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‘Between a rock and a hard place’: family members’ experiences of supporting a relative with bipolar disorder

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Abstract

Purpose

Clinical guidelines emphasise the central role of family members in supporting people with bipolar disorder. However, there has been little focus on the challenges family members face in supporting their relative. This qualitative study explored the challenges of providing support to a relative with bipolar disorder, and how family members attempted to meet these challenges. Factors that helped or hindered their efforts were also explored, including experiences of professional support.

Methods

Semi-structured interviews were conducted with 18 family members (partners, parents, adult children, and siblings). Transcripts were analysed using the Framework approach.

Results

Participants faced numerous challenges pertaining to the nature of the disorder and specific illness phases, their relative’s responses to their attempts to help, and the limitations of support from healthcare professionals. Although participants were resourceful in managing these challenges, they strongly valued professional input. Six themes were identified: ‘Not knowing: like being in a minefield’, ‘It’s out of my control: sitting waiting for the next thing to happen’, ‘Treading on eggshells’, ‘Picking up on signs’, ‘Times of crisis: between a rock and a hard place’, and ‘I have to make my voice heard’.

Conclusions

Family members supporting a relative with bipolar disorder face significant challenges but show considerable resourcefulness in managing them. The findings underline the importance of input from healthcare professionals to help family members effectively support their relative and manage the challenges they face. Professional support should be strengths-based, and tailored to family members’ needs.

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Notes

  1. The term ‘carer’ is often used to describe those who provide informal support. However, carers are predominantly family members [1], and the term can be perceived negatively by people with mental health problems and their families [2]. The term ‘family member’ will, therefore, be used where possible, and the person with bipolar disorder referred to as their ‘relative’. Family members include parents, partners, adult children and siblings.

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Acknowledgements

We thank the volunteer research assistants who helped transcribe interviews and the organisations that assisted with recruitment (who must remain nameless due to confidentiality concerns). We also thank the family members who participated for sharing their stories.

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Authors and Affiliations

  1. Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK

    Ella Baruch, Nancy Pistrang & Chris Barker

Authors
  1. Ella Baruch
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  2. Nancy Pistrang
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  3. Chris Barker
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Corresponding author

Correspondence to Ella Baruch.

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Ethical standards

All persons gave informed consent prior to their inclusion in the study. The study was approved by the university ethics committee and, therefore, has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Baruch, E., Pistrang, N. & Barker, C. ‘Between a rock and a hard place’: family members’ experiences of supporting a relative with bipolar disorder. Soc Psychiatry Psychiatr Epidemiol 53, 1123–1131 (2018). https://doi.org/10.1007/s00127-018-1560-8

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  • DOI: https://doi.org/10.1007/s00127-018-1560-8

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