Cognitive Behavioral Therapy for Three Patients with Bipolar II Disorder during Depressive Episodes

Bipolar II disorder is a recurrent mental health disorder characterized by alternating hypomanic and depressive episodes. Providingcognitive behavioral therapy (CBT) as an adjuvant to pharmacotherapy can reduce the recurrence rate of bipolar disorder. It hasnot been examined whether CBT can be started during a depressive episode in patients with bipolar II disorder; however, theuse of CBT during the remission period has been demonstrated to reduce recurrence. The current study is a case reportinvolving three Japanese patients with bipolar II disorder, who started CBT during the depressive phase after a hypomanicepisode was stabilized by pharmacotherapy. All patients experienced excessively positive thinking one week apart and were ableto choose behaviors that would stabilize bipolar mood by observing its precursors. After intervention, patients’bipolar moodaccording to the Internal State Scale (ISS) and the Beck Depression Inventory-II (BDI-II) was improved. Ourfindings suggestedthat providing CBT to patients with bipolar II disorder during depressive episodes as an adjunct to pharmacotherapy is feasible.