Surviving Manic Depression by E. Fuller Torrey M.D

Author:E. Fuller Torrey, M.D. [E. Fuller Torrey, M.D And Michael B. Knable, D.O.]
Language: eng
Format: epub
Publisher: Basic Books
Published: 2012-02-03T16:00:00+00:00

Since family members are usually an integral part of a person’s support network, educating them about that person’s illness will almost inevitably improve the overall outcome of the illness. An educated family is better able to understand the person’s symptoms and the need for medication and to identify the early signs of relapse.

One particular form of family therapy that has been promoted for manic-depressive illness is family-focused treatment.15 This family therapy usefully focuses on the education of the family and the development of communication and problem-solving skills. The main problem with family-focused treatment, however, is that it is structured on the outmoded theoretical underpinnings of “expressed emotion,” a blame-the-family approach that has been largely discredited.16

Several studies have been carried out on the effectiveness of family therapy on manic-depressive illness. Although these studies all have major methodological shortcomings, they suggest that such therapy can be helpful in improving medication compliance and reducing rehospitalization rates.17

Group Therapy. Group therapy is on the same continuum as the support groups described above. The major difference is that group therapy is led by a professional group leader and costs money, whereas support groups are led by their members and cost nothing except possibly a nominal fee to rent the meeting room. Like support groups, therapy groups may include any combination of education, interpersonal problem solving, and support. Studies of the efficacy of group therapy have suggested that they may be helpful in improving medication compliance, lessening symptoms, and decreasing hospitalization.18

In summary, psychotherapy in one form or another may help some people with manic-depressive illness, but it is not needed by everyone. All forms of psychotherapy appear to be at least somewhat effective. At least some of their effectiveness is related to the fact that each improves medication compliance, which may be the common denominator. It is not clear whether any particular form of psychotherapy for manic-depressive illness is any better than another, or whether any of them have effective ingredients beyond the four basic ones associated with all psychotherapies: a shared worldview, the personal qualities of the therapist, the expectations of the patient, and an improved sense of mastery by the patient.19

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