Talk Therapy

When I was diagnosed with bipolar disorder as a college student, over twenty years ago, I was told that I didn't need a therapist because I simply had a "chemical imbalance" which would be corrected by taking lithium. I was also advised not to attend support groups because I was "higher functioning" than most people with bipolar disorder and my psychiatrist thought that the members of support groups would be a bad influence. My psychiatrist also explained that it would be unwise to go public with my bipolar disorder. I was cautioned to keep my diagnosis to myself because there was still a huge stigma to having a mental disorder. I felt very much alone in guarding my secret disorder.

Since my diagnosis, it has been found that a combination of medication and talk therapy is the best treatment for bipolar disorder. However, these days, most  psychiatrists no longer provide talk therapy, opting instead to conduct a fifteen minute med check, because it is reimbursed more generously by health insurance companies than a med check combined with talk therapy. My psychiatrist practices medicine this way, although she does run over the fifteen minutes if necessary.

About five years after my diagnosis, I decided to begin talk therapy. My first therapist was recommended by a family friend and had a PhD in psychology. I went to him for a couple of years and got almost nothing out of my time spent with him. It eventually dawned on me that he was more voyeuristic than helpful, and also kind of creepy, so I discontinued therapy. About five years after that I started therapy again. I went as part of an employee assistance program. My therapist was a licensed clinical social worker who was also a tough and condescending woman. I only went three times and I don't think I benefited in any way.

Five years ago, I finally found a therapist who has been able to help me. She is a licensed clinical social worker.  My psychiatrist, at the time, gave me her name because he thought she would be a good match for me. I was reluctant to go to my first appointment because her office is on the campus of a mental hospital where I have been a patient, the site of bad memories for me, but I went anyway. She is a great listener and stops me at appropriate times to make comments or ask questions. Talking to her is like talking to a friend, but different, because she is completely impartial. She helps me to clarify my thoughts, set goals, and solve problems. I make an appointment at least once a month, but I have gone weekly when I have been having serious problems, like during my last depression. I know that she provides effective therapy because, after each appointment, my thoughts and goals are much clearer. Throughout the month, when I am making decisions, I often reflect on conversations we have had during past appointments.

Since I have been in talk therapy, I have attended two different support groups as needed. One support group is a small support group formed by a law professor with bipolar disorder who teaches at a local university. The other support group is a DBSA support group which is larger. Appointments with my therapist have helped me to solve many personal problems, but support groups help when I am feeling alone, isolated, or misunderstood, which is more likely to be when I am depressed. At those times, it is good to know that I am not alone and that there are many people who deal with the same issues, and hearing how they deal with their symptoms often gives me ideas about how to better care for myself. I also feel good knowing that when I share my experiences, others may be helped.


  1. I agree that talk therapy is an essential piece of my bipolar treatment (along with the meds). I think that if I could participate in bipolar groups I would feel less isolated as someone struggling alone with this illness. Stigma continues to be a giant issue for me. I don't quite understand why other people with the illness seem to make less of an issue about it. I feel that if I were outed to my colleagues it would seriously jeopardize my future job prospects. This is intolerable.

  2. Anonymous8/10/2011

    When I was first diagnosed, I bought a very soft, red t-shirt that had Grumpy of the Seven Dwarfs on it and in 70's like marquee-like letters it said MOODY on it. Now, I wasn't trying to stigmatize myself, I was trying to get comfortable with the diagnosis . . . applying my strange sense of humor to it at the same time. I knew that people wouldn't automaticaly assume bipolar by looking at it, yet at the same time it was a somewhat public way of getting used to the idea. Plus I used the softness of the shirt as a distraction from self-harm issues. It was just . . . a way for me to get comfortable in this new skin I was in, even though of course I was the same person I was before the diagnosis, except being diagnosed changes you.

    This won't let me post under my google or typepad accounts . . .

  3. I completely agree also. I think finding the right meds is crucial, but so is talking things out and having effective ways to deal with things in life. thank you for this post!

  4. Talk Therapy has saved my life many times. The drugs are good and help a lot. But drugs are enhanced with talk therapy.