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CREST.BD Relationships & Bipolar Disorder Slides

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A warm welcome to CREST.BD’s Bipolar Wellness Centre webinar series! These webinar slides provide a summary of current research evidence on the interplay between relationships, bipolar disorder (BD) and quality of life (QoL), as well as pointing you to some tools and resources to help you flourish in your relationships.

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CREST.BD Relationships & Bipolar Disorder Slides

  1. 1. 1 CREST.BDBipolar Wellness Center Webinars Connect. Learn. Engage.
  2. 2. 2 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Relationships
  3. 3. 3 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BDCREST.BD Featuring: Dr. Sheri Johnson CREST.BD Member, Professor of Psychology, Department of Psychology and Director, Cal Mania (Calm) Program, University of California Berkeley Relationships
  4. 4. 4 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Webinar focus Defining relationships and social support Why relationships are important to your QoL Relationships and BD How you can take action
  5. 5. 5 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Defining relationships and social support Human beings are social by nature • We can survive on our own, but we truly thrive when surrounded by supportive others Even contact through distant and casual relationships (e.g., shop owners, librarians, pharmacists), can provide social support1 1 Townley, G., et al. (2013). A little goes a long way: The impact of distal social support on community integration and recovery of individuals with psychiatric disabilities. Amer J of Community Psyc, 52(1-2): 84-96.
  6. 6. 6 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Defining relationships and social support Relationships are often described as a person’s ‘social support’ system Includes: • emotional support (e.g., love, compassion, etc.) • informational support (e.g., giving advice) • tangible support (e.g., help with day to day needs)2 2 Thoits, P.A. (1985). Social support processes and psychological well-being: theoretical possibilities. In: Sarason, I. G., et al. (1985). SpringerLink (Online service), & SpringerLINK eBooks - English/International Collection (Archive). Social support: Theory, research and applications. Springer NL.
  7. 7. 7 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Why are relationships important to QoL? Social support linked to physical health (e.g., immune functioning, stress hormones and cardiovascular function)3 , and psychological benefits Living in close contact with someone can reduce isolation and loneliness1 3 Uchino, B. N., et al. (1996). The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psyc Bulletin, 119: 488-531. 1 Townley, G., et al. (2013). A little goes a long way: The impact of distal social support on community integration and recovery of individuals with psychiatric disabilities. Amer J Comm Psyc, 52(1-2): 84-96.
  8. 8. 8 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Why are relationships important to QoL? How much social support a person thinks they have may make more of a difference to their well-being than the actual amount of social support they have4 4 Blairy, S., et al. (2004). Social adjustment and self-esteem of bipolar patients: a multicentric study. J Affective Disorders, 79: 97-103.
  9. 9. 9 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD 5 Cecil, H., et al. (1995). Psychometric properties of the MSPSS and NOS in psychiatric outpatients. J Clin Psyc, 51: 593- 602. 6 Romans, S. E., et al. (1992). The social networks of bipolar affective disorder patients. J Affective Disorders, 25: 221- 228. 7 Bauwens, F., et al. (1991). Social adjustment of remitted bipolar and unipolar out-patients. A comparison with age- and sex-matched controls. Br J Psychiatry, 159(2): 239-244. Relationships and BD Many people with BD experience low social support5 • Describe both close and distant relationships as unavailable or inadequate6 Even between episodes, people with BD report less contact with friends7
  10. 10. 10 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Relationships and BD People with BD can be more sensitive to rejection8 Relates to self-esteem (feelings of self-worth and confidence)7 People who have had many lifetime mood episodes (especially manic) report the most challenges9,10 8 Miklowitz, D.J., et al. (2004). Family-focused treatment for adolescents with BD. J Affective Disorders, 82S: 113–128. 7 Blairy, S., et al. (2004). Social adjustment and self-esteem of bipolar patients: a multicentric study. J Affective Disorders, 79: 97-103. 9 O’Connell, R.A., et al. (1991). Outcome of BD on long-term treatment with lithium. Br J Psychiatry, 159: 123–129. 10 Cohen, A.N., et al. (2004). Effects of stress and social support on recurrence in BD. J Affective Disorders, 82: 143-147.
  11. 11. 11 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Relationships and BD People with BD with better social support: • recover more quickly from mood episodes11 • describe better overall functioning and fewer weeks of mood episodes,9 especially depression,6,10 than people with less social support 11 Johnson, S. L., et al. (1999). Social support and the course of bipolar disorder. J Abnorm Psyc, 108(4): 558-566. 9 O’Connell, R.A., et al. (1991). Outcome of BD on long-term treatment with lithium. Br J Psychiatry, 159: 123–129. 6 Romans, S. E., et al. (1992). The social networks of bipolar affective disorder patients. J Affective Disorders, 25: 221- 228. 10 Cohen, A.N., et al. (2004). Effects of stress and social support on recurrence in BD. J Affective Disorders, 82: 143-147.
  12. 12. 12 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Relationships and BD Not all relationships are helpful • Family interaction styles that are critical, hostile, intrusive or over-involved predict higher rates of relapse8, 12 ❒❒ Also predict poorer overall functioning7 and longer episodes6 While relationships may provide support, those with a lot of conflict can add to your stress - a ‘double edged sword’ 8 Miklowitz, D.J., et al. (2004). Family-focused treatment for adolescents with BD. J Affective Disorders, 82S: 113–128. 12 Johnson, L., et al. (2003). Social Support in BD: its relevance to remission and relapse. BP Disorders, 5 (2): 129–137. 7 Bauwens, F., et al. (1991). Social adjustment of remitted bipolar and unipolar out-patients. A comparison with age- and sex-matched controls. Br J Psychiatry, 159(2): 239-244. 6 Romans, S. E., et al. (1992). The social networks of bipolar affective disorder patients. J Affective Disorders, 25: 221- 228.
