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Part 2: Causes As with other human characteristics, there is an ongoing debate about what causes the tendency to extreme mood states that can lead to a diagnosis of bipolar disorder. Inherited tendencies, life experiences and the way we see the world and interpret events can all play a role. No-one can ever know for sure exactly what elements combined together to cause problems for a particular individual. Similarly, people who have themselves received the diagnosis hold a wide variety of views about the nature and causes of their difficulties (Van der Gucht, 2009).

Section 5: Life/social circumstances and bipolar experiences Key points n People in difficult life circumstances are much more likely to experience all kinds of mental health problems. n The same applies to people who have had a difficult childhood. n Having a supportive network of family and friends can make it less likely that mood problems will return. Conversely people are more likely to experience ongoing problems if their family members are either highly critical or overprotective towards them. n Therapists should therefore consider family as well as individual therapy work in bipolar disorder. In either case it is important to pay attention to life circumstances as well as what the individual themselves might be able to do differently. 5.1 Family characteristics Life circumstances and family characteristics can influence not only whether or not someone experiences the problems which can lead to a diagnosis of bipolar disorder but also how the problems develop over time. It can of course also work the other way round: having a member who experiences mood problems can affect family and social relationships. Two main areas are particularly important. Firstly, people in families with overly protective or critical patterns of family communication (known as high expressed emotion; Miklowitz et al., 1988) are at increased risk for future mood episodes. These patterns of communication can be addressed using family based psychological help (Ryan et al., 2005; Weinstock et al., 2006). Secondly, the range of genuine friendships and other sources of informal support that the person has access to (social support and social networks; Johnson et al., 1999; 2003) can be crucially important. 5.2 Family functioning Expressed emotion research began with work in families of people diagnosed with schizophrenia. This showed that when families were critical or overprotective towards their relative (high levels of expressed emotion: high EE) episodes of acute schizophrenia were more common. Essentially the same findings have been reported in relation to bipolar disorder with people having more relapses of mania or depression and gaining fewer benefits from drug treatment if they live in high EE environments (Honig et al., 1997; Miklowitz et al., 1988; Priebe et al., 1989).

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Understanding Bipolar Disorder

Understanding Bipolar Disorder  

This report was written by a working party of clinical psychologists who were chosen because of their particular expertise on the subject of...

Understanding Bipolar Disorder  

This report was written by a working party of clinical psychologists who were chosen because of their particular expertise on the subject of...