Occupational Therapy Treatment for Bipolar Disorders: Options and Interventions

Occupational therapists may provide education and support to family members and caregivers of clients with bipolar disorder.

Bipolar disorder encompasses a spectrum of mood disorders, including bipolar I, bipolar II, cyclothymic disorder, and other specified and unspecified bipolar disorders. Individuals with bipolar disorder often experience manic episodes characterized by heightened energy, impulsivity, and grandiosity, as well as depressive episodes marked by low mood, fatigue, and feelings of worthlessness. As occupational therapists, what therapy treatment for bipolar disorders is most effective?

Recommended course: Bipolar and Related Disorders: Signs, Symptoms, and Treatment Strategies for OT

Occupational therapy treatment for bipolar disorder: Collaboration and assessments

Occupational therapists (OTs) emphasize the importance of meaningful occupation in promoting mental health and well-being. OTs collaborate with individuals with bipolar disorder to identify personal goals, develop coping strategies, and establish routines that support emotional regulation and stability.

OTs can use assessments such as the Canadian Occupational Performance Measure (COPM) to determine areas of occupational dysfunction. In a case study, the COPM results of a woman with bipolar disorder showed she was having challenges with the following occupations:

• Sleep
• Relaxation
• Budgeting
• Verbal reporting
• Managing responsibilities

Are there occupational therapy interventions for bipolar disorder?

Evidence-based OT interventions for clients with bipolar disorder can include:

• Occupation-based treatments
• Occupational management
• Cognitive-behavioral theory
• Environmental modifications
• Interprofessional collaboration
• Family and caregiver education
• Yoga

Occupation-based therapy treatment for bipolar disorders

Another review study found that occupation-based treatments are effective in addressing the symptoms of severe mental illness. During occupation-based interventions, participation in the meaningful activity itself is the therapeutic agent of change.

Occupation management

OTs assist individuals in adapting activities to accommodate fluctuations in mood and energy levels. OTs work with individuals to create schedules that include balanced activities, such as work, leisure, self-care, and sleep, to promote stability and mitigate mood fluctuations. This may involve:

• Breaking tasks into manageable steps
• Using visual schedules
• Incorporating relaxation techniques to manage stress and anxiety
• Establishing a structured daily routine is fundamental in managing bipolar disorder

Yoga

A systematic review published in 2024 sought to explore the use of yoga as a modality for OT to increase participation in meaningful ADLs for individuals with mood disorders. Although more research is required, the review found yoga as a viable intervention to address mood disorders such as bipolar disorder.

In one study reviewed, hatha and vinyasa were the most popular types of yoga for clients with bipolar disorder. Decreased anxiety and increased cognition were noted as benefits.

Cognitive Behavioral Therapy for bipolar disorders

Cognitive-behavioral therapy (CBT) strategies, including cognitive restructuring and behavioral activation, help individuals identify and challenge negative thought patterns. This assists with increasing engagement in occupational performance.

A 2021 study stated CBT is an evidence-based therapy for all stages of bipolar disorder except acute mania. The study identifies that a psychosocial intervention such as CBT is beneficial to support clients who are compliant or non-compliant with their course of medication treatment.

Environmental modifications

Creating supportive environments is essential for individuals with bipolar disorder. OTs assess home and work environments to identify potential stressors and implement modifications that promote safety, organization, and comfort.

Therapy treatment for bipolar disorders: Interprofessional collaboration

OTs collaborate with other healthcare professionals, including psychiatrists, psychologists, and social workers, to ensure comprehensive care for individuals with bipolar disorder. This interdisciplinary approach enables holistic treatment planning and coordination of support services.

Facilitating collaborative, client-centered care can be achieved by asking questions of the team and by having each healthcare provider reflect on what information they should be sharing. Interprofessional collaboration has many benefits such as:

• Improves client outcomes
• Reinforces client skills by providing additional practice with multiple disciplines
• Increases communication between disciplines
• Increases the knowledge of multi-disciplinary teams

Examples of questions that facilitate interprofessional collaboration include:

• What parent and/or client education is being provided by each discipline?
• Which techniques are working well?
• Which techniques are not working so well?
• What educational resources (articles, books, continuing education, etc.) are available/appropriate for each discipline?
• What are the client goals for each discipline?

Family and caregiver education

Occupational therapists may provide education and support to family members and caregivers of clients with bipolar disorder. They can help families understand the condition's effect on the client’s occupational performance. OTs can also educate families and caregivers about effective communication techniques and develop strategies for providing support.

Conclusion

Occupational therapists play an important role in the therapy treatment of bipolar disorder, focusing on empowering individuals to manage symptoms, enhance functioning, and improve quality of life. By employing a comprehensive range of treatment strategies, OTs facilitate the development of skills and coping mechanisms necessary for navigating the challenges associated with bipolar disorder, supporting occupational performance.