Hypnosis as a Bipolar Treatment?
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Q:  Hypnosis as a Bipolar Treatment?

Doctor Phelps,
              I recently discovered that my daughters boyfriend has been diagnosed with bipolar. I was wondering if hypnosis could be a treatment that his mother could look into? If so, could you recommend a good Doctor in Ohio? I do know that he has been on just about every kind of medicine that is given for this disorder. Nothing has been working for this kid. Please Help.

Thank You

Dear Ms. C' -- 
I interpret your question as boiling down to this (pardon me if I'm off target):  there are treatments for bipolar disorder that have evidence for their effectiveness; and then there are treatments that are offered by someone, for some reason, that do not.  Usually the reason for considering the no-evidence group is money:  the person offering the treatment "sold it" very well, and raised some patient or family's hopes. Sometimes I wonder how someone could do this, taking people's money for something that has no evidence for its effectiveness.  

Sometimes the reason for considering the no-evidence approach is hope.  Sometimes people just want to believe a certain treatment could work.  It might be cheaper, or appear to be faster, or it might be more acceptable to the patient and/or her family in some way.  For example, some people are much more comfortable with the idea of an herb or otherwise "natural" treatment.  For them, such an option may seem more attractive than a "chemical", unless somehow the chemical has something else going for it (e.g evidence for effectiveness).

But here's the catch:  the person who offers a treatment that has no evidence for its effectiveness usually believes, totally, that what he (sic) is offering is going to help that patient.  And as a result, the treatment might just work!  There's pretty good evidence that really believing in the treatment you're offering -- just that, just believing in it -- can make a treatment work.  Humans are very persuade-able, very "suggestible" under some conditions, and being desperate for help is one of those.  So if somebody really believes what they're doing can help, and is able to really project that belief in some way so that it's obvious to the person in the patient-role, for many mental health conditions that's enough to get 25% to 30% of people clearly better.  Depression is one of these.  This is part of the "placebo" response you've heard about. 

Hypnosis is a treatment built upon suggestion and persuasion.  To my knowledge there is no evidence for hypnosis, as such, as part of a treatment for bipolar disorder.  However, hypnosis has one big advantage over many no-evidence treatments you might find offered out there:  except financially, its unlikely to make the person worse or present any long-term risks (at least if the hypnotist is a responsible practitioner who does not take advantage of his/her patients).  

(You can find a summary of evidence-based approaches to the treatment of bipolar disorder on my website's section on bipolar disorder; look at the section on Treatment; though it was written primarily for bipolar II, it applies fairly well to bipolar disorder generally).  

Dr. Phelps

Published February, 2004


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