by guest blogger Sheri Van Dijk, MSW

As part of my job at the hospital I work at, I have been running a bipolar disorder group for the past two years. I’ve yet to run a group in which the question of the usefulness of talk therapy for bipolar disorder is not raised. Many people are under the impression that bipolar is strictly a biological illness and is therefore treated only with medication. While we do know that bipolar disorder is in part a biological illness, it’s important to recognize that our biological make-up is only one part of the equation.

As with other mental illnesses, researchers continue to debate how much of bipolar disorder is biological, and how much is caused by our environment—the old “nature versus nurture” debate. There is no longer any question that both our physical make-up and our environment play a part. People with bipolar disorder are born with a genetic predisposition for the illness, but something needs to happen in their life to activate the illness—to turn it on, so to speak. Then once it’s been activated, subsequent triggers keep re-activating it, causing episodes of depression, mania/hypomania, or mixed states.

These triggers could be something like growing up in a stressful environment—for example, where a child is abused or neglected. Or the trigger could involve a sensitive child growing up with a family who is not as sensitive, creating a mismatch of personalities, which can cause stress and invalidation. Triggers can also come in the form of more specific life events—which can be positive or negative—such as the birth of a child, the death of a loved one, a change in jobs, or a move. So, while medications for bipolar disorder are usually essential, equally essential for living a healthy, positive life with bipolar disorder is learning skills to help you cope with life stressors, which can continue to trigger episodes.

Medications can’t change your thinking patterns or alter how you communicate with people. They might help you feel less depressed so you are more able to assert yourself, but they don’t provide you with the skills to assert yourself. Through talk therapy, or through reading certain self-help books, you can learn to think about situations in a different way. You can learn to have healthier, more satisfying relationships, to deal with crisis situations more effectively, and to manage your illness so that it has less of an overall impact on your life. Medications are essential in helping people with bipolar disorder live a healthier life, but in my opinion, psychotherapy is just as important and shouldn’t be overlooked. You are not at the mercy of your brain!


Sheri Van Dijk, MSW, is a therapist working in private practice and at Southlake Regional Health Centre in Ontario, Canada.  She is the author of Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life.