Adjunctive behavioral activation for bipolar I disorder : single case

Abstract

Background: Bipolar disorder is a negatively impairing and disabling disorder. The depression phase of the disorder is poorly understood and researched, yet individuals spend roughly one-third to half of their lives suffering from depression symptoms. Treatment guidelines suggest the same treatment for bipolar depression as for unipolar depression but almost no research has established those treatments for bipolar depression. The question asked is whether a well-known depression treatment, BA, is feasible for bipolar depression.Method: The study is a single case. A 30year old man with bipolar I disorder recruited through the bipolar team at the psychiatric department of The National University Hospital of Iceland received a 11-session modified Behavioral activation (BA) treatment. Symptom severity was assessed and pre-, post- and 1-month follow up measures were done. Results: Depression symptoms declined from moderate to mild/none. Mania symptoms also reduced. Improvement were in suicidal ideation from mild to none as well as improvements in alcohol and drug abuse according to patient, from being inhibitory to no use at all. Conclusion: Although further studies are needed, the current study points to feasibility of BA for bipolar depression. It also reveals, that with the right pharmacological intervention, there is a possible acceptability to modified BA as an intervention to prevent early signs of mania developing further into a manic episode.Keywords: Bipolar disorder, bipolar depression, behavioral activation