Table 2.

Principles of psychiatric management

Principle

Comments

Establish and maintain a therapeutic alