September 20, 2005
Relatives' Criticism Increases Bipolar Severity
Getting upset due to the criticism of relatives and close friends apparently increases the severity of the symptoms of bipolar disorder. High levels of expressed emotion from those close to the person with bipolar disorder can have adverse effects on their course of illness. Researchers used expressed emotion (EE) levels to predict the course of illness over 1 year.
360 individuals with bipolar disorder took a four-item Perceived Criticism Scale (PCS) for 1 or more of their close relatives or friends. They were then monitored over 1 year for symptoms of mania and depression, as well as the amount of time spent recovering. "Contrary to their expectations, the researchers found that the severity of perceived criticism was not associated with patients' scores on the Montgomery Åsberg Depression Rating Scale (MADRS) or the Beck Depression Inventory (BDI)-II over the study year.
However, the results did show that the degree to which patients reported feeling upset by criticisms from relatives strongly predicted their MADRS scores, even after including all covariates" (PsychiatrySource.com).
Every 1 point of increase in their distress to criticism on the PCS, led to a 0.33 point increase on the Montgomery Åsberg Depression Rating Scale (MADRS), upon follow up. Those with higher PCS scores (distress from criticism) tended to have higher BDI-II scores on follow up. Researchers noted that those most greatly affected may be "stress sensitive" to their environment. They believe that it may be beneficial for clinicians treating bipolar disorder to include a measure of their perception of their family relationships.
SOURCE: Getting upset by relatives' criticism increases bipolar disorder severity. PsychiatrySource.com. September 20, 2005.
This research article was published in Psych Res 2005; 136: 101–111.
Here is another study on the effects of expressed emotion in bipolar disorder.
Here is an article on the effects of sociocultural factors on bipolar disorder.
Check out this research article on Family Transactions and Relapse in Bipolar Disorder.
Our site has a coping area for friends and family of someone with bipolar disorder. It gives information on how to deal with your feelings and how to best react to the person with bipolar disorder. Click here to read.
Posted by at September 20, 2005 11:39 AM
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Very interesting & informative for myself & son. Would enjoy more info,especially interaction for family members, as this is a new diagnosis for my son, aged 20.
Posted by: Lanna Aber at March 18, 2006 3:58 PM
I am writing this out of desperation! My mother who is 52 years old has severe bi polar disorder she also has a history of alcholism, mild drug use/and throid disorder. She has used alcohol to treat her mania, and it of course only made things worse. She is mentally disabled, and on disabilty, She cannot work, and has lived with me and my husband and kids for at least 13 of my 16 years married. You can NOT even imaging all I have been through! Once if not more a year I have to put her in rehab for help because she gets so bad. She argues all the time, about anything and gets louder and louder, she can never Not speak her mind even when she knows it will only make matters worse. For so many years I have been her fail safe always there to rescue her when she was evicted or didnt have food or when or whatever her crisis. However, I give up now, I feel so guilty, because I feel if I let her move out she will not live long, or she will get in trouble and i cant save her. I have two young daughters who listen to the loud mean agruments that she often starts and her behavior is affecting my kids too. I do not know what she will or can do but I myself am only 36 and I have been her Parent for soo long, I just cant deal with the guilt of getting angry with her or putting her in rehab, as she blames me and our family for causing the problems and she plays on my guilt. I know i am not the only adult child of a person with severe bi poplar but i need any help or advise there is to be offerd, i am desperate.
Posted by: Andrea Wells at September 2, 2006 7:03 PM
your story seems all too familiar, i too have been coping with my mums illness since age 12 i am now 37... i ended up having to make a cruel choice for which im only half guilty...i chose my daughter she was being too traumatised by my mums behaviour...i just couldnt do it anymore. I have suffered the burden since childhood i couldnt put it on my daughter or myself anymore, each manic episode brings with it horrible flashbacks of things she has done while manic before....what can i say, i feel for you. I know the drill all too well
Posted by: Rebecca at October 23, 2006 9:10 AM
My family thinks I'm the devil himself. Part of it is the bipolar, and the rest of it living in a dysfunctional family. It has been postulated that growing up in a perfection-expectant environment is about the same as growing up in a family where alcoholics are practicing their disease. I'll take responsibility for what I own, but I am definitely NOT the only sick person in my family.
Posted by: Ginger at March 1, 2008 10:57 PM
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Very interesting & informative for myself & son. Would enjoy more info,especially interaction for family members, as this is a new diagnosis for my son, aged 20.
Posted by: Lanna Aber at March 18, 2006 3:58 PM
I am writing this out of desperation! My mother who is 52 years old has severe bi polar disorder she also has a history of alcholism, mild drug use/and throid disorder. She has used alcohol to treat her mania, and it of course only made things worse. She is mentally disabled, and on disabilty, She cannot work, and has lived with me and my husband and kids for at least 13 of my 16 years married. You can NOT even imaging all I have been through! Once if not more a year I have to put her in rehab for help because she gets so bad. She argues all the time, about anything and gets louder and louder, she can never Not speak her mind even when she knows it will only make matters worse. For so many years I have been her fail safe always there to rescue her when she was evicted or didnt have food or when or whatever her crisis. However, I give up now, I feel so guilty, because I feel if I let her move out she will not live long, or she will get in trouble and i cant save her. I have two young daughters who listen to the loud mean agruments that she often starts and her behavior is affecting my kids too. I do not know what she will or can do but I myself am only 36 and I have been her Parent for soo long, I just cant deal with the guilt of getting angry with her or putting her in rehab, as she blames me and our family for causing the problems and she plays on my guilt. I know i am not the only adult child of a person with severe bi poplar but i need any help or advise there is to be offerd, i am desperate.
Posted by: Andrea Wells at September 2, 2006 7:03 PM
your story seems all too familiar, i too have been coping with my mums illness since age 12 i am now 37... i ended up having to make a cruel choice for which im only half guilty...i chose my daughter she was being too traumatised by my mums behaviour...i just couldnt do it anymore. I have suffered the burden since childhood i couldnt put it on my daughter or myself anymore, each manic episode brings with it horrible flashbacks of things she has done while manic before....what can i say, i feel for you. I know the drill all too well
Posted by: Rebecca at October 23, 2006 9:10 AM
My family thinks I'm the devil himself. Part of it is the bipolar, and the rest of it living in a dysfunctional family. It has been postulated that growing up in a perfection-expectant environment is about the same as growing up in a family where alcoholics are practicing their disease. I'll take responsibility for what I own, but I am definitely NOT the only sick person in my family.
Posted by: Ginger at March 1, 2008 10:57 PM