Stable relationships and routines help stabilize mood, doctors say

Love Is As Good As A New Drug!  It’s Now Part Of The Guidelines For
Treatment of Bipolar Disorder...
Therapy That Boosts Relationships And Social “Rhythms”
Prevents Mood Swings In Bipolar Disorder...

Key Words: Bipolar Affective Disorder, Bipolar Treatment, Social Rhythms, Cognitive Behavior Therapy, Social Rhythm Therapy, Interpersonal Therapy, Quality Of Life, Preventing Mood Swings

by Harris Jensen, MD
Editor, Good Day Journal

“Love is all we need...” or so goes a popular song from the 1970’s, but when it comes to dealing with the pain and suffering of bipolar affective disorder, songs like that seem like just so much superficial “hype.”

On the other hand, based on the hard science of new, well controlled studies, counseling that strengthens relationships and daily routines not only works, doctors are now asked to use it in their treatment of bipolar affective disorder. 
This is now clearly spelled out in the practice guidelines for how psychiatrists are to treat bipolar disorder. 

See the link: Bipolar Treatment Guidelines or the link: APA Practice Guidelines For Bipolar Affective Disorder,
You can also Google “bipolar treatment guidelines.”

Stable routines and stable relationships clearly help control the unstable mood swings of bipolar affective disorder.  A review of interpersonal social rhythm therapy is at this link: rhythm.
Here’s why psychiatrists are now changing the way they do business in treating bipolar disorder.
In a groundbreaking research discovery, a team of researcher from the University of Pittsburgh School of Medicine, Pittsburge, PA, has found that love matters.  And so does healthy daily social routines.  Things we take for granted. 
But when a person’s brain is suffering, it needs proper care, and that involves feeling close to those who care for you, thinking reasonably, and staying active in the usual daily routines...like getting up at a usual time in the morning, socializing, eating three meals per day at usual times, and getting to sleep at a usual time.
The brain, it seems, is a creature of habit.
So, getting back into those habits is helpful.
The researchers involved 175 severely ill patients with bipolar affective disorde in the study.  They were treated in one of four groups:
1.Interpersonal and social rhythm therapy (IPSRT)
2. Intensive clinical managment (ICM),  (medication and brief counseling)
3. Start with IPSRT then ICM
4. Start with ICM, then use IPSRT
The use of interpersonal therapy and social rhythm was then really put to the test: could it prevent mood swings in this group of severely ill patients over a two year period?
Could love and good habits make a biological difference?
The answer was good news for bipolar patients and their families who love them.
Yes.
Love makes a difference!  Good habits make a difference!
People receiving IPSRT actually did have better quality habits and relationships...and that made a difference...there were fewer mood swings breaking through ove a two year period and the rate of improvement was directly correlated to the improvement in habits and close relationships.
To see this article click this link: love matters.
For a review from PubMed website on related articles, showing lifestyle and psychotherapy interventions really do make a difference, when used with medication, in treating bipolar affective disorder, see the link: social life matters.
So for those who say that bipolar disorder is just biological, only medicines help, and nothing but medicines help...well, that just isn’t based on science.  Nowdays, that idea doesn’t hold any ring of truth with the scientific communnity.
What other education works?
In another report, just teaching patients with bipolar how to identify the early “warning” signs of the start of a manic or depressive episode, actually reduced the occurrances of the full mood swings, because patients were able to make changes in medication and lifestyle (destress), and avoid the “full” mood swings.  See the link: Out think the mood swings.
A dramatic help was found for bipolar patients in an earlier study on cognitive therapy.  Cognitive therapy (learning rational, common sense thinking skills) resulted in bipolar patients having fewer hospital admissions, less mood swings, and overall spending less time in a depression or manic episode.  See the link “cognitive therapy works in bipolar.”
In fact, family education and family therapy also improves how a person does with bipolar.  See the link “love and understanding works.”
What’s the big deal about loving relationships and a calm daily routine in one’s life?
Doctors hear about it all the time...when one of those is lost.  The loss of a relationship or the loss of a peaceful routine is what often triggers a mood swing.
So strengthening the bond between loved ones protects against a mood swing.
Strengthening daily routines for sleep, eating, paying bills, socializing, protects against mood swings.  This isn’t just some wishful thinking.  An earlier study showed that mood swings are, in deed, often started with a loss in a relationship (death or breakup or argument) or a lifestyle (financial stress, job loss, family stress, loneliness).  For the facts, see the link: broken social rhythms.

(Photo credits: Wayne Vedvig.)
HJ