-behavioral, examining and alleviating symptomatic behavior; and existential-experiential, encouraging clients to be more aware of feelings and their connection to actions. All approaches strive to positively affect attitudes and behavior.

While all approaches can be effective with mood disorders, I think there is a hierarchy of approaches. Initially, one who has been recently diagnosed and is suffering from debilitating symptomatic behavior will gain the most from a cognitive-behavioral approach. The specific attention to symptom management is a needed first experience in talk therapy. The cognitive-behavioral approach is usually time-limited, often lasting less than six months. Once medication management is effective and symptoms are self-monitored, clients are advised to continue with an interpersonal form of talk therapy, in order to further examine underlying behaviors and continue to work toward a fuller and richer lifestyle.

However, the most important factor regarding success in talk therapy is the extent to which clients feel their therapist understands them. In other words, your chances of getting better are greatly enhanced when you have confidence in your therapist and enjoy a trusting relationship with him/her.

So, the short answer to your question is that cognitive-behavioral talk therapy works best initially. Other approaches are as good or better once a patient is stabilized on medication.

But, the most important factor, regardless of approach, is the quality of the relationship between client and therapist. When selecting a therapist, pay attention to your own feelings, they are usually right on target. You are the consumer, shop around until you find a therapist whom you trust and feel is accepting, warm, and understanding.