Residential treatment of bipolar disorder

If you or a loved one has been diagnosed with bipolar disorder or a related condition, we want you to know:

There is hope.

Our holistic residential treatment programs for bipolar disorder have helped adults aged 18+ regulate their moods effectively, cultivate emotional stability, and regain control of their lives.

We can help you or your loved one too.

Recovery is Possible

We treat adults aged 18+ with bipolar disorder.

Our Approach to Healing Bipolar Disorder

Authored by Eric Levine, Ed.D. and Reviewed by Amy Zimmerman, DO Psychiatrist

A Focus on Wellness & Possibility

Bipolar disorder can jumble people’s senses of self, fracture their relationships, and turn day-to-day life into a confusing tumult. That’s why we begin our bipolar residential treatment programs by helping individuals with this condition make sense of both it and themselves. At The Farm (our long term residential treatment center) and CooperRiis at Asheville (our short-term residential treatment center), we remove the stigma and shame associated with bipolar disorder, shifting residents’ focus from negative experiences they’ve had in the past towards uplifting possibilities we firmly believe they can achieve in the future.

What is bipolar disorder?

Bipolar disorder is a mood disorder that affects 2.6 percent of American adults. It is characterized by extreme variability in temperament that includes periods of mania or hypomania and periods of depression. Individuals with this condition experience dramatic shifts in energy level, emotionality, self image, and connection to reality throughout their lives. These shifts make it very difficult to maintain work, relationships, and personal health over time.

What are the signs and symptoms of bipolar disorder?

Bipolar disorder is associated with a broad spectrum of symptoms that vary significantly in severity from person to person. The hallmark of this condition is the experience of dramatic changes in mood, energy, sleep, and behavior that are so severe, they threaten personal wellbeing and safety. For an individual to be diagnosed with bipolar disorder, they must have had at least one manic or hypomanic episode.

Manic Episodes:

During manic episodes, an individual experiences an elevated state — usually lasting about one week — in which they may:

Have trouble sleeping or less need for sleep
Excessive and irrational worry
Feel restless
Feel wired
Feel elated
Feel agitated or irritable
Talk more than usual
Talk loudly or rapidly
Have trouble focusing
Have increased activity levels, doing many activities at once, overscheduling
Be more impulsive
Engage in risky behaviors (e.g.: reckless sex, reckless driving, reckless spending)
Have an unusually high sex drive
Have uncontrollable, racing thoughts
Experience disjointed thinking
Have an exaggerated sense self-esteem or grandiosity
Experience psychosis
Engage in drug and/or alcohol abuse

Hypomanic Episodes:

Hypomanic episodes are less severe than manic episodes; they last at least four days in a row and are characterized by similar symptoms that are more moderate in intensity.

Depressive Episodes:

In addition to manic or hypomanic episodes, individuals with bipolar disorder also experience major depressive episodes. These typically last at least two weeks and feature at least five of the following symptoms, including one of the first two in the list:

Intense sadness or despair; feeling helpless, hopeless, or worthless
Loss of interest in activities once enjoyed
Feeling guilty
Feeling worried
Feeling empty
Becoming forgetful
Experiencing changes in sleep patterns such as sleeping too little or too much
Feeling restless or agitated
Having slowed speech or moving slowly
Eating too much or too little
Experiencing energy loss, fatigue
Having difficulty making decisions
Having frequent thoughts of death or suicide
Declining activity levels
Experiencing difficulty concentrating

Mixed States:

Between manic/hypomanic and depressive episodes, individuals with bipolar disorder may also experience mixed states with symptoms of both the former and the latter at once. Examples include:

Feeling energized and hopeless at the same time
Feeling restlessness and emptiness together

Because such a wide range of symptoms are associated with bipolar disorder, it’s often mistaken for other conditions, such as borderline personality disorder (BPD) or schizophrenia. If you suspect that you or a loved one may be experiencing bipolar disorder, it’s important to schedule a full psychiatric evaluation with a professional who can provide an accurate diagnosis if necessary.

What are the four different types of bipolar disorder?

The four basic types of bipolar disorder are:

Bipolar I disorder
Bipolar II disorder
Cyclothymic disorder
Unspecified bipolar and related disorders

All four types involve changes in mood, energy, and activity levels that impede daily functioning, interrupt healthy relationship development, and can jeopardize personal safety.

Bipolar I Disorder:

To be diagnosed with bipolar I disorder, a person must have a manic episode that lasts at least seven days or have manic symptoms so severe that immediate hospitalization is required. Usually, an individual who meets this criteria has also experienced one or more depressive episodes, but that is not necessary for diagnosis. Between periods of mania and depression, individuals with bipolar I disorder can feel normal.

