People with bipolar disorder (Bipolar I, Bipolar II, or Cyclothymic disorder) have extreme mood swings and emotion regulation issues that manifest with various psychological, behavioral, mood, and cognitive symptoms. Though it’s not curable, there are many options for bipolar disorder treatment. 

Certain types of cognitive therapy, bipolar medication, and various self-help tactics have all been found effective ways to manage symptoms of bipolar disorder. For people who haven’t yet found success through any of the mainstream options, though, online dialectical behavior therapy (DBT) might be something worth considering. Many people with bipolar spectrum disorder have turned to DBT because of the success that’s been attributed to it when treating this challenging mental health condition. 

In part, DBT treatment can be a good option for bipolar treatment because it targets emotional dysregulation, which often presents itself as extreme emotional intensity with a slow return to a baseline emotional state in people who are bipolar.

Keep reading to learn more about how and why DBT therapy techniques can be effective in treating bipolar spectrum disorder. 

Is DBT Good for Bipolar?

In a recent study of people with bipolar disorder who completed a DBT 12-week group skills class, 88% of participants reported they felt they benefited from the program. 

People also saw substantial increases in psychological well-being, distress tolerance, and mindfulness. There were also notable decreases in emotional dysregulation and emotional reactivity. Even more critical, manic bipolar symptoms remained low from post treatment to a follow-up 3 months later. 

While cognitive behavioral therapy was originally the first-line treatment for bipolar disorder, DBT gives people an effective alternative option.

Benefits of DBT for Bipolar Disorder

There are several benefits of DBT for bipolar disorder, including:

  • Improved emotional regulation
  • Reduced negative coping behaviors
  • Reduced vulnerability to strong emotions 

The main components of DBT therapy include mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation. These four techniques have been shown to help people with bipolar disorder learn effective coping tools and strategies that allow them to better regulate their emotions.

“Dialectical behavioral therapy (DBT) specifically enhances skills to support emotional regulation, which is particularly effective in treating bipolar disorder. People with bipolar disorder struggle with mood and phases of episodic dysregulation, which impairs daily functioning and of course interpersonal relationships.”

Talkspace therapist Elizabeth Keohan, LCSW-C, MSW

DBT Techniques That Help Bipolar Disorder 

The four cornerstone techniques that drive DBT offer multiple approaches that all aim to achieve improvement in slightly different areas in your life. 

“Dialectical behavioral therapy (DBT) is better-supported by a trained therapist who can lend expertise and help elevate skills to learn how to focus and also de-escalate when emotions ride high or feel disruptive. If coupled with group therapy, a more comprehensive approach can help you acquire both self-awareness and insight and also a forum for practicing new coping.”

Talkspace therapist Elizabeth Keohan, LCSW-C, MSW


Mindfulness is the foundational element of DBT, teaching people with bipolar disorder how to identify their emotions and label them appropriately. In addition, mindfulness also helps people focus on how to be present in the moment. 

When someone with bipolar disorder learns to be more aware of their thoughts and learn emotion regulation skills, behaviors, and emotions, they’ll usually see an increase in self-control, giving them an effective strategy to manage distressing emotions. 

This DBT module offers skills that will eventually help someone with bipolar disorder facilitate mindfulness practice. Therapy can provide an opportunity to use and practice mindfulness to the point that it becomes like second nature. When you practice it consistently, mindfulness can reduce stress levels and increase happiness. 

Distress tolerance

The distress tolerance technique teaches people with bipolar disorder alternate ways to cope with impulsive urges that are common during a manic episode. For example, desires for self-harm, the use of drugs or alcohol, gambling, or overspending are sometimes overwhelming during phases of mania or hypomania. Teaching distress tolerance skills can help people with bipolar disorder cope in an appropriate way when faced with these urges. 

Distress tolerance skills such as distraction techniques, radical acceptance, and self-soothing also address impulsive behavior stemming from the inability to handle intense emotions. In addition, DBT can teach people with bipolar disorder to identify triggers for self-harm or suicide. Once they can identify these triggers, they’re more apt to use one of the crisis-management strategies they’ve learned to avoid destructive, harmful behavior. 

Emotional regulation

People with bipolar disorder typically have emotional dysregulation, which can cause overwhelming feelings and negative emotional responses. Learning emotional regulation skills, an emphasis in DBT, helps people with bipolar disorder cope with their heightened feelings in more effective ways. 

First, they learn how to identify emotions and label them. Then, they learn the functions of emotions and how to reduce their susceptibility to the ones that are negative. 

It’s also critical to teach people with bipolar disorder how to increase their positive emotions, acting in opposition to their emotional urges that can be negative or inappropriate. Being able to act appropriately, rather than giving into emotional urges, can be beneficial when dealing with bipolar depression or mania.

Interpersonal effectiveness

Interpersonal effectiveness is the last technique of DBT, but it’s not any less important. Interpersonal skills help people with bipolar disorder improve their relationships.

Unfortunately, those living with bipolar disorder often have damaged relationships as a result of unmanaged symptoms. When symptoms go uncontrolled, they usually manifest as irritability, anger, or impulsivity. Impulsivity can result in substance abuse, gambling, or even marital affairs. 

Learning interpersonal effectiveness through DBT treatment can be key in repairing damaged relationships and preventing future interpersonal issues that are related to someone’s condition.

Get Connected to a DBT Therapist with Talkspace

If you have bipolar disorder and have already tried other treatments with little or no success, it might be worth attempting dialectical behavior therapy. Research shows promise with DBT for bipolar and DBT for depression treatments. You don’t have to live with the pain and struggles that often come along with a bipolar disorder diagnosis. Though it’s not curable, bipolar disorder is treatable, and as our most recent research shows, treatment can be extremely effective. 

If you or someone you love is trying to manage symptoms of bipolar disorder, finding a therapist who’s skilled and trained in DBT can be your next step forward. Talkspace is an online therapy platform that’s changing how people approach and access therapy. Our therapists are all highly trained and ready to help you improve your mental health. 

You can learn to manage bipolar disorder, and Talkspace dialectical behavioral therapy might be the way you do it. Reach out today to learn more.