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Studying Bipolar Disorder in Young Adults

Posted on July 22, 2009

Communication with young adults is complicated, admits Aude Henin (bio), but putting in that effort is vital.

 

I have a study to look at young adults with bipolar disorder, and this is a population that often struggles with medication adherence. It's developmentally, I think, a period where being on medications is tricky for all sorts of reasons, and so one of the things that we really try to do is have an open discussion about medications, and the pros and cons, and why stay on or not. And help encourage ongoing communication with their treating psychiatrist or nurse practitioner, whoever is prescribing, and so I think that's a very helpful approach.

We're also very much focused on improving functioning. So medications can help reduce symptoms, but there's now data to suggest that even if symptoms remit or improve, a lot of young people still have a great deal of functional impairments. And so I think that's another arena that psychosocial treatments can really be beneficial is in helping to improve certain aspects of functioning, whether they be family, or school, or interpersonal.

We're also very much focused on reducing some of the high-risk behaviors that young people can get involved in that can have all sorts of negative effects on the course of their illness and potentially the course of their lives. And so I think really finding targeted areas for psychosocial treatments is probably a helpful approach overall.

So definitely how to communicate to an adolescent or a young adult [is key] because I think the tendency is probably to want to affect behavioral change. So we know where they should be and what they should be doing, and I think that's probably not a very helpful posture to take.

Certainly this is a period where autonomy, and independence, and autonomous decision making are key, and bipolar disorder can rob people of some of that because it can put them in a position of having to be more dependent on families or others.

And so I think really respecting that drive to be autonomous, to make their own decisions is key. And certainly we can provide information, and we can help guide young people towards certain decisions. But in the end, it really is about choice, and helping them recognize the pros and the cons of making particular choices or particular decisions, and helping them think through it.

If they do want to change, then providing some of the instrumental skills and strategies for doing so, but recognizing that some people may really not be in that place yet and not quite ready to do what it is, perhaps, that we think they ought to. And that has to be okay sometimes.

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Excerpted from interview with researcher at the 2009 Career Development Institute for Bipolar Disorder in Pittsburgh, PA.

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