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Bipolar Disorder and Recovery Sara Lapsley CREST BD

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BD and Recovery: A Literature Review <ul><li>AIM </li></ul><ul><li>-A review of qualitative empirical studies that look at what recovery means to people living with BD </li></ul><ul><li>CENTRAL QUESTIONS </li></ul><ul><li>-What common recovery themes have studies identified in the lived experience of those with BD </li></ul><ul><li>-How do people get and stay well? </li></ul><ul><li>-What does it mean to recover? </li></ul>

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The Literature Search <ul><li>Databases </li></ul><ul><li>-Medline, PsychInfo, CINHAL, EMBASE, AgeLine, Cochrane Database of Systematic Reviews, DARE, Web of Science </li></ul><ul><li>Search Terms </li></ul><ul><li>-Bipolar Disorder (including mania, hypomania etc…) AND recovery </li></ul>

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The Literature Search Con’d <ul><li>Methods </li></ul><ul><li>-qualitative </li></ul><ul><li>-mixed methods </li></ul><ul><li>-first person case studies </li></ul><ul><li>Samples </li></ul><ul><li>-BD only </li></ul><ul><li>-samples that include participants with a range of Mental Illnesses, but have analyzed BD data separately </li></ul>

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What is Recovery? <ul><li>Two definitions </li></ul><ul><li>Consumers: subjective process </li></ul><ul><li>Clinical: measurable outcomes based on functioning </li></ul>

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Literature Specific to BD <ul><li>Clinical Literature: Poor Outcomes </li></ul><ul><li>Subjective Reports of Consumers with BD </li></ul><ul><li>Experience life as chronic and unstable </li></ul><ul><li>Circumstances out of their control </li></ul><ul><li>Life is characterized by loss and deficit </li></ul><ul><li>(Lim, Nathan, O’Brien-Malone, & Williams, 2004) </li></ul>

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Clinician’s Illusion <ul><li>Clinicians are exposed to a biased sample </li></ul><ul><li>Basing judgment on functional outcomes creates pessimism </li></ul><ul><li>Instills belief in clients that they can’t recover </li></ul><ul><li>Where are the clients that are doing well? </li></ul>

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Recovery Literature Specific to BD <ul><li>CREST BD Wellness Data </li></ul><ul><li>Russell: Staying Well (2004) </li></ul><ul><li>Mansell et al: Process of Recovery in BD (2009) </li></ul>

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Mansell et al. <ul><li>Compiled qualitative studies on BD & Recovery to date </li></ul><ul><li>Collected original data </li></ul><ul><li>Ambivalent Approaches: avoidance of mania, medication, prior illness vs. current wellness, sense of identity </li></ul><ul><li>Helpful Approaches: Understanding, Life-style fundamentals, Support and Companionship, Social Change </li></ul>

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Russell & Browne: Staying Well with BD <ul><li>Acceptance of Diagnosis </li></ul><ul><li>Mindfulness </li></ul><ul><li>Education </li></ul><ul><li>Identify Trigger Factors </li></ul><ul><li>Recognize warning signs </li></ul><ul><li>Managing sleep and stress </li></ul><ul><li>Make lifestyle changes </li></ul><ul><li>Treatment </li></ul><ul><li>Access Support </li></ul><ul><li>Stay Well Plans </li></ul>

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CREST BD data: Tips from the Experts <ul><li>Sleep, Rest, Exercise, & Diet </li></ul><ul><li>Ongoing Monitoring </li></ul><ul><li>Enacting a Plan </li></ul><ul><li>Reflective and Meditative Practices </li></ul><ul><li>Understanding BD and Educating Others </li></ul><ul><li>Connecting with Others </li></ul>

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Integrating Recovery in Mental Health Services <ul><li>Findings from studies such as this can help clinicians promote: </li></ul><ul><li>empowerment </li></ul><ul><li>proactive wellbeing strategies in their clients </li></ul><ul><li>a strengths based approach </li></ul><ul><li>A lot of talk in Mental Health Services, need more action. </li></ul>

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Future Directions <ul><li>Need for more research to: </li></ul><ul><li>Identify overlap with mixed samples </li></ul><ul><li>Identify challenges/strengths in recovery unique to BD </li></ul><ul><li>Mood switch </li></ul><ul><li>Creativity/achievement </li></ul><ul><li>Mania/hypomania </li></ul><ul><li>Cognitive decline </li></ul><ul><li>Sleep Hygiene </li></ul><ul><li>Goal orientation/reward sensitivity </li></ul>

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<ul><li>Questions? </li></ul>