Bipolar disorder isn't for the faint of heart — and that's true for both people diagnosed with it and those who love them.
When bipolar disorder takes someone who has it on a wild mood-episode ride, the people who live with them or are deeply involved in their lives come along for the ride too, affected by the person's mania, hypomania, or depression right alongside them. Worrying about the wellbeing of a loved-one with bipolar disorder is stressful, and can deal real mental health blows. Some caregivers of people with bipolar disorder even develop clinical depression themselves, as a result of the stress they are under.
That's a problem.
Research has shown, after all, that if you've got a bipolar diagnosis and your loved-ones are either especially critical, blaming, or hostile towards you, your diagnosis, or your symptoms, or — at the other end of the spectrum — overprotective and coddling, you are more likely to relapse and experience mania or depression.
These mood episodes are in turn likely to trigger more of kind of behavior that really doesn't help you manage your moods — and there you have a vicious cycle in the making.
Bipolar disorder doesn't only impact people who have it, but also their families. Those families aren't just impacted by their loved-one's bipolar disorder, but also influence symptoms. That, in short, means that whether you or someone you love has bipolar disorder, you're in this together.
What is family-focused therapy for bipolar disorder?
Family-focused therapy is a kind of psychoeducation that can help bipolar disorder patients and their families. Both people diagnosed with bipolar disorder and their relatives — often household members like spouses, children, parents, or siblings — learn more about bipolar disorder and the most effective ways to manage it.
On top of that, relatives are armed with communication and problem-solving strategies that allow them to better understand each other and avoid conflict.
Family-focused therapy isn't a replacement for other treatment strategies — like medication and individual talk therapy sessions — but it can play a key role in:
- Making sure the people closest to someone with bipolar disorder actually understand what bipolar disorder is and how it affects those diagnosed with it. Relatives will also learn to recognize the early warning signs of bipolar mood episodes, and what to do when they hit.
- Helping bipolar patients and their loved ones communicate better. This portion is called communication enhancement training, and it teaches everyone to practice active listening and empathy, and do away with the negative, reactive, cycles that can often cause conflict.
- Helping you all problem-solve better. That can involve figuring out what kinds of things in your daily life, like chores or therapy sessions, are causing you stress at the moment, and how to overcome them.
Details of each program will vary, but it's not unusual for family-focused therapy to take 21 weekly sessions. This will start with basic and more in-depth information about the nature of bipolar disorder, then tackle communication skills, and finally finish off with problem-solving work.
Family-focused therapy can be delivered in single-family settings, or in groups with multiple families. It can be offered to families in which adults as well as children have bipolar disorder.
Is family-focused therapy effective for people with bipolar disorder and their families?
Yes. A wide variety of studies has shown family-focused therapy to have a pretty significant positive impact on the lives of people with bipolar disorder.
People with bipolar disorder who have attended this kind of therapy with their household members:
- Are more likely to consistently take their prescribed medications as instructed.
- Function better in their daily lives.
- Suffer from mood episodes (mania, hypomania, and depression) less often, recover more quickly when mood episodes do strike, and are less likely to need hospitalization.
Relatives, meanwhile, also benefit. After participating in family-focused therapy, people who are caregivers for someone with bipolar disorder have a lower risk of becoming depressed, as well as a lower risk of engaging in unhealthy coping behaviors.
If family-focused therapy is offered to you, it will take a significant amount of your time and emotional investment. In return, its benefits can be lasting — for everyone who participated.
What else can relatives do?
Acknowledge that bipolar disorder is stressful and can have a life-altering impact on not just people diagnosed with it, but everyone around them on a regular basis, too.
Acknowledge that nobody chooses to have bipolar disorder, and it's not your loved-one's fault. Blaming your loved-one for their symptoms, or feeling hostile towards them because they have the diagnosis they do and everything that comes along with that, is counterproductive (and also unfair).
They have a potentially devastating mental illness — but one that can effectively be managed with medications and talk therapy. Acknowledge that your loved one needs your love and support, but don't be overprotective or coddling, because they're not a toddler and they haven't lost agency or competence.
If, after completing family-focused therapy, you find you would benefit from individual therapy sessions just for you, there's no shame in that. Talking to others whose loved-ones have bipolar disorder can help, as well, and so can remembering to care for yourself and your own needs.
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