Research on DBT and Bipolar Disorder

Dialectical Behavior Therapy (DBT) is a model of treatment originally developed and designed by Marshal Linehan. It is a modified form of cognitive behavior therapy specifically developed to target specific types of dysfunction utilizing cognitive behavioral techniques that are very effective with specific areas with a focus on skill building. This treatment was originally used for the treatment with borderline personality disorder with good outcomes. Many of the symptoms of borderline personality disorder are similar to those of bipolar disorder. Mental illness is sometimes a complicated subject, and it is no wonder that some disorders seem to have overlapping symptoms. Thus, it is only natural that some therapeutic interventions might be useful for more than one mental health issue.

Both disorders share the problems of tolerating distress, suicidality, depression, self harm, self medication with drugs, high risk taking, impulsivity, difficulty with interpersonal relationships, and difficulty with regulating emotion in common. Of course, this is not all inclusive, and, not everyone with either one or the other disorder will have problems in all of these areas. The idea of DBT is to build specific skills to help individuals tolerate distress, find appropriate solutions, increase efficacy with interpersonal skills, and regulate emotions. With that said, the interventions include Mindfulness, Distress Tolerance, Emotional Regulation, and Interpersonal Effectiveness. Each intervention provides a large set of treatments and skill building approaches that help the participant acquire, master, and use a repertoire of skills to help manage their life. As I use this approach with my own patients, I notice that their self image, sense of how they relate to the community, and overall approach to life seems to change in a very positive way.

There has been some initial research on the effectiveness of Dialectical Behavior Therapy (DBT) that seems to show positive results as a useful tool for the treatment for bipolar disorder. A March 5, 2013 study called “A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder” [i] It is the first of its kind; hopefully pointing the way to further research.

The results of the study show a trend in reduced depressive symptoms with significant improvement in areas such as mindful awareness, less fear of emotional states, and more control of emotional states. Individuals who attended groups had reduced emergency room visits as well as reduced mental health related admissions in the six months following treatment. The conclusion was that there is “preliminary evidence that DBT skills reduce depressive symptoms, improve affective control, and improve mindfulness self-efficacy in BD” (Bipolar Disorder). It was concluded that the positive results from this pilot study warrants further research.

[i] A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder. March 5, 2013Volume 145, Issue 3, Pages 386–393- Retrieved from http://www.jad-journal.com/article/S0165-0327(12)00437-5/abstract?cc=y (3/31/2015)

You can purchase the entire journal article through at: http://www.sciencedirect.com/science/article/pii/S0165032712004375