  13. 13. 13 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action Assess your social network • Remember, social support comes in many shapes and sizes! • Keep an open mind for all the possibilities for relationships Ask yourself what your ideal social life looks like Ask yourself how close your actual relationships and social life are to your ideal vision of them
  14. 14. 14 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action If your actual social network is dissimilar to your ideal, consider taking some of these steps: • Prioritize relationship-building • Make social meetings regular (e.g., a walk with a friend at the same time each week) • Combine socializing with activities (e.g., cook, carpool or exercise together) • Allow closeness without pushing it • Try to be vulnerable, open and accepting to allow for intimacy to develop
  15. 15. 15 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action If your actual social network is dissimilar to your ideal, consider taking some of these steps: • Find balance in your friendships between giving and receiving • Nurture and build a variety of relationships, not relying on just one person for support • Set SMART goals, e.g., instead of “I’m going to create an ideal social network”, try “I’m going to call Roy today”
  16. 16. 16 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD SMART criteria. (n.d.). Retrieved Jan 13, 2015 from Wikipedia: http://en.wikipedia.org/wiki/SMART_criteria#cite_note- Siegert-12 Setting reasonable goals (SMART) • S - Specific [what, how, where, when] • M- Measurable [how will I know when it’s achieved?] • A - Acceptable [will I feel good about this?] • R - Realistic [can I do this?] • T - Time-limited [when will this be achieved?] Taking Action: Just Do It! Assessing Your Progress Goal setting
  17. 17. 17 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action You may want to widen your network by creating new relationships: • Can you meet people through your leisure interests? • Are there familiar faces in your life who seem open to friendship? • Are there local support groups or programs you could join? • Could you volunteer, take classes or meet people at work? • How about joining a community or fitness center, club or spiritual community? • Can you choose to live in a shared space with other people?
  18. 18. 18 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD 13 Proudfoot, J.G., et al. (2012). Mechanisms underpinning effective peer support: a qualitative analysis of interactions between expert peers and patients newly-diagnosed with BD. BMC Psychiatry, 12: 196. How you can take action You may want to revamp your social networks to promote healthier relationships and lifestyles • Find friends who don’t use drugs or take part in unhealthy behaviours that may put you at risk for a mood episode • Find ‘informed supporters’ who are living well with a condition similar to yours & trained by a mental health professional to provide support13 • Becoming a peer supporter can help you feel a greater sense of connectedness with your community13
  19. 19. 19 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action Ensure that you have a healthy balance of social contact • You might find that your depressed mood improves with more social contact • However, too much social contact can be exhausting or over-stimulating, increasing your risk for hypomania or mania • It’s essential to find the right balance for you
  20. 20. 20 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action Many therapies have proven helpful for people living with BD • Family-focused Therapy (FFT) targets family interactions to help make relationships more supportive • Interpersonal and Social Rhythm Therapy (IPSRT) helps people build and maintain healthy relationships, while learning to recognize and end unhealthy ones • While Assertiveness Skills Training is not specific to BD, it may be helpful, rather than using passive-aggressive or aggressive communication styles
  21. 21. 21 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action If socializing is difficult for you, you may want to consider Social Skills Training or Cognitive Behavioural Therapy (CBT) • CBT can be helpful for symptoms of mood and social anxiety ❒❒ It can help challenge distorted (or false) thinking patterns about yourself or others ❒❒ In particular, CBT can help to cope with over-sensitivity to rejection, which many people living with BD report ❒❒ CBT also works to gradually schedule in regular social activities and other healthy behaviours
  22. 22. 22 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Tools and Resources
  23. 23. 23 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Resources: Bipolarcaregivers.org: Maintaining or rebuilding your relationship Directed towards supporters of people who live with BD; gives concrete, evidence-based tips. http://www.bipolarcaregivers.org/taking-care-of-yourself/maintaining-or- rebuilding-your-relationship-with-the-person
  24. 24. 24 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD BP Hope: Relationships and the bipolar trap Article by a person living with BD specifically about maintaining friendships. http://www.bphope.com/Relationships-and-the-bipolar-trap/ Resources
  25. 25. 25 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Resources Bipolar Manifesto: Maintaining friendships and relationships with bipolar disorder Well-written article by an individual living with BD on ways to keep long-term friendships and relationships with BD, from their own experience. http://www.bipolarmanifesto.com/wordpress/2012/01/19/maintaining- friendships-and-relationships-with-bipolar-disorder/
  26. 26. 26 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Helpguide: Relationships Advice for finding and keeping healthy relationships from advisors, including a social worker and health counselor. http://www.helpguide.org/ home-pages/relationships. htm Resources
  27. 27. 27 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD The Atlantic: Masters of Love Enjoyable article based on a research study into the science of lasting relationships. http://www.theatlantic.com/ health/archive/2014/06/ happily-ever-after/372573/ Resources
  28. 28. 28 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD For more information and resources, visit our Bipolar Wellness Center at: http://www.bdwellness.com/ To assess your quality of life, visit our QoL tool at: http://www.bdqol.com/
  29. 29. 29 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Acknowledgments

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