If you live with bipolar 1 disorder, you may experience episodes of mania and, often, depressive episodes. As you go through different phases of your condition, you might find yourself wishing you had more emotional support and better coping skills to navigate these mood changes.

Supportive psychotherapy, or supportive therapy, is a flexible form of therapy that follows your cues — your therapist evaluates and reevaluates your needs to tailor your care. Your therapist attempts to understand your feelings and symptoms, then helps you build coping skills to help regulate your mood and prepare for future problems you might experience.

Although supportive therapy can be very helpful for someone with bipolar 1, it’s normal to feel nervous about trying something new or being vulnerable with a therapist you haven’t met yet. In this article, we offer tips for preparing for supportive therapy to help you feel more confident about giving it a try.

What Is Supportive Therapy?

Supportive therapy is a form of psychotherapy focused on reducing distress, strengthening coping, and supporting daily functioning. Sessions are often flexible and guided by the person’s current needs. Some therapists may incorporate techniques from cognitive behavioral therapy (CBT), interpersonal therapy, and other approaches.

It starts with a detailed assessment of your mental health in its current state, even if you’ve been in therapy in the past.

A key goal of supportive therapy is to meet you where you are by taking into account your symptoms, past traumatic experiences, and current stressors. It focuses on:

• Offering emotional support
• Teaching you healthy coping skills
• Suggesting problem-solving skills
• Fostering collaboration between you and a trusted therapist

Usually, supportive therapy is part of a broader bipolar I treatment plan, which will likely also include medications like a mood stabilizer or antipsychotic medication.

Steps To Prepare for Bipolar Disorder Supportive Therapy

Supportive therapy with a trusted therapist can help you build confidence and feel more grounded while living with bipolar I. Whether or not you’ve been in therapy before, the following steps can help you prepare for supportive therapy and feel more confident going in.

1. Clarify Your Goals

Setting goals is one of the first steps in supportive therapy, and it can help to clarify your goals before bringing them to your therapist. When thinking of goals to work toward in therapy, think of your most pressing problems and the bipolar symptoms that affect you the most. What changes would you like to see in how you feel or how you behave?

It’s also important to be realistic: If your goals for the distant future feel too far out of reach, set smaller, short-term goals first.

Before attending your first supportive therapy session, come up with two or three personal goals for yourself. These will be different for everyone but might include:

• Managing changes in mood
• Improving your relationships and communication with friends or family
• Improving your self-esteem
• Taking your medication more consistently
• Getting better sleep
• Avoiding alcohol or recreational drugs

Keep in mind that your goals may change over time as you go through supportive therapy. Your therapist can help you reassess your goals and well-being on a regular basis.

2. Track Your Moods and Energy

Your therapist can get a better idea of your symptoms and needs if you track them for some time. You might not think your mood changes have any rhyme or reason, but tracking them can help you and your therapist notice patterns.

By noticing patterns, you may be able to identify early warning signs of hypomania, mania, or depression. In the days or weeks leading up to your supportive therapy session, keep a journal of your:

• Moods
• Energy levels
• Sleep patterns
• Possible triggers for depression or mania, including stress

Journaling about your moods and symptoms can be helpful for your own records, too. As one MyDepressionTeam member suggested, “It definitely is good to maintain a journal to keep track of your moods. I write in it first thing in the a.m. and last thing at night. I write down what I plan to do and what I did.”

“It definitely is good to maintain a journal to keep track of your moods. I write in it first thing in the a.m. and last thing at night. I write down what I plan to do and what I did.”

— A MyDepressionTeam member

3. Gather Important Background Information

Just like when you see a new doctor for the first time, you’ll want to gather important background information for when you first meet with a new therapist. You’ll want to fill them in on anything relevant to your bipolar disorder and overall mental health. This includes:

• All your diagnoses, including bipolar 1
• The dates of any past hospitalizations
• Information about current or past substance use
• Family history of mental health diagnoses
• Information about significant trauma or current stressors in your life

4. Create a List of Current Medications

On a similar note, it may help you to prepare a list of medications and supplements you currently take before your appointment. Be sure to make a note if any medication causes side effects, and write down what they are.

5. Bring Questions for Your Therapist

Some people might hesitate because they’re unsure if they’ll connect with their therapist. One MyDepressionTeam member shared concern that they were “overwhelming” their therapist, adding “he doesn't know how to address the coping strategies I so desperately need. It’s not him, but my psychiatrist told me it has to ‘click’ between us so there’s a better understanding and proper treatment options offered.”

Another member suggested, “Ultimately, you need to do what’s best for you! If you can, try to do some research and see if you can find someone who specializes in what you want help with.”

Asking questions about your therapist’s experience and protocols before diving into talk therapy can help you decide if your therapist aligns with your needs, goals, and beliefs. Try preparing a list of questions before your first appointment, such as:

• Do you have experience treating bipolar 1?
• What is your protocol for handling a mental health crisis?
• How will you coordinate care with my primary care provider, psychiatrist, and other members of my care team?
• What are the limits of confidentiality in our sessions?
• What are your therapy credentials?

Asking questions about your therapist’s experience and protocols before diving into talk therapy can help you decide if your therapist aligns with your needs, goals, and beliefs.

It can take time to find a therapist who feels like a good fit, so don’t lose hope if you need to interview several therapists before finding one you trust.

What To Expect in Supportive Therapy

Supportive therapy for bipolar 1 disorder starts with a detailed mental health evaluation, which usually takes at least an hour and might need to span multiple sessions. Your therapist’s goal in these first few sessions is to develop an understanding of how bipolar 1 affects you, how you function, and the parts of your life that might contribute to your symptoms.

After establishing your therapy goals, you can talk about the problems that contribute to your bipolar symptoms and the problems your bipolar symptoms cause in your life. You can bring up other concerns you have, too, such as substance use issues or relationship problems, for example. Depending on your preferences and what’s available in your area, your sessions can take place in person or online.

When To Seek Urgent Help

While living with bipolar 1, there are times when you should seek urgent help instead of waiting until your next appointment. Seek immediate care if you:

• Feel like hurting yourself or others
• Feel like you’re not in control of your alcohol or substance use
• Have increasing signs of mania
• Aren’t eating or sleeping enough because of your mania
• Experience signs of psychosis, like hallucinations and delusions
• Experience impulses to do dangerous things

Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

Join the Conversation

On MyDepressionTeam, people share their experiences with depression and related conditions, get advice, and find support from others who understand.

What steps have you taken to prepare for supportive therapy for bipolar disorder? Let others know in the comments below.