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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Bipolar Disorder and the Need for Psychoeducation

Allan N. Schwartz, LCSW, Ph.D. Updated: May 3rd 2006

I read an interesting article today in a European journal of psychiatry that discussed the fact that medication alone is not enough to treat Bipolar Disorder. The article pointed out that psycho educational and cognitive-behavioral techniques are necessary to help people understand and manage their illness. In addition, it is vitally important that family members take part in the psycho educational sessions in order to learn about and help the patient manage their illness.

The importance of this finding was recently driven home to me when a married couple consulted me for some difficulties they were having in their relationship. The husband immediately and correctly informed me that he was diagnosed with and was taking medication for bipolar disorder. His diagnosis and treatment had begun twenty years earlier. He also stated that he did not need psychotherapy for this disorder as the medication, with which he is compliant, was keeping him stable. In other words, the couple was in my office for their marital problems and nothing more.

What quickly became clear was the fact that some of the problems plaguing this couple were complicated by the fact that he started drinking about six months ago after twenty years of abstinence. Although he considered himself fully knowledgeable about his illness he forgot how alcohol negates the effects of the medication and provokes relapse into the illness. Both he and his wife admitted that they did not realize or forgot how alcohol complicates bipolar disorder, as it does many other mental illnesses. The only thing that he was aware of was that his alcoholism had relapsed. He then promised to resume his attendance at AA meetings more than once per week in order to return to sobriety and allow the medication to have its full effects.

In addition to forgetting how alcohol and drug abuse can complicate bipolar disorder, they forgot or were unaware of how stress and life crises can cause a relapse of drinking and bipolar disorder. As they had experienced some severe and tragic events in their lives, the husband slipped back into relapse, either never knowing how life events can exacerbate this illness or completely forgetting whatever psychoducation he had in the past.

I completely agree with the findings discussed in the journal article and urge all of those living with this diagnosis, both patients and family, to attend psycho educational sessions and learn all they can. In fact, there is no reason why there should be any time limit on attending these sessions. The case above is a good example of the need for ongoing learning even for those who have had the illness for twenty years or more.

The article points out that there are group psycho educational sessions that can be attended and I urge all of those involved with this controllable illness to attend.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

Reader Comments
Discuss this issue below or in our forums.

I love my sister - - Mar 23rd 2008
She doesn't know how beautiful she is. She doesn't know how much fun or how funny she is. She thinks nothing of herself. She has trouble getting out of  bed. Her depression has led to an eating disorder and an unhealthy weight gain. A dangerous weight gain for anyone, but probably worse for her with diabetes running in the family. That sounds like risky behavior to me. At times, she is happy. So happy and hyper at times that she talks a mile a minute and looks to and fro rapidly. But it is her down times that bother me most.  When she thinks she has no reason to live.  Oh my God! Where did this come from? How? Why?

Desperate to help my son - Sherrie DiSabatino - Jul 16th 2007
My son is 26 years old.  Is a college graduate but is unable to hold a job.  He does not drink or use drugs (he has said he used pot in college).  He has moved approximately 12 times within the last year.. always something wrong with the other person or situation.  He has had severe anger moments in my home where he has thrown things - his keys through my front window  - or thrown something at the wals.. but this last weekend... I said he could move back into my home. He was angry the whole time and proceeded to have the most severe outburst where he put his fist in the pictures on my wall, took his brothers motorcycle helmet and bashed it .. over ten times into the glass on the floor, kicked in the garage door, and threw the helmet into the closet door, threw part of the broken picture frame at me, picked up the coffee table and broke it, picked up a wood chair and smashed it into the laminate living room floor.  His hand was severely cut.. he picked up his laptop computer.. said just horrible things to me and stormed out of the house.  Although he has not been diagnosed I believe my son is bipolar.  There have been nights when I sat up all night long talking to him when he has felt depressed and did not want to live.  I can no longer reach him.. and my heart breaks for him.. I truly need hlep

living with a brother with a mental problem - Elaine Molosiwa - Jan 4th 2007
i really want to understand my brother's condition, i must assume his condition started two years ago. he went to a mental hospital and talked to some doctors there who then called my mother for a meeting or consultation. after the meeting i learnt my little brother is disturbed but can be helped thru councelling. one big problem, he refuses to see the councellors, psychiatrists, psychologists or anybody who can help professionally. he would ask for my uncle or family friends always male and other popular people in my country- Botswana.i have a 10 year old son who sometimes visits my mom and him, is it safe for my son to be alone with him. and please how can we help him because my mom is single and i am his only sibling and he is persuing his BSc. we talked about changing programme but he does not want to do anything that is not science based. his name is Lee. please help this intelligent 22 year old. instead of talking out problems if he feels troubled he rather reports to the police that he is being ill-treated at home.

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