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https://studentshare.org/other/1409446-psychological-issue-summary.
People's emotions are inextricably linked to their behavior and its consequences, what they know and what they think they know, and their social interactions. It is true that there is a neurophysiological component to bipolar disorder, but there are also cognitive, behavioral and social elements, and treatment has to proceed on those fronts too. People get depressed when they perceive bad things happening, whether bipolar or not. One of the problems with pessimistic outlooks and people with chronic depression is that they arrange their perception of events such as to be insulting, unfair or harmful to them.
Irrational thoughts cause depression just as much as depression causes irrational thoughts. I would have a bipolar sufferer talk me through some of the things going through their heads and then suggest that they step into the role of devil's advocate for a moment and provide a counter view to what they perceive. I would use the four column approach to try to indicate to the patient that, no matter what the objective situation, they become depressed and suggest that it is their own thoughts and perceptions that are misleading them.
I would then proceed to use behavioral therapy in that vein suggested by the work we did in the cognitive section. I would have them practice behaviors that they typically do when depressed, then work on making those behaviors extinct and replacing them with healthy behaviors. For example: I would have them walk through calling a friend to talk. Finally, it seems that most of the reasons people are depressed are interpersonal. Friends are distant or unfair or non-existent, one isn't dating or is having a bad relationship, one's boss is arbitrary, etc.
Worse, there comes to be a cyclical pattern where someone who is depressed alienates people who are optimistic, making a wind tunnel effect and reducing their social circle. I would teach them social techniques like asking how other people are doing, making jokes about bad situations instead of complaining about them, and using art instead of complaint.
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