You can learn to manage your symptoms by taking care of yourself. Self-care includes looking after your diet, sleep, exercise, daily routine, relationships, and emotional wellbeing. You are in the best position to notice the areas of your life that may need attention or change.
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What lifestyle changes can I make?
Making small, manageable lifestyle changes can boost your wellbeing and support your recovery.
Establishing a routine can be especially helpful for mental health. A structured day provides stability and can give you a sense of purpose.
Simple routines might include eating meals at consistent times, going to bed and waking up at regular hours, and planning weekly activities like grocery shopping. Creating these habits can make a significant difference in how you feel day-to-day.
Your healthcare team should guide you in developing a personalised plan that combines healthy eating, regular exercise, and consistent sleep to support your overall wellbeing.
What are support groups?
Support groups are gatherings where people come together to share experiences, exchange information, and offer each other encouragement. Just like the SharingBipolar Community provides an online space to connect with others around the world, a local support group can offer focused support in your own area.
You can often find local groups by searching online. For example, the charity Bipolar UK currently runs face-to-face support groups in several areas of the country.
What are recovery colleges?
Recovery colleges are run by healthcare providers and offer free courses on mental health. Their goal is to help you understand and manage your symptoms, take control of your life, and become confident in your own wellbeing and recovery. Most recovery colleges allow self-referral.
In the UK, the NHS runs recovery colleges, but they aren’t available in every area. You can check for local options by searching online using a search engine like Google.
Wellness Recovery Action Plan (WRAP)
The Wellness Recovery Action Plan, or WRAP, is a self-designed tool to help you get well, stay well, reach your goals, and take control of your life.
Developed in 1997 by people seeking ways to overcome their mental health challenges, WRAP has since helped many people worldwide improve their wellbeing and achieve their life goals.
WRAP encourages you to notice early signs of mania or depression and plan strategies to manage them. You can work on a WRAP with your healthcare professional or request a template to guide you.
Only I know aspects of my life that need improving, it's time to make changes!
learn: self help
Set Goals. Celebrate!
No one likes to feel they’ve failed, especially when the challenges are beyond your control. It’s important to understand your limitations and set boundaries. If something feels too much to manage alone, don’t hesitate to ask for help.
Break your progress into bite-sized, achievable steps. Create an action plan to manage your condition. You can push a little further each day if you feel able, but always take time to celebrate the small wins—each success brings you closer to your goals.
A win could be as simple as getting out of bed, making a phone call, preparing a meal, or completing your weekly shopping. These everyday achievements are important milestones, and you should be proud of them.
learn: coping mechanisms
Mental Training
Cognitive Behavioural Therapy (CBT)
CBT (Cognitive Behavioural Therapy) for bipolar disorder helps you understand your condition, why treatment works, and what factors can influence your mood. It focuses on changing thought patterns and behaviours that may worsen symptoms.
A 2021 review suggests that CBT can be effective for all types of bipolar disorder except acute mania, which is a sudden and severe manic episode. CBT may also help manage co-occurring conditions, such as anxiety, providing tools to cope with daily challenges.
The average CBT course for bipolar disorder consists of around 20 sessions. Your doctor may recommend it alongside medication or other therapies to provide a comprehensive approach to managing your condition.
CBT can help manage Bipolar Disorder
Research shows that medication alone is rarely enough, so psychosocial interventions are essential. CBT is widely recommended as a key treatment for all types of bipolar disorder, except acute mania. While CBT has many components, the educational aspect—helping you understand your condition, treatment, and triggers—is often the most valuable for managing symptoms.
Evidence indicates that CBT as an add-on treatment may help with:
- noncompliance with medication
- loss of function socially, at work, or cognitively
- partial responses to other treatments
Additionally, recent research suggests that cognitive behavioural therapy is effective in prolonging remissions and reducing the likelihood of recurring episodes.
CBT also addresses co-occurring conditions that can worsen symptoms, such as:
- anxiety
- autism
- post-traumatic stress
- avoidant personality issues
- obsessive-compulsive disorder
- substance use disorders
- sleep disturbances
Education and Awareness
CBT begins with psychoeducation—teaching a person about bipolar disorder. This includes:
- common patterns in bipolar
- the rationale for treatment and importance of adherence
- key social, biological, and psychological factors that influence mood
Interventions to Change Thoughts and Behaviours
After education, CBT typically focuses on:
- recognising and replacing negative thoughts seen in depression
- developing stress and sleep management skills
- practising problem-solving and conflict resolution
- addressing co-occurring psychological conditions
Interventions to Prevent or Reduce Episode Severity
This includes training to spot early signs of episodes and act quickly. Strategies may involve family meetings, sometimes including close friends, to provide support and guidance.
There’s no hard or fast rule…
The time needed to see results varies. Research suggests that the average CBT treatment plan consists of about 20 sessions.
There is no standard duration because it depends on the severity and subtype of bipolar disorder, along with other personal factors. Some people notice improvements after just a few sessions, while others may need several months of treatment.
Sessions usually last around an hour and occur once a week. Meetings can be conducted online, but there is typically “homework” for the individual to complete between sessions. The effectiveness of CBT is closely linked to the effort and engagement put into the process.
I wish there was a quick fix, I guess I'll just have to put the effort in!
Interpersonal and Social Rhythm Therapy (IPSRT)
IPSRT helps you stabilise daily routines and improve relationships:
Regular meals
Consistent sleep-wake cycles
Balanced rest and activity times
IPSRT also aims to enhance social role performance and improve interpersonal relationships. A 2020 clinical trial suggested it may improve symptoms, though more research is needed.
Family-Focused Therapy (FFT)
FFT helps adults, children, and supporters manage bipolar disorder through education and skills training:
Speed up recovery
Reduce symptom severity
Lower frequency and recurrence of mood episodes
So… What now?
Cognitive behavioural therapy (CBT) for bipolar disorder starts with education about the condition and continues with interventions to change thoughts and behaviours.
CBT is recommended as a second-line treatment after medication. It may help with challenges such as noncompliance with medication or difficulties in social, occupational, or daily functioning.
The average number of CBT sessions is 20.
Alternative psychotherapies to CBT include interpersonal and social rhythm therapy (IPSRT) and family-focused therapy (FFT). While research is still limited, these approaches have shown promise in helping people manage mood episodes, improve relationships, and maintain daily routines alongside medication. Choosing the right therapy depends on your personal preferences, lifestyle, and specific challenges.
Questions to ask
The following questions can help you discuss CBT with your healthcare practitioner:
How many CBT sessions may be necessary?
What results should I expect from CBT?
If CBT is not effective, are there alternative therapies?
What is the cost per session?
Can I attend sessions remotely?