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Role of the Family and Caregivers

Bipolar disorder can be a serious disability. Just as one would build ramps and make other household changes to accommodate a loved one confined to a wheel chair, certain accommodations are also necessary to deal with bipolar disorder. For example, it is necessary to be aware of the current state of the illness and learn not to take things personally at certain times. It is necessary to distinguish behaviors that arise from the illness from those that arise from environmental circumstances, and detach emotionally to avoid amplifying a mood swing. It may be necessary to adjust one's sleep cycle or work schedule to conform to the requirements of a loved one's stability plan.

Living with someone with this illness can be, at times, stressful and isolating. Don't forget to take care of the caretaker. Therapy can be helpful in finding ways to cope. Internet bulletin boards and mailing lists like BPSO are also useful, as well as face-to-face in-person support through groups hosted by organizations like NAMI or DBSA. It is also important to see friends and family, and have interests and activities that have nothing to do with bipolar disorder. Don't get lost in the illness. These things help maintain perspective and give life some joy during the hard times. Sometimes people with bipolar disorder cannot be as reliable or emotionally available as one would wish. Special arrangements and adjustments may need to be made for things like child care, credit card access, housework and other things. Good friendships or close relatives may be important to provide additional emotional support during a personal crisis.


Coping & Caring for the Caregiver
60 Tips for Helping People who have Schizophrenia Much of this applies to helping people with Bipolar Disorder. Includes
  • Tips for Handling a crisis
  • Tips for Communicating
  • Tips for Avoiding Relapses
  • Setting Boundaries
  • How to behave around someone with a brain disease like schizophrenia
  • Tips for Coping with Having a Family Member who has schizophrenia
By Rex Dickens or the NAMI Sibling and Adult Children Network
Beating the Marriage Odds An article from BP Magazine, reproduced on the NAMI web site -- The erratic behavior of a person in the throes of mania or depression can shake the foundation of a marriage. The diagnosis of a lifelong, life-threatening illness can scare a spouse away. Of course, no marriage or long-term partnership is easy. In the United States and Canada, at least 40 percent of all marriages fail. But the statistics for marriages involving a person who has bipolar disorder are especially sobering—an estimated 90 percent of these end in divorce, according to a November 2003 article, “Managing Bipolar Disorder,” in Psychology Today.
bipolarcaregivers.org Bipolar disorder affects not only the life of the person with the illness but the lives of those who care for them. Family members, partners and friends (caregivers) can be a primary source of support for a person with bipolar disorder. The site provides information and suggestions for caregivers about: (*) bipolar disorder, how it is treated and managed and helpful resources; (*) ways to help a person with bipolar disorder who is 18 years or over; and (*) ways caregivers can take care of themselves and deal with the personal impact of bipolar disorder.
BPSO Discussion on Parenting Excerpts from a BPSO List discussion on the subject of parenting when one parent suffers from bipolar disorder and is not yet stable.
Burden for families Psychiatry24x7.com. In addition to the profound impact that the illness has on patients, there can be an equally severe impact on the patient's family and care-givers.
Families in Limbo By Margaret Leggatt, Ph.D. Past President of the World Fellowship for Schizophrenia and Allied Disorders. This paper demonstrates some of the contradictory or paradoxical situations in which families of seriously mentally ill adult offspring find themselves, and which justify the title 'Families in Limbo'. While 'Limbo' was the region on the border of Hell, its meaning now equates with a sense of being unable to move, to be in circumstances from which there seems to be no way out, to not know which way to turn – the feeling of being caught in a 'Catch 22'.
Family and Relationship Fallout We may have depression or bipolar, but our loved ones suffer from it, by John McManamy. "One of the cruelest aspects of depression and bipolar disorder is the incalculable damage it inflicts upon unsuspecting families. Mothers and fathers, husbands and wives, sons and daughters, brothers and sisters - these tend to be the forgotten parties."
Family Psychoeducational Approach Rationale for a Multigenerational Treatment Modality for the Major Affective Disorders, by Demitri F. Papalos. A technical article discussing the role that the hereditary nature of affective disorders plays in treatment.
Guide to Recovery Available for free download. The Organization for Bipolar Affective Disorders has produced a book called "A Guide to Recovery". This book was compiled and created through the hard work and dedication of many individuals who have a mood disorder and has been a tremendous resource for both OBAD as well as the thousands of people who have read it. OBAD's book not only covers issues such as what Bipolar Affective Disorder, Unipolar Disorder and Schizoaffective Disorders are, but also ideas and methods for coping, dealing and living with these illnesses.
Helping a Loved One with Bipolar Disorder If someone close to you has bipolar disorder, your love and support can make a difference in treatment and recovery. You can help by learning about the illness, offering hope and encouragement, keeping track of symptoms, and being a partner in treatment. But caring for a person with bipolar disorder will take a toll if you neglect your own needs, so it’s important to find a balance between supporting your loved one and taking care of yourself.
Husbands, wives and partners - getting involved Mental Health Care. Mental health information from the Institute of Psychiatry, King's College London, the South London and Maudsley NHS Trust and Rethink.
Mental Illness - Information for Families By Vicki Koenig, PhD. If one of your family members has been diagnosed with mental illness, then you and your family, no doubt, are experiencing a number of concerns, emotions and questions about these disorders. The following information is intended to inform you about mental illness and also to provide you and your family with coping skills which will be helpful to you. From Sanctuary Psychiatric Centers of Santa Barbara.
Mutual Education, Support and Advocacy The following document is a reproduction of materials distributed in a course called Mutual Education, Support and Advocacy (MESA) for family members of persons with bipolar disorder or schizophrenia. The 12 week course was sponsored by NAMI (National Alliance for the Mentally Ill).
Pathways to Promise Ministry and Mental Illness. An interfaith technical assistance and resource center which offers liturgical and educational materials, program models, and networking information to promote a caring ministry with people with mental illness and their families.
S.A.F.E. Mental Health Facts for Families Support and Family Education (SAFE), an 18-session family education program for people who care about someone with mental illness, by Michelle D. Sherman, Ph.D. of Oklahoma City Veterans Affairs Medical Center. Posted on the web site of University of Oklahoma Health Sciences Center.
Talking with the Family From a bpso list discussion, some advice on sharing information about the bipolar diagnosis with family.
Twelve things What to do if your loved one has depression, manic-depression, or some other mood disorder.
Well Spouse Association The Well Spouse Association, a nonprofit 501(c)(3) membership organization, advocates for and addresses the needs of individuals caring for a chronically ill and/or disabled spouse/partner. We offer peer to peer support and educate health care professionals and the general public about the special challenges and unique issues "well" spouses face every day. More information here.


