Therapy alongside bipolar disorder

The diagnosis explained a great deal, and it did not tell you how to live with it. Medication may have taken the top and bottom off, and you are still left managing sleep, work, relationships and the quiet dread of the next episode.

There is often a loss to sit with too — of a job, a relationship, a version of yourself, or of trust in your own read on things. Am I actually happy, or is this the start of something? Am I tired, or is this the beginning of a low? Second-guessing your own mood is exhausting in a way that is hard to explain to anyone who has not done it.

And there is the practical work nobody hands you a manual for: what to tell an employer, how to talk to family about warning signs without being watched all the time, how to rebuild after an episode.

The between-episode time is where most of life actually happens, and it gets the least attention. Services understandably focus on crisis; what is left over is the ordinary work of holding down a job, repairing relationships, and living with a diagnosis that other people have opinions about. That is the ground therapy is genuinely good at.

We start by understanding your history, your current care and who else is involved. Work is usually 12–20 weekly sessions of 50 minutes, with the option of spacing out towards the end so that the gap between sessions grows as things steady.

I will ask that you stay connected to your GP or psychiatrist while we work, and with your agreement it is often useful for me to be in touch with them. Therapy that runs in isolation from the rest of your care is less safe and less useful.

Sessions run online across the UK and worldwide, or in person at Sanctuary Therapy Centre in Prestwich and Hebden Bridge. I will be straightforward with you if I think what you need is more than an individual therapist can safely provide.

Can therapy replace my medication? No, and I would not support that. Therapy for bipolar disorder works alongside medication and psychiatric care. Any change to medication is a decision for you and your prescriber.

Do you diagnose bipolar disorder? No. I am a CBT and EMDR therapist, not a psychiatrist. If you suspect bipolar disorder and have not been assessed, your GP is the route to that.

What if I become unwell while we are working together? We plan for it in advance — what your warning signs are, who to contact, and what we do with sessions. That plan is one of the more useful things to come out of the work.

Is there anything therapy is genuinely good at here? Yes: recognising early warning signs, protecting sleep and routine, reducing the anxiety and low mood between episodes, and repairing self-esteem afterwards.

Will you tell me I am becoming unwell? If I notice a change against the warning signs we have agreed, yes — and we will have decided together in advance how you want me to raise it. Being told is a lot easier when you were the one who wrote the plan.

Can therapy help with the aftermath of an episode? Often this is the most useful part. Episodes leave real consequences — money spent, things said, work missed, relationships strained — and the shame that follows can be heavier than the episode itself, as well as a risk factor for the next low. We work on repairing what can be repaired, on separating what you did while unwell from who you are, and on the practical rebuilding that nobody hands you a manual for.

Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.