Family Therapy Advances Treatment for Bipolar Disorder
> 7/26/2007 11:39:08 AM

Individuals familar with bipolar disorder - and particularly the family and friends of bipolar patients - understand that the often devastating effects of this disease do not begin and end with the affected individual. Those who care for and/or live in close proximity to these patients know all too well the hopeful lulls and subsequent depths of despair constituting the bipolar experience. They too may suffer in not knowing how best to help their loved ones, but many therapists advocate an active solution through participation in the treatment process, a practice known as "family inclusive therapy."

Bipolar disorder is unquestionably a physical condition caused by particular irregularities of function within the affected brain, and it almost always requires one or more medications for relief, but traditional talk therapy is also recommended by nearly all professionals as a medical supplement (not a substitute for pharmaceutical treatment). Significant, if unsurprising, research has demonstrated the relative value of long-term therapy among bipolar patients - those participating in 30-50 sessions over a nine-month period reported higher rates of recovery than those attending three longer sessions administered over six weeks. The disorder's influence asserts itself on a very personal level, disrupting the social and professional lives of patients who often encounter difficulty assimiliating into proper society and maintaining relationships. Despite these tendencies, bipolar symptoms differ in type and severity, and patients can and do live successful lives while struggling with their condition. Identifying particular behavioral issues and areas of concern is therefore crucial to any treatment regimen, and patients themselves cannot always be relied upon to develop an objective analysis of their own disorder. Some of the most important testimony in the bipolar equation may come from the parents, siblings, spouses and children of the patients. Unfortunately, family members are often, for various reasons, excluded from this process. New research may help reverse that trend as formal studies and expert testimony repeatedly indicate the advantages of including the related parties in the treatment equation.

Surveys also demonstrate a considerably higher instance of depression (up to 33%) among family members of patients suffering from bipolar disorder. They, too, can benefit greatly from inclusive therapy - but this is not to take the focus away from the patients themselves. The uncertainty of the extreme mood swings characterizing bipolar disorder leaves many confused in attempts to formulate a proper response, and these individuals would do well to ask for advice from experienced professionals. Some uninformed third parties and, by implication, unsatisfactory therapists, place blame on other family members for a patient's inability to make significant steps toward recovery. Such accusations are unfortunate and very rarely correct, but the fear they inspire is one of the many reasons that many family members either hesitate to join the therapy experience or opt out altogether. Patients themselves often discourage the participation of their families because of a perceived threat or attack highlighting their personal failings. But parents, spouses and children can not only offer an outside perspective on the patient's condition but offer moral support and encourage a more comprehensive dialogue regarding the disorder itself. Therapists concerned about issues of confidentiality and professional responsibility may produce agreements for each family member to sign regarding the disclosure of sensitive information. Going behind a patient's back to enlist help from family is unnecessary and unethical.

Intensive, long-term therapy is crucial the treatment equation. Individuals suffering from the disease have no desire to hurt those closest to them, but the effects of watching bipolar disorder slowly destabilize a loved one can be devastating, and the desperation brought on by severe depressive episodes can be visited upon those who deserve it least - caring wives, husbands, sons, daughters, mothers, sisters...creating an active role in therapy for all parties affected by the disease can help grant them the knowledge and instruction they need to fight it together - as a family.

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