I suspect that patients don't recognize the symptoms in many cases or we would not have such a lengthy time from onset to diagnosis for bipolar. So in that respect the family can be of great assistance here.

But so many families are clueless. Mine sure was.

And as a bipolar with a daughter who we are now realizing is most likely bipolar, I would like to think I have something to add to the treatment equation for her.

But I have to tell you, the first sentence struck me wrong "not treating the family"--what, they don't need it living with a bipolar? after having my daughter home for a semester and experiencing her, I needed more therapy. I told my wife I was finally seeing what she went through all those years.

Then it went on to say "using" the family. Why does that word stick with me, negatively, like it does?

That is probably not rational, but......

As the sibling of someone who had various mental health struggles when we were growing up, this one hits home pretty hard.
while i can understand how the day-to-day intimacy of family life could be an important observational tool, i know that in my experience i would have deeply resented being "used to help the paitent". it was hard enough just living with my sibling, whose health needs would sometimes overshadow anything else going on in our family, that to be told i now had the job of helping with his treatment would have felt like an undue burden for a teenager with my own shit going on. Were it happening now, as an adult, totally fine. But, i hope this doc is careful when 'family' includes children or teens.

Before I forget my train of thought, what's the difference between "picking up subtle shades of lipstick" (moods) in a person and accusing someone of "going manic"? I was explaining - I thought cogently - a savings rationale which didn't involve spending away my future, and was accused of sounding "like (family friend) gets when he's manic".

This family-based diagnostic concept seems very much a double-edged sword, or, more likely, the bipolar diagnosis being the "sword of Damocles" hanging over me. For people with bipolar disorder, it seems like the HMOs/PPOs are slipping it to us again by substituting proxies for psychological/psychiatric involvement in treatment.

I suggest that most ADULT-onset patients' families are not involved sufficiently with treatment plans, spend little if any time with treating psychiatrists, and have no family counseling/therapy. Therefore, what tools do they have to gauge the difference between a normal human blip - or, in my case, connecting a series of arguments with a conclusion - and an onset of a manic episode? Who alerts the psy-doc and when? And when does the false alarm go off one too many times with the doc, or worse, the alarm is never pulled at all?

A side question: is there some sort of APA/American Psychiatric Association handout family members are given at discharge which is a national standard for information about the disorder, with checkmarks for docs/discharge planners to go over with family members about the condition? I think not.

I'm always curious about what other takes are on ideas here.

Hi,

My name's Trish. I have bipolar and the family & friends component is the hardest for me. We all want to feel understood, accepted & loved. If we don't belong in our families, where do we really belong? There's a sadness that won't go away as long as we don't belong.

Having a sense of belonging & battling loneliness & isolation is a full - time job for me.

My family love me & want to help - for that I'm grateful. But the family dynamic is stressful.

Personally, I feel that our family dynamics contributed to the development of my dis(ease), and the dis(ease) of my family.

I think that bipolar doesn't happen in a vacuum. It is a living, dynamic, changing thing. Families need to be involved if true healing is going to happen, and the person is to feel like they belong in the family, with respect & dignity, understood & accepted.

Thank you.