Unit 1 - Awareness of the disorder

Summary

Unit 1 is fundamental, because its objective is to give the patient the basic information about bipolar disorders. We, the professionals, must not fall into the trap of considering that our patients obviously know all the information concerning the causes and symptoms of the disorder, since most of them ignore the biological, clinical and recurrent nature of their disorder. This unit must always be the first, because it will introduce concepts that will later be absolutely necessary during the group program. For example, we do not believe that it makes sense to carry out the brief intervention merely designed to identify the symptoms early, if we have not first correctly defined what the bipolar disorder is and why its symptoms appear. Consequently, we dedicate a very large number of sessions to this matter (the first five) for two main reasons: (1) on the one hand, because we believe that this is the point that warrants more specific work, as demonstrated by the high rates of lack of illness insight, which are associated to poor adherence, and (2) because, in a way, it is a manner of “refocusing” the patient included in a psychoeducation group in the fundamental aspect of their treatment: its biological nature and the need for drugs.

Quite a large number of patients misunderstand their joining the therapy group as the beginning of their “depsychiatrization” or, in other words, the first step toward becoming medication free, and they so declare in the first session. At least, this is what happened in one of our groups.