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Bipolar disorder - Management
How should I address the needs of family and carers?

  • Consider:
    • The impact of the disorder on relationships.
    • The welfare of dependent children, siblings, and vulnerable adults.
    • Carers' physical, social, and mental health needs.
    • Referral of family or carers to a counsellor (or for other psychological therapy) if necessary.
  • Advise family and carers:
    • To encourage treatment adherence and regulation of lifestyle.
    • To monitor for signs of relapse.
    • About self-help and support groups and encourage them to get involved. Such groups may provide information on early warning signs, treatment and adverse effects, and support in time of crisis.
Clarification / Additional information
  • Consider referral to a couples or family therapist for the person with bipolar disorder and their family or carer if:
    • The person with bipolar disorder feels misunderstood or unsupported by family despite the GP's interventions, or
    • Family dynamics trigger relapses, or
    • Family members are overly involved or over-reacting to the person's illness, affecting their independent functioning and recovery.
Basis for recommendation
  • These recommendations are based on the National Institute for Health and Clinical Excellence (NICE) guideline Bipolar disorder: the management of bipolar disorder in adults, children and adolescents, in primary and secondary care [NICE, 2006], and a review article on the management of bipolar disorder in general practice [Mitchell et al, 2006].

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