Bipolar II Disorder:

Individuals with bipolar II (vs. bipolar I) disorder do not enter states of full-blown mania. Instead, they experience depressive episodes — sometimes longer and more severe than those experienced by individuals with bipolar I disorder — interspersed with hypomanic episodes. Between periods of depression and hypomania, individuals with this condition can feel normal.

Cyclothymic Disorder:

Cyclothymic disorder is a milder form of bipolar disorder. Individuals with this condition experience a chronically unstable mood with alternating hypomania and depression symptoms for at least two years. Though these symptoms are less severe than the symptoms associated with bipolar I or bipolar II disorder, they impede day-to-day functioning.

Other Specified/ Unspecified:

Those who do not meet the diagnosis criteria for bipolar I, bipolar II, or cyclothymic disorder but still experience significant mood swings and/or mood elevation may receive a diagnosis of “other specified” or “unspecified” bipolar disorder.

Is bipolar disorder genetic?

Research is still being conducted on what causes bipolar disorder; scientists believe that a mixture of genetic and environmental factors can predispose individuals to developing this condition.

Can bipolar disorder go away?

There currently is no “cure” for bipolar disorder. However, with holistic, relationship-driven treatment and strong support networks, individuals with this diagnosis can learn how to manage their symptoms, regulate their moods, and live full, gratifying lives. If you want to learn more about whether residential treatment for bipolar disorder at CooperRiis is right for you or your loved one, give us a call today

Dream Statements

Upon entering our care, every CooperRiis resident works with staff members to craft a Dream Statement. Dream Statements express life aspirations. They guide residents’ development of core goals (attainable in 3 months) and achievable goals (attainable in 1-2 weeks), enabling them to map clear paths towards personally fulfilling lives.

Education and Empowerment

Psychoeducation is a critical facet of recovery for individuals with bipolar disorder. That's why we not only conduct a comprehensive psychiatric evaluation for every resident that enters our care, but we also make sure to discuss evaluation results with residents themselves. We make sure that individuals who are diagnosed with bipolar disorder understand why and how this condition affects them.

Then, we work with each resident to develop a recovery plan that suits their needs and preferences. This plan involves lifestyle modifications that will keep their symptoms from flaring up. By helping residents with bipolar disorder choose career paths, create routines, and develop social habits that promote stability, we empower them to become stewards of their own health.

Relationship-Driven, Resident-Centered Care

The success of our approach to treating bipolar disorder hinges on the trusting relationships we cultivate with residents. We take the time to understand their preferences and thoroughly explain our recommendations as we partner with them to create treatment plans they’re bought into.

At CooperRiis, we are not interested in subduing anyone into social conformity. Instead, we aim to support residents in managing their symptoms so they can express themselves as fully and authentically as possible. That’s why we’re more than an inpatient bipolar treatment facility; we’re a whole-person recovery center.

Collaborating To Recover

Consistency and self-care are critical for staving off manic or hypomanic and depressive episodes. We collaborate with residents to establish medication protocols and social rhythms that will help them maintain their emotional equilibrium after their time at CooperRiis. We also help them recognize early signs of symptom development and adopt effective coping strategies, enabling them to interrupt spirals on their own.

By helping residents cultivate lifestyles and acquire symptom management skills that are tailored to their unique needs, preferences and goals, we ensure the self-regulation strategies they learn within CooperRiis are transferable outside of it. In this way, our program does more than temporarily mitigate symptoms; it lays the foundation for lifelong wellbeing.

Strong Support Networks

We help residents develop strong support networks made up of family members, friends, and advocates who can provide them with the compassionate feedback and ongoing reassurance they need to maintain their health over time. When early warning signs of manic, hypomanic or depressive episodes are hard for residents to detect, community members can alert them to symptom onset. And when self care practices feel tedious or encumbering, those same community members can encourage residents to keep them up anyway.

Integrated, Whole-Person Treatment

Individuals with bipolar disorder respond best to multimodal treatment plans that combine medication with sustainable lifestyle interventions. That’s why, rather than relying exclusively on any one type of treatment, we combine a variety of evidence-based therapies to address all of the following seven domains of health for our residents:

The Seven Domains of Recovery

Treatment Plans That Meet Residents Where They Are

No matter where they are on their recovery journey, every CooperRiis resident receives personalized care that allows them to make sustainable progress towards their goals. While this means every individual’s recovery plan is unique, the following types of treatments have been especially beneficial for our residents with bipolar disorder:

Consistent, Soothing Environment

On CooperRiis' campuses, residents' schedules are consistent and soothing. We help those with bipolar disorder establish regular routines composed of work, artistic, movement, and social activities that they find meaningful and enjoyable. By removing the triggers of everyday life and offering a variety of opportunities for self expression, both the Farm and CooperRiis at Asheville help stabilize residents' moods and energy levels.

