Bipolar disorder

Citation

(2012), "Bipolar disorder", Health Education, Vol. 112 No. 5. https://doi.org/10.1108/he.2012.142112eaa.001

Bipolar disorder

Article Type: Internet review From: Health Education, Volume 112, Issue 5

It was interesting to see in the recent UK television series “Homeland”, the leading lady was a character who had been secretly diagnosed with bipolar disorder and she was desperately trying to hide this from her friends, colleagues and employer. It is very rare to see the leading roles in any films played by people with mental illness, unless of course they are the evil protagonist! This says a lot about our attitudes to mental illness. In the UK, bipolar disorder, or as it is sometimes called, manic-depression, is found in up to 3 percent of the population. Bipolar disorder is in fact not a single condition and it exists in several variants characterised by the severity and frequency of the manic and depressive episodes. The condition is equally common in men and women though women are more likely to exhibit what is called rapid cycling, i.e. having four or more bouts of the symptoms in any 12-month period. For most people onset is in early adulthood, 15-24 years, and about half of people with the disorder also have a family member who has suffered with the condition. There is no cure for bipolar disorder but the symptoms can usually be controlled through medication, often lithium based products. In this review the focus will not be on treatment but rather on how the Internet might be used to support people with bipolar disorder, as well as their families, friends and carers.

MIND: www.mind.org.uk/help/diagnoses_and_conditions/bipolar_disorder_manic_depression

This is the website of one of the leading mental health charities in the UK. The sheer volume of information dealing with mental health issues in this web site precludes any one issue being dealt with in great depth. In the case of bipolar disorder, users are presented with a single page summarizing all the main issues associated with the condition. A single paragraph briefly explains the nature of bipolar and lists the symptoms associated with manic and depressive episodes. Also included in this section is a link to a “Mindcast”, actually a podcast of an interview with a woman talking about what it is like to live with a diagnosis of bipolar disorder.

In dealing with the causes of the condition the website is refreshingly honest in admitting that we know very little about the causes. That the condition responds to drug treatment suggests a neurological problem of some type, but genetics and environmental stressors also seem to play a part.

The section on treatments is very informative with simple descriptions of the types of drugs used and how they function. There is a brief reference to “talking treatments” but no great detail. For users who want to learn more about this a useful link is provided that accesses a different part of the Mind website.

The section that is most relevant to this review is that dealing with self-help and although not comprehensive, the advice given is sound and practical. Readers are informed that manic episodes can be frightening for other people and may impact on relationships as a result. Learning to recognise the onset of symptoms is very important, though not always easy. Distinguishing between feelings of confidence, creativity and social ease, from the symptoms of mania can be quite difficult for the individual with the condition. Checklists and diaries are suggested as a means of helping with this. Avoiding stress at work is recommended and Mind produce an online resource, “The Mind Guide to Surviving Working Life” that could be very useful in this respect. The section on what friends and relatives can do to help is particularly welcome. Coping with people who are suffering manic or depressive episodes can be very difficult but the guidance given here explains what to expect, what can be done to help, and how to avoid making things worse. Again there are online resources to help with practical issues like managing money as well as the more emotionally demanding “How to help someone who is suicidal”.

Finally, the web site provides lots of useful links to other organisations that could be of help as well as a comprehensive list of the online resources that are available through the Mind website.

As you would expect from a leading charity, the web site is thoroughly professional, well designed, and has a host of useful information and external links, well worth a look.

Bipolaraware: www.bipolaraware.co.uk/index.html

Websites like this one serve to remind us that although the Internet might be dominated by the large corporations and well-funded charities, there is still room for ordinary people with little or no backing, but a lot of enthusiasm, to make a useful contribution to particular issues. Bipolaraware is the work of a young man who was diagnosed with bipolar disorder when he was just eighteen years old. Realising that not many people really knew much about the condition, this web site is one persons’ attempt to remedy that situation. Although it does have an “amateur” feel to it, the web site, nevertheless, is attractive to look at, and well organised in terms of content.

