Manic Depressive Disorder (Bipolar Disorder) and its effect on the family unit

Abstract

Bipolar affective disorder can mean many years of pain, confusion and loneliness for sufferers. This can also be said to be true for their families. Most relatives develop a fixed set of attitudes ranging from supportive, whatever the circumstances, to the persistently critical and hostile. It is not possible to know if the latter may be a trait or the outcome of a developmental process, but the complexity of these emotions would have some significance in the relapse, and on the family unit as a whole. This study focuses on how family members are affected by living with bipolar disorder sufferers. It is based on relative studies of schizophrenia (The Nithsdale Schizophrenia Surveys 1993, McCreadie et al). Aspects examined include: relationships, practical management, emotional support care given to relatives suffering from bipolar disorder on relative's own health, the extreme difficulty that people with the illness experience in learning from life, and the significance of stress for relatives, both financial and social. The study uses in-depth interviewing and questionnaires methodology to measure the emotions, attitudes and feelings of relatives living closely with the sufferers, and the social consequences on the family unit. The results show that the high-EE (Expressed Emotion) critical families, when the sufferers and relatives are in conflict there is a prolonged and escalating "mutual" negativity. It makes no distinction as to the originators of the negative sequence. Furthermore, in contrast to work on EE or affective style, the results indicate that in low-EE families there is an actively supportive attitude to the sufferers. This parallel is present in the study, but the findings also stress the need for the sufferers to be supporting of their carers. The cases of relapse show that the sufferers and the carers play at least an equal part in the negative inter-action associated with relapse.