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interventions will therefore often centre around helping people to take a different perspective on their problems and accessing help and support that might address practical difficulties (Hawton et al., 1995; Williams & Pollack, 1993). Recent studies also suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a promising new approach for those who have experienced suicidal ideation in the past (Williams et al., 2006; Williams, et al., 2008). MBCT integrates cognitive therapy techniques with training in meditation and is specifically designed for people in recovery, rather than in an acute state of crisis. 12.4 Crisis plans Once recognised, a person’s patterns of emotional response and negative thinking (sometimes called relapse signatures) can serve as warning signals. Detecting these warning signs can help avoid suicidal feelings in the future by helping the individual to adopt coping strategies to reduce the impact of these signs on mood. 12.5 Risk through drugs and Alcohol People with experience of bipolar disorder seem to be more likely to use drugs and alcohol than members of the general population or indeed people with experience of psychosis or depression alone. Studies have indicated that 40–50 per cent of people with experience of bipolar disorder will be dependent on, or use significant amounts of, drugs or alcohol in their lifetime (Care, 2007; Cassidy et al., 2001; Regier et al., 1990). These rates are higher than those in the general population, although it is important to note that potentially harmful levels of substance use are apparent in up to a quarter of adults in the general population if alcohol use is included (Care, 2007; Regier et al., 1990). Use of drugs and alcohol are notable across mood states so are not limited to periods of mania or depression only. The high rates of substance use are important because individuals who have problems with drugs and/or alcohol as well as experience of bipolar disorder tend to have more severe mood problems and benefit less well from available treatments than individuals who do not use substances in this way (Salloum & Thase, 2000; Strakowski et al., 1988). 12.6 Risk to other people There are often reports in the press of people with mental health problems who have engaged in violent acts. This can lead to the perception that people with experience of psychosis, bipolar disorder or depression tend to be more violent than the general population. The research evidence does not support such a proposal. A key factor in risk of violence seems to be the extent to which the individual is using drugs or alcohol independent of particular mental health diagnosis (Monahan et al., 2000; Monahan et al., 2005). Additionally, when individuals with a history of mental health problems (including bipolar disorder) were compared with individuals without mental health diagnoses who lived in similar areas there were essentially no differences in rates of violence if individuals were not abusing substances (Steadman et al., 1998). 12.8 Risk from other people In contrast to reports concerning violence by people with mental health problems, the popular press rarely covers the extent to which the same individuals can be at risk of victimisation from society at large. Many individuals with experience of bipolar disorder report histories of physical or sexual abuse preceding their mood problems (Hammersley et al., 2003). Additionally, there is evidence that a significant proportion of individuals with

Part 3: Help and treatment

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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...