JH, a person with a bipolar disorder type 2 diagnosis, reflects on their experience with Cognitive Remediation therapy received as part of the Cognitive Remediation in Bipolar study.

Sitting at home with seemingly endless time on my hands, in the twilight zone between illness and full recovery, I thought that I should make myself useful by participating in a study. I found the CRIB2 study via the Take Part in Research website and was intrigued by its premise. My mind was still foggy from a severe depressive episode; I was starting to lose hope that it would ever return to normal, and the promise of sharpening my mind was enticing.

After going through the screening and baseline appointment, I was pleased to hear that I was allocated to the intervention arm. Very quickly, in my second session, I learnt that I was impulsive (more than I would class myself to be!), and that I would frequently neglect to check my answers before submitting. I also learnt that I was distractible, with these difficulties amplified by physical tiredness/hunger/etc. I had been proud of my efficiency in the past, however, was now aware of the adverse effects this could cause. In therapy, I was forced to slow down and reflect, and to balance accuracy with speed.

Having sessions twice a week with hours of practice in between required hard work and dedication. At times, I felt disheartened by the process. Why could I not get these simple tasks 100% right? The perfectionist in me screamed in frustration. I was reassured by my therapist that these cognitive difficulties are common in people with bipolar disorder, and using cognitive remediation strategies could mitigate against its effects.

I had a good relationship with my therapist; he was patient and encouraging, steady and clear in his directions. I was grateful that he picked up an episode of mood elevation during therapy, encouraged me to seek help and adjusted the therapy according to what I could manage.

The concept of PrIME (Plan, Implement, Monitor, Evaluate) was drilled into me during the 12 weeks; I realised that my weakness was in the monitor stage, and looked towards my daily activities to identify where this failed me. I became more in tune with my mind and body. For example, at work I learnt to identify when I was tired and gave myself permission to take breaks, ultimately increasing accuracy and productivity. I also learnt to slow down when making decisions, using logic and reason rather than gut feelings.

Now, whenever I encounter a difficult situation, before acting, I make sure to check in on myself first and think about the problem in greater detail than I would have in the past. I then continue to check in on myself periodically and alter my actions accordingly.

I am happy to say that six months on after completing therapy, I remain clear in my mind and able to take on daily challenges easily. I have successfully returned to work, which in part I give credence to the skills I’d learnt through cognitive remediation.

I feel privileged to have been given a chance to experience this therapy and have the added satisfaction that I’ve helped to advance research. I wholeheartedly recommend cognitive remediation for anyone with bipolar disorder - you’ll find blind spots you never knew were there before, and the skills learnt translate into very real effects in daily life. I hope that this therapy will be readily available in the future for anyone, not just in the research setting.

To find out more about the study and how to enrol, please click here: The CRiB2 Study | King's College London (kcl.ac.uk)

Last updated: 10 September 2024