Starting with “True Facts” the link provides the authors’ perspective on the most important facts about bipolar disorder gathered from a variety of UK sources. Some of this is perhaps a little limited, for example one sentence describing the condition is probably not enough to do justice to its complexity. Similarly the information on prevalence, gender differences and environmental factors could do with a little more detail.

The next section deal with “Recognition” and does provide a better level of detail as the symptoms of the condition are described. This section is followed by “What is it” and this provides even more detailed information on the nature of bipolar disorder. All of this is quite well written, avoiding too much jargon, and making the necessary technical terms understandable.

The section on “Treatment” is probably the best part of this website. The many different forms of treatment are described, the medications likely to be used, including their trade names, and there is a good account of how these medicines work and their effectiveness.

The self-help section is headed “Education” and it has masses of useful ideas and tips for coping with the disorder. Written by someone who knows what it is like to suffer from bipolar disorder, it emphasises the importance of health education in helping to deal with the condition. As the author points out, bipolar disorder is a lifelong disorder and since there is no cure individuals have to do as much as they can to help themselves and their friends and family come to terms with the condition.

Finally the website provides an interesting book list and links to relevant organisations. Unfortunately the “Forum” section of the website was not operational at the time of access, but that looks like it could be a welcome addition to this web site. The advertisements that are sprinkled around this website are something of a distraction but that is the cost we pay for “free” websites.

Helpguide: www.helpguide.org/mental/bipolar_disorder_self_help.htm

In contrast to the above, Helpguide prides itself, and advertises the fact, on being advertisement free. This Helpguide organisation is based in North America and describes itself as a non-profit organisation supported mainly by the Rotary Club of Santa Monica. Rather like Bipolaraware above, this website grew out of personal tragedy following the suicide of the daughter of the founders. From small beginnings more than ten years ago, this web site has grown to be an extremely professional enterprise, attracting over 1 million viewers per week. The founders and co-publishers, Robert and Jeanne Segal, have backgrounds in Educational Psychology and Psychotherapy and have been active in local and national community organisations for many years. Although it may have had its foundations in a particular mental health problem, this website now provides help guides on many different mental health conditions including, addiction, eating disorders, schizophrenia and of course bipolar disorder. Each help guide has been produced with the help of the Harvard Medical School and are therefore very professional in terms of both content and presentation. In describing the condition there is a tremendous amount of detail, some might argue too much for the lay person, but health educational professionals will certainly find it useful. As well as descriptions of the condition and information on available treatments there is also a link to a suicide prevention resource that could prove valuable.

An additional resource that is common to all the help guides is a free mental health “Toolkit”. This resource alone is justification for visiting this web site, it really is an excellent resource for dealing with many different mental health issues. Following a five step plan users are provide with videos to watch, leaflets to read, mindfulness meditation exercises, and a particularly useful stress busting kit.

The design, content and accessibility are all excellent and easily generalizable to users located elsewhere in the world. It is highly recommended to lay users and health educational professionals alike.

Bipolar Beat: http://blogs.psychcentral.com/bipolar/2008/12/10-bipolar-disorder-self-help-tips/

For people who want a quick assessment and advice web site, you cannot go far wrong with this. Bipolar Beat is part of PsychCentral, an organisation that describes itself as the “Internet’s largest and oldest mental health and psychology network”. This particular part of PsychCentral is written by two psychiatrists who between them have extensive experience of dealing with the condition. As an aside there is a quick quiz that users can complete to assess the likelihood that they are showing the symptoms of the condition. However the main content of this web site is a list of ten self-help tips for coping with bipolar disorder. Briefly, these include “Taking ownership of your illness”, “Take your medication”, “Avoid alcohol and other stimulants”, “Sleep well”, and others culminating with “Ask for help”. None of this is rocket science but rather sound advice based on years of experience and extensive knowledge about bipolar disorder. Although the ten tips sound easy and straightforward, the authors do stress that they will need a lot of work if they are to be effective.

As a first step towards learning to manage the condition these ten tips are quite useful but the danger is that they oversimplify what is a very complex problem. As long as users keep this in mind then this website could be a very useful resource.