Personal Accounts of Loved Ones
BPSO Letter to Ann Landers 
Dr. Gail Waldby's Personal Pages My son has bipolar disorder. The key to successful treatment is correct diagnosis, skilled treatment preferably by a psychopharmacologist, who specializes in bipolar meds, strict med compliance, cognitive therapy and family involvement in treatment. Here are bipolar resources I find helpful.
Non-Borderline Daughter A thoughtful, insightful and clearly-written book-length analysis of the impact of mental illness on the affected person's children, written by the daughter of a woman diagnosed with borderline personality disorder and bipolar disorder. The issues faced by loved ones of people with borderline personality and bipolar disorders are very similar. From the site's home page: "Family and significant others, friends, co-workers, health providers and even therapists struggle to understand their individual who suffers an outwardly imperceptible and very slippery volatile sickness of the mind. Each of these “others” is also affected to some substantial degree by the illness that claims the one they care about. It creates distresses that may go unrecognized, misidentified or minimized until circumstances and symptoms become intolerable. This unavoidable contagion surfaces more often later than sooner, especially when we may have functioned quite normally in many aspects—while still under the shadowy secondary influences of someone else's disorder which may escape detection but causes no less pain to us all."
Reflections on living with and loving someone with bipolar disorder Also see some further reflections this piece inspired at Thoughts.
Will I Go Crazy? This site has some good information on self-care, insight, and the role of the family.


Separation and Divorce
BPSO discussion on the subject of separation 
Leaving: The End of the Relationship and Afterwards From Helen's World of BPD Resources. Oriented toward Borderline Personality Disorder, this site contains an enormous collection of links related abusive relationships and separation.

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