WRAP Groups

Wellness Recovery Action Plan (WRAP) groups help individuals with bipolar disorder create personalized health management plans. During these staff-facilitated sessions, residents write down what wellbeing looks like for them along with the routines and self-care practices that support it. They also record their triggers, early signs of symptom onset, and typical patterns of symptomatic progression. Finally, they outline coping strategies they can use to interrupt these patterns and regain stability.

Exercise/Movement Practices

Movement practices serve two important roles for residents with bipolar disorder: First, during manic or hypomanic episodes, exercise offers a positive outlet for extra energy and a method for reducing activation. Second, it is a powerful mood stabilizer. We support residents in establishing sustainable habits around movement practices that align with their interests, making sure to position exercise as an empowering, uplifting, and enjoyable activity.

Nutrition and Supplements

Because individuals with bipolar disorder have a heightened sensitivity to changes in their environment, the establishment of a balanced, consistent diet is an important part of treatment. We collaborate with each of our residents to create personalized nutrition plans that provide them all of the nourishment they need while helping to regulate their moods. For some individuals, we recommend the addition of supplements to enhance the benefits of their wellness practices.

Medication

Like everything at CooperRiis, decisions about medication for bipolar disorder are collaborative: Our integrative psychiatrists work with residents to develop approaches to medication that align with their specific needs, goals, and preferences. We strive to prescribe the lowest dose that will support the highest quality of life for all our residents, and we maintain regular communications with each so necessary medication adjustments can be made in real time.

Self Care Routines

We help residents with bipolar disorder establish self care routines that can help regulate their moods and energy levels,¹ both within CooperRiis and outside of it. From administering their own medications to engaging in daily mindfulness and movement practices, self care routines ensure that bipolar treatment plans remain as effective as possible over the long term. They also establish order and predictability in residents' lives, counteracting the destabilizing effects of environmental change.

Psychotherapy

Our accredited, experienced psychotherapists offer a variety of therapeutic modalities in both individual and group settings so residents can select the treatments that work best for them. We find that those with bipolar disorder often benefit from the integration of Cognitive Behavioral Therapy (CBT) into their recovery plans. This modality, when paired with a psychoeducation, results in better adherence to personal health management plans.

Community

Supportive, compassionate, and affirming, the community at CooperRiis provides residents with bipolar disorder a sense of belonging that promotes their self-worth and aids them in managing their health. Residents engage with their community through activities, group therapy, work crews, and other outlets. This variety of structured social opportunities provides them with the feedback they need to regulate their symptoms while helping them grow their support network.

Family Education

Familial support reduces the rate of re-hospitalization for those with mental illnesses, according to a recent study.² We not only keep family members updated on their loved one's progress with us, but we also provide them with an in-depth education on how they can become the support system individuals with personality disorders need in order to achieve their highest levels of health and wellness.

Our Recovery Model Works

Data collected over 10 years show that the residential treatment program for bipolar disorders at CooperRiis works. Individuals who benefit from our holistic, recovery-focused model of care make demonstrable progress in multiple domains of health.

After participating in our program, people with bipolar disorder:

Experience improved emotional stability.
Are better able to maintain work, relationships, and personal health.
Possess a more unified, positive sense of self.
Are empowered to become stewards of their own health.

An extensive body of research and clinical experience affirms these findings: Combining psychotherapy with a strong, supportive community, structured daily routines, physical wellness programs, and an integrative approach to medication can dramatically improve the lives of individuals with bipolar disorder.

2019 Alumni Survey Results

1 %

are engaged in either competitive employment, volunteering, or going to school.

1 %

are living independently with roommates or on their own.

1 %

report they have had no psychiatric hospitalizations.

Research Citations

¹Pelletier, L., Shamila, S., Scott B., P., & Demers, A. (2017). Self-management of mood and/or anxiety disorders through physical activity/exercise. Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice, 37(5), 27–32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5650020/

²Tomita, A., Lukens, E. P., & Herman, D. B. (2014). Mediation analysis of critical time intervention for persons living with serious mental illnesses: Assessing the role of family relations in reducing psychiatric rehospitalization. Psychiatric Rehabilitation Journal, 37(1), 4–10. https://doi.org/10.1037/prj0000015

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Residential Treatment for Bipolar Disorder at CooperRiis