Educating Patients About Bipolar Disorders

Teaching patients is a central role for physicians, and it is especially important in chronic illnesses, such as bipolar disorder. For an illness in which misunderstanding of the condition is the norm and in which patients often do not follow treatment recommendations, it is clear that psychoeducation leads to substantially better outcomes.¹

What does a typical patient with newly diagnosed bipolar disorder know about his or her illness? Most likely very little-and what he thinks he knows may be working against you.

• I haven’t had a manic episode, so this diagnosis must not be correct

• They just want me to take handfuls of pills

• Lithium will make my kidneys fail/make me feel like a zombie/make me gain weight/etc

• I’ll never be well again/get a job/live on my own/get married/etc

• I’m better now; I don’t need to keep taking these medications

A new diagnosis of bipolar disorder is like a new diagnosis of diabetes mellitus. The patient’s world changes, or should change, and there is a vast amount to learn . . . more than a busy clinician alone can teach. In addition to using efficient teaching resources, you must strive to teach your patients how to learn about the illness on their own, rather than wait for someone to teach them-otherwise, bipolar disorder itself may be the teacher.

Fortunately, the clinician also benefits from this emphasis on patient education. One of the most frustrating experiences in your work is a patient’s failure to follow through on treatment recommendations, particularly when the result is another mood episode that you are expected to manage. Improved adherence and recognition of early symptoms can prevent some of these episodes. Moreover, improved adherence to treatment recommendations is likely to improve the overall treatment alliance, making your job more satisfying and maybe even a little easier.

Doctor (noun, from Latin docere): “To show, teach, cause to know.”

Bipolar basics

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