CREST.BD Relationships & Bipolar Disorder Slides

1
CREST.BDBipolar Wellness Center Webinars
Connect. Learn. Engage.

2
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Relationships

3
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
Webinar focus
Defining relationships and social support
Why relationships are important to your QoL
Relationships and BD
How you can take action

5
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
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
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
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
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.
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
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
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
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
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
228.

13
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
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
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
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
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
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.
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
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
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
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
Tools and Resources

23
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
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
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
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
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
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
Acknowledgments

CREST.BD Relationships & Bipolar Disorder Slides

Recomendados

Recomendados

Más contenido relacionado

La actualidad más candente

La actualidad más candente (17)

Similar a CREST.BD Relationships & Bipolar Disorder Slides

Similar a CREST.BD Relationships & Bipolar Disorder Slides (20)

Más de Collaborative RESearch Team to study Bipolar Disorder, UBC

Más de Collaborative RESearch Team to study Bipolar Disorder, UBC (20)

Último

Último (20)

CREST.BD Relationships & Bipolar Disorder Slides