Novel intervention for anxiety symptoms among people with bipolar disorder

Psychologists at Lancaster University have devised a novel psychological intervention to address anxiety in bipolar disorder (AIBD).

Anxiety is common in bipolar disorder (BD) and associated with worse clinical outcomes including increased suicidality. Despite effective psychological treatments for anxiety, research into treating anxiety in BD is underdeveloped.

Researchers led by Professors Steven Jones and Fiona Lobban offered adults with both bipolar disorder and clinically significant anxiety symptoms either treatment as usual or the novel intervention.

This new AIBD intervention included 10 sessions of psychological therapy. AIBD was offered flexibly in terms of location and session duration, with sessions supported by client workbooks including client therapy record and anxiety recovery plans, lived experience accounts of anxiety and BD and information about additional resources and support.

Professor Jones said: "The individualised formulation-driven approach took into account level of engagement and motivation and explored links between anxiety and bipolar experiences, including issues around functioning, to elicit personally valued treatment goals."

The specific intervention plan in each case was guided by the individual formulation, and included appropriate cognitive behavioural strategies focussed on addressing anxiety experiences and consequent behaviour.

The CBT approach typically included learning more about the nature of their anxiety symptoms and developing coping strategies for dealing with them using CBT techniques such as relaxation and breathing techniques, cognitive restructuring, behavioural experiments, thought monitoring and challenging and adaptive problem solving.

Participants indicated they valued the intervention in contrast with previous forms of support received. They identified the benefits of treating anxiety and BD together in contrast with previous experiences of having these problems addressed separately.

Coping strategies learnt in AIBD were helpful in:

• overcoming anxiety-based social isolation and functional limitations
• increasing confidence in dealing with BD

Professor Jones said: "The trial was successful in demonstrating feasibility and acceptability of selection, recruitment and intervention procedures. Although AIBD was generally well received, some participants wanted more sessions."