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Do I Still Need Therapy If I'm Medicated?

Question:

For years I was diagnosed with major depression but after a serious suicide attempt in May, I have been told that I have bipolar disorder. The current therapist that I see because of insurance reasons keeps telling me I really won’t need therapy once my meds are stabilized and he pretty much does all the talking. Is this true–that if my medications are stable, I do not need any other kind of therapy? The trouble is that it has been since May and I still have not found medications that keep me stable.

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  • Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
  • Dr. Dombeck intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
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  • Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
Answer:

I seriously doubt that your therapist has given you sound advice here. If you are in fact truely Bipolar, it is true that medication (usually involving a mood-stabilizer (like lithium) and sometimes an anti-depressant) will be your best bet for achieving emotional stability. However, getting on a good course of medication doesn’t mean that psychotherapy will become unimportant for you by any means! There is no such thing as a truely stable course of medication (as you are finding out). Bipolar meds are not always well tolerated, or appreciated by patients, and a therapist can help with medication compliance, and advice for when to seek immediate medical help. Therapists can also serve as trained eyes who can provide external structure and containment for patients who are becoming harmfully manic or depressive and don’t have the judgement to realize that this is happening. In another vein, it is a very stressful and complicated thing for a person to live with a disabling and potentially fatal disease like Bipolar Disorder. Just being properly medicated doesn’t mean that life stresses go away or are easily managed by patients. A good therapist can help the bipolar patient with all manner of problem solving skills that can help keep Bipolar patients from relapsing because of life stressors. If your insurance will pay for this therapist, might they not pay for a different one? You may wish to explore working with a new therapist who doesn’t monopolize your sessions and who isn’t so unrealistic as to believe medication is a total solution.

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Comments
  • Anonymous-1

    This is the first time I see a conviction on the part of a professional that admits that medication for BP is not the absolution. Maybe I'm just hearing what the BP wants me to hear, but to me it is profound hearing what have thought from the get-go. You must have behavior therapy along with the meds for a lifetime worth living!!! Both for yourself and for the others around you.

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