Why are psychological treatments recommended in bipolar II disorder?

This section will help you to understand the different add-on psychological options recommended for bipolar II disorder (BPII).

Although medication forms the main treatment for most people with BPII, people may still relapse into depression or hypomania even when they are taking medication. ‘Real-world’ studies of people with bipolar I and II disorders suggest that on average, for any type of episode (depression or hypomania) :

WITHIN 2 YEARS
50 in 100
people treated with medication will NOT RELAPSE within 2 years
50 in 100
people will RELAPSE
WITHIN 5 YEARS
10-30 in 100
people treated with medication will NOT RELAPSE within 5 years
70-90 in 100
people will RELAPSE

Because medication does not offer complete protection against relapse in BPII, adjunctive psychological interventions or ’talking therapies’ are added to help prevent relapse.

Studies show that when used together with medication, two bipolar-specific psychological treatments are effective in preventing relapse:

Add on options effectiveness

These two psychological treatments are presented in detail in the following sections. For a summary of the advantages and disadvantages, see "Summary table of the advantages and disadvantages of add-on psychological options".

There are other psychological treatments available which may also be helpful to you. For more information about other types of psychological treatments, talk to your clinician (see Australian Psychological Society “Find a psychologist” under Further resources.)

These psychological treatments appear to:

  • be more effective at preventing relapse than medication only and usual care
  • be similar in terms of effectiveness, suggesting that any of these treatments will help
  • have a number of common core strategies, such as ways you can prevent relapse and stay on medication
  • help with other issues besides just preventing relapse, such as accepting diagnosis, identifying your early warning signs or triggers for relapse, and reducing the impact of lows and highs on your life and relationships.
Because of this, it is up to you to consider which psychological treatment fits in best with your life and preferences. As with medication, the option your clinician recommends will depend on your individual needs and life situation. Your clinician may also combine elements of these psychological treatments with others to help you in the most effective way.