Treatment for Bipolar Insomnia

Insomnia in bipolar disorder is difficult to treat because treatments can often vary depending on weather the patient is in a manic or depressive state. As bipolar disorder is highly episodic, it's important to note that insomnia that persists in one phase of the disorder, may not occur in the other. Despite this, several paths can be taken when treating bipolar insomnia including medication, relaxation techniques, behavioral modification and cognitive therapy

  1. Depressive vs. Manic Insomnia

    • It's important to distinguish between the nature of insomnia experienced during a depressive and manic episode. It's common to have insomnia in one or both stages. Insomnia caused by depression is usually characterized by persistent thoughts of self worth that keep someone awake, worries about accomplishment and an overall feeling of dread. In contrast, insomnia seen during a manic episode may be characterized by racing thoughts, a lesser need for sleep in general, and overabundant energy.

    Medication

    • Robert M. Julien explains in his book "A Primer of Drug Action," that medication commonly used to treat bipolar disorder may also help sedate insomnia associated with the disorder. Medications commonly used to treat bipolar disorder include lithium, anticonvulsant mood stabilizers, antidepressants (though increased research states that antidepressants aren't particularly effective in bipolar disorders), mood stabilizers, antipsychotics and benzodiazepines. Some medications man work differently on one person than on another, so monitor your medications with the help of your doctor.

    Relaxation Techniques

    • According to the Anxiety Disorders Association of America, co-occurring symptoms of bipolar disorder and anxiety (insomnia is often caused by anxiety), can be treated with relaxation techniques. Relaxation techniques that have proved effective in such instances include breathing re-training, progressive muscle relaxation as well as exercise.

    Behavioral Modification Therapy

    • The Anxiety Disorders Association of America also suggests behavioral modification therapy for treatment of co-occurring bipolar disorder and anxiety. Behavioral modification is the process of replacing maladaptive behaviors with ones that create positive results. By changing behaviors such as drinking caffeine before bed time, conducting stressful business close to bedtime and not keeping a consistent sleep schedule, the bipolar patient may be able to lessen the insomnia.

    Cognitive Therapy

    • Along with standard therapeutic interventions, cognitive therapy is also suggested. Cognitive therapy works the belief that by replacing negative thoughts with positive ones, a person's beliefs about themselves can be changed. As insomnia in depressive episodes are often caused by negative perceptions of self worth, and persistent thoughts of underachievement, replacing these thoughts with those of positive self image and a belief in one's abilities. A cognitively trained therapist knows several intervention strategies to promote healthy thoughts and seeing such a therapist can be highly beneficial to a patient with bipolar disorder and insomnia.

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