Sounds very interesting, no one I personally know has used it. Can he continue that therapy outpatient through the hospital? I agree, my husband reacts to any emotion he has with rage. But he was never stable long enough for our therapist to use behavior modification effectively with him. Keep me posted if you find out more. Meds don't seem to be effective for very long, it's so sad, and he hurts my heart with the things he says.

Hi, CBT can be used along with medication but medication is the primary treatment.

While it can seem like situations like stress may be triggering the BP the BP is there anyway and it will usually find a way out. I think to an extent "triggers" are over emphasised and alot of people are given the false hope tyhat if they can somehow avoid their triggers they will be ok.

The main "triggers" for me are changes in the light (unavoidable), major life changes (largely unavoidable), death of my 2nd wife (unavoidable) and sustained work stress. Actually alot of these are causes of sleep disturbance and sleep disturbance is probably the underlying "trigger".

Work stress might be something that could be tackled via CBT but having talked to non BP work colleagues extensively it seems in many ways they are worse off with being unable to sleep, relationship issues, health issues and so I somewhat doubt that CBT that can take away that stress from anyone, BP or not.

It does take a while to sort out the meds - what mood stabilizers has he tried? Don't forget it can take several months on a med before you know it works - it's harder to get someone who has had an episode back to stability than someone who is currently not in an episode if you see what I mean.

The other possibility if he has "tried it all" that the diagnosis is wrong and it might be something like borderline.

see
http://www.dailystrength.org/c/Family_and_Friends_of_Bipolar/forum/12521924-borderline-personality-disorder-article

Thanks for the feed back. Sleep issues are a big part of the problem and one that doesn't seem to be solved yet. My husband has tried nearly everything and found issues with most all of it. There was brief time that we had the bp and anxiety pretty much under control, but adding in the ADHD meds messed that up. It would be nice to get back to the place if possible, but doubtful.

We had a good talk this weekend and he admitted that he wasn't trying very hard to address some of the issues causing him additional stress and was thinking about trying the CBT methods again. He thought they had some positive effects, but stopped doing them when he was no longer accountable to someone.

Acuriousfish, thank you for your insights. Maybe we need to work harder at finding a good solution to the sleep problem. I know we will never get rid of the triggers, or stop the cycles from happening, but I'm hoping we can find a way to get things back to a place where my husband can go back to doing the job he loves. He is so up and down right now that the long interview process is a real problem to through.

hi, re the sleep issue - a couple of suggestions.

1. with some meds you can vary the timing you take them. For example I take lamotrigine twice a day, I used to take it at breakfast and evening meal (about 6.30pm). When I had sleep problems my psychiatrist asked me to shift to morning and lunchtime doses which worked. Obviously you would need to discuss that with your doctor.

2. not sure what you have tried for sleep. Personally I avoid sleeping pills because they are addictive and caused me to have suicidal thoughts - I also avoid benzos for similar reasons. I had tried trazadone - it's an anti-depressent but you take it at much lower dosages. The other thing that is popular with Bpers is over the counter sleep meds based on anti-histamine. I think I discussed it with my psychiatrist and he was ok with it. I try not to use it very often though.