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Bipolar Disorder and the Need for Psychoeducation

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

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.

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