AAMFT Consumer Update
Bipolar Disorder

Bipolar disorder is a major mental illness that involves extreme swings in mood, ranging from the low of depression to the high of mania. When depressed, a person may feel sad, have problems with sleeping, eating, and loosing weight, have many negative thoughts about oneself (including thoughts about death and hurting oneself), and experience difficulties with attention and concentration. During periods of mania, the individual may experience euphoric or irritable mood, inflated self-esteem and over-confidence, increased talkativeness, distractibility, and boundless energy, including a decreased need for sleep. People with bipolar disorder also have hallucinations (such as hearing voices when no one is talking to them) and delusions (such as the paranoid delusion that someone is out to get the person when no one is) when their mood is either depressed or manic, but these symptoms usually go away when the person's mood becomes normal again.

Bipolar disorder can have a dramatic effect on a person's functioning. It can affect relationships with family members and others, self-care skills, as well as the ability to work, attend school, parent, or be a homemaker. When the symptoms of bipolar disorder are severe, and the person presents a threat to self or others, temporary psychiatric hospitalization may be necessary.

What Causes Bipolar Disorder?

Bipolar disorder occurs in between 1 in 100 and 1 in 200 people. The disorder occurs equally among men and women, different racial and ethnic groups, and different social classes. Bipolar disorder is believed to be caused by biochemical imbalances in the brain and is not the result of parenting or family relationships. Although bipolar disorder is a serious illness, if it is diagnosed and treated appropriately, the symptoms can be effectively controlled, relapses can be prevented, and the person can live a happy and rewarding life.

What Types of Treatments are Commonly Used?

The most important ingredient for effective treatment of bipolar disorder is medication. Several different medications have been found to be effective for treating bipolar disorder, including lithium carbonate (Lithobid), valproic acid (Depakote), carbamazepine (Tegratol), and antipsychotic medications such as olanzapine (Zypreza). All of these medications have been found to reduce the severity of symptoms and to prevent relapses and re-hospitalizations. Sometimes other medications may be used as well, such as antidepressant medication during periods of depression.

In addition to medications, therapy can also be helpful and beneficial. Cognitive-behavioral therapy has been shown to be effective and is aimed at helping consumers develop relapse prevention plans, cope with persistent symptoms, and develop strategies for making progress toward personal goals. Other kinds of therapy can also be helpful, such as supportive therapy or therapy aimed at helping people develop meaningful structure in their lives.

Because the symptoms of bipolar disorder can be quite severe and can have a major effect on people whom the person is close to, family therapy can be very helpful in the management of the condition. The primary goal of family therapy for bipolar disorder is to teach the family, including the client, information and skills necessary to effectively manage this condition. Family therapy is provided in a collaborative, positive, educational fashion in order to inform all family members about bipolar disorder and to get everyone working together. Families can play a critical role in helping to monitor the symptoms of bipolar disorder, collaborating with the treatment team to prevent relapses, and working together to achieve personal and shared goals. To accomplish this, family therapy usually involves educating the family about bipolar disorder, improving communication skills, and teaching problem solving techniques so that families are able to solve problems on their own.

Alcohol Problems and Drug Use

All individuals and families experiencing bipolar disorder should be aware of the common problem of drug and alcohol abuse in persons with this disorder. Because of their extreme mood swings and their biological sensitivity to mind-altering substances, people with bipolar disorder are more prone to developing problems with alcohol and drug use compared to people who do not have bipolar disorder. In fact, more than half of all individuals with bipolar disorder experience problems related to alcohol and drug use, compared to less then one-fifth of people who do not have bipolar disorder.

Drug or alcohol abuse can make it much more difficult to successfully treat bipolar disorder. If an individual with bipolar disorder has substance use problems, it is of critical importance to treat these problems as soon as possible. The most effective treatment for substance abuse in people with bipolar disorder is when the same practitioner (or team of practitioners) treats both disorders at the same time in an integrated fashion. By integrating treatment, both disorders receive attention, and the interactions between the two disorders can be most effectively addressed.

Successful Management of Bipolar Disorder

Bipolar disorder can be frightening to both people with the illness and their family members. In addition, because bipolar disorder often develops early in life and has disruptive effects on functioning, the illness can interrupt normal development and interfere with people's desires to achieve their aspirations. However, there are very good reasons to be hopeful that through collaborative work among individuals, their families, and practitioners, bipolar disorder can be successfully managed and people can achieve their personal life goals. Many people with bipolar disorder are extremely bright, talented, and creative. For example, the writer Virginia Woolf, the artist Vincent van Gogh, and the actress Patty Duke all had bipolar disorder. With proper treatment and family help, individuals with bipolar disorder can pursue and fulfill their life goals and dreams.

Consumer Resources

Organizations

Depression and Bipolar Support Alliance (DBSA)
(800) 826-3632  *  Web site: www.dbsalliance.org

The DBSA educates the public concerning the nature of depressive and bipolar illnesses as treatable medical diseases. Their toll-free information and referral line, as well their informative website, are available to anyone seeking information on these conditions.

Child & Adolescent Bipolar Foundation (CABF)
(847) 256-8525 *  Web site: www.bpkids.org
This group educates families, professionals, and the public about early-onset bipolar disorders; supports families to maximize the well-being of the child while minimizing the adverse impact of bipolar disorders on the family; and advocates for increased services to families and research on the nature, causes, and treatment of bipolar disorders in the young.

Books

Berger, D., & Berger, L. (1991). We Heard the Angels of Madness: A Family Guide to Coping with Manic Depression. New York: Morrow.

Written by the mother and sister of a person who developed bipolar disorder, this guide intersperses the telling of their family story with practical advice to families on how to cope with the disorder.

Burns, D. D. (1980). Feeling Good: The New Mood Therapy. New York: Avon.

A classic self-help book that describes how to identify and challenge self-defeating, negativistic thoughts that underlie depression.

Duke, P., & Hochman, G. (1992). A Brilliant Madness: Living with Manic-Depressive Illness. New York: Bantam Books.

An autobiography by the actress about her experience of living with bipolar disorder, including excellent first-person accounts of many of the symptoms.

Jamison, K. R. (1996). An Unquiet Mind: A Memoir of Moods and Madness. New York: Vintage.

A moving autobiography by a noted psychologist and professor of her struggle with bipolar disorder, which is also the focus of her research.

Miklowitz, D. J. (2002). The Bipolar Disorder Survival Guide: What You and Your Family Need to Know. New York: Guilford Press.

This is a user-friendly guide for consumers and family members about how to manage bipolar disorder, written by a leading authority on family treatment for this disorder-very readable and helpful.

Wurtzel, E. (1994). Prozac Nation: Young and Depressed in America. Boston: Houghton Mifflin.

An excellently written memoir by a young woman who developed symptoms of bipolar disorder soon after graduating college.

The text for this brochure was written by Kim T. Mueser, Ph.D.

Keywords: manic depression, mood disorder, manic depressive.

Marriage and family therapists are mental health professionals who treat a wide array of disorders, working with individuals, couples, and families. Marriage and family therapy clients report that they are highly satisfied with the services they have received, and research shows that marriage and family therapy is a cost-effective, short-term, and results-oriented form of treatment.

The American Association for Marriage and Family Therapy (AAMFT), the professional organization representing marriage and family therapists, believes that therapists with specific and rigorous training in marriage and family therapy provide the most effective mental health care to individuals, couples, and families. This brochure is courtesy of:
the AAMFT.

Visit the AAMFT TherapistLocator.net, a public service of the AAMFT. There you will find information about a range of problems facing today's families, and you can search for a qualified family therapist in your area.