1) Social support

'''My brother, Andrew, has been living with bipolar disorder for a number of years now. He does not feel that he has enough support from his family and friends. Myself and several other friends and family members have tried to support him as best we can but we have trouble getting through to him! He is just so emotional sometimes. Right now Andrew seems so depressed and I am worried about him. How can I help him feel supported?'''

One important point to make is that you must take care of yourself in order to help Andrew. It is perfectly normal for people with bipolar disorder to perceive a low level of support. It is essential to help Andrew realize that he is supported by his family and friends as low support, even a perceived level of low support, can be a predictor of re-occurrence of bipolar disorder symptoms, especially depressive symptoms. This perceived level of low support can even mean a longer time to recover from episodes. As you can see, it is very important for Andrew to feel support and one avenue to assist in showing him your support can be to improve communication between the two of you. There are many resources to assist in improving communication – please refer to the “Education” sections (Educating Oneself and Education Q & A) for additional information.

'''We have tried to get Andrew to talk to a professional but he does not feel like they respected him when he went. What should we do, should we give up on this?'''

It is important for Andrew to feel that he is respected in this professional relationship. The professional should focus on Andrew’s strengths in order to make him feel good about himself. The professional should also be available to help you as you need it. One way this may be done is by offering you information and to work on communication between Andrew and his caregivers. Several professionals may be seen before Andrew and yourself find someone to connect with - this is perfectly normal! "If the medication isn't working, the therapist isn't progressing, or the relationship is struggling - make some changes! . . . try and try again to find something that does work . . ." (Meehl, & Meehl, 2005, p. 66).

It is important that you and your loved one ask questions of the professional when you meet them in order to gain a sense if this relationship will work for you. Some questions that might be considered:


 * What experience with bipolar disorder do you have?
 * Will you meet separately with me to evaluate my loved one’s progress?
 * Are you available in emergency situations? If not, what are the back up procedures?
 * What kinds of therapy do you use? (for example, dialectic behaviour therapy, cognitive behaviour therapy, etc.); will you inform us of the current focus of treatment?
 * Will you provide us with background information on bipolar disorder, support groups available and education on how to deal with a family member who has a mental illness?

These and other questions that you may have are important to raise in your quest to find a good professional to work with.

'''I am one of Andrew’s sisters and I want to be able to support him but caring for him is starting to impact my life. The relationship with some of my family members is strained, I don’t have time to see my friends and do other things I used to enjoy and even my work is impacted! I want to learn how to cope with these things for myself but I don’t know where to start! Help!'''

One question to ask yourself is what areas are impacting your care giving and support? Is it when Andrew is exhibiting difficult behaviour? Does he stay with you at times? It is essential to pinpoint what area is having the most impact so that this area can be the focus of your work. Some interventions that you may want to consider are to utilize support groups or to become involved in group psycho-education of some sort. As has been stated above, it is important for you to be strong in order for you to be strong for Andrew! Take time to focus on yourself. Try to stay away from bad coping behaviours that some caregivers fall victim to, including resorting to smoking, drinking or taking pills. Many family caregivers have problems with their own health, stress level, anxiety and depression, as well as seeing negative effects on their self-esteem and confidence. Some effective techniques to assist you in relieving the burden you are feeling in supporting Andrew are to try to decrease your stress, learn adaptive coping techniques, and practice good health behaviours.

It is very important for you to effectively cope with your burden of dealing with Andrew, for both of you! Research shows that poor coping can have a negative impact on the person with bipolar disorder and from the information you gave us one can see that it also affects you! I would suggest you try to find a support group to attend by looking to your local mental health resources. If a face-to-face support group is not available there are many online support groups. Quality of online support groups can vary but they can be an important link for those in areas where face-to-face groups are not available. Some places to try include:


 * http://www.cmellc.com/topics/bip-support.html - a list of support groups, organizations and other useful information on bipolar disorder
 * http://www.walkers.org
 * http://selfhelpgroups.org – helps people find a group
 * http://www.dbsalliance.org
 * http://www.nami.org
 * http://www.cmha.ca
 * http://www.mooddisorderscanada.ca

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