Abnormal Psychology

Mood Disorders and Suicide 229

medication should take it for as brief a period as possible (Rosenbaum et al., 2005).

Antidepressants may not be prescribed for people with rapid cycling, however,

because these drugs can exacerbate the cycling (Schneck et al., 2008). For a manic

episode, an antipsychotic medication such as olanzapine (Zyprexa) or aripiprazole

(Ablify), or a high dose of a benzodiazepine may be given (Arana & Rosenbaum,

2000; Keck et al., 2009).

Despite the number of medications available to treat bipolar disorders, mood

episodes still recur; in one study, half of the participants developed a subsequent

mood episode within 2 years of recovery from an earlier episode (Perlis, Ostacher,

et al., 2006).

Targeting Psychological Factors: Thoughts,

Moods, and Relapse Prevention

Medication can be an effective component of treatment for bipolar disorders,

but often it isn’t the only component. Treatment that targets psychological fac-

tors focuses on helping patients develop patterns of thought and behavior that

minimize the risk of relapse (Fava et al., 2001; Jones, 2004; Scott & Gutier-

rez, 2004), including consistently taking medication. CBT can help patients to

stick with their medication schedules, develop better sleeping strategies, and

recognize early signs of mood episodes, such as needing less sleep (Ball et al.,

Figure 6.6

6.6 • Assessing Social Rhythms One component of interpersonal and social rhythm therapy

helps patients determine what types of social rhythm disruptions are likely to trigger a mood episode. A

daily social rhythm log, like this one, can help patients identify the disruptions that increase their mood

symptoms. Once they identify these disruptions, they can develop strategies to minimize them.

Source: Frank, Gonzalez, & Fagiolini, 2006, p. 984, Figure 2. For more information see the Permissions section.

66 ii ii ll hh hh

Directions:

• Write the ideal target time you would like to do these daily activities.


• Record the time you actually did the activity each day.


• Record the people involved in the activity: 0=Alone; 1=Others present; 2=Others actively involved; 3=Others very stimulating

Target

Time

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

People People People People People People People

Activity

Out of bed

First contact with

other person

Start work/school/

volunteer/family care

Dinner

To bed

Date (week of):

Daily Log of Social Rhythms

Rate MOOD each day from –5 to +5

–5=very depressed

+5=very elated

Time Time Time Time Time Time Time