Intended for healthcare professionals

Rapid response to:

Clinical Review

Bipolar disorder

BMJ 2012; 345 doi: (Published 27 December 2012) Cite this as: BMJ 2012;345:e8508

Rapid Response:

Re: Bipolar disorder

The six-page review of the management of bipolar disorder (1) gives a comprehensive appraisal of the subject for Britain except in one important respect – the omission of what is commonly but slightly misleadingly called ‘self management’. (The term ‘partnership management’ is more accurate.)

To be fair, the review did note, under the heading Resources for patients, the contact details for five organisations and in relation to one of them (Bipolar UK) it stated that the organisation “provides a range of self help groups and self management courses”. Having attended one of these 3-day self management courses and having participated in meetings of two of their self help groups in North London I would like to briefly outline the essential features. The focus is on developing ‘expert patients’ though this is not the description they normally use.

In the 3-day courses, a group of about 12 patients with a moderator discuss the assessment of moods and key features of hypomania, mania and depression with a view to helping patients to quickly recognise their current mood and status. Also discussed are ‘triggers’ for elevated or depressed states – and how to avoid or reduce them. A fundamental aim is to recognise significant change early and act promptly to recover equilibrium.

Also discussed is self medication, which is typically of great interest to course members but is rarely practised since it depends on the collaboration of GPs and psychiatrists.

Given current NHS policies and financial pressures to maximise treatment in the community rather than in hospital, it seems likely that over the next few years in Britain there may be more courses for suitable bipolar patients to become expert patients.

Peter Draper public health consultant (retired).

1 Anderson I, Haddad P, Scott J. Bipolar disorder BMJ 2012;345:e508 doi:10.1136/bmj.e8508 (5 January.)

BMJ BP letter

Competing interests: No competing interests

14 January 2013
Peter A Draper
Public health (retired)
Guy's Hospital Medical School
68 Southwood lane London N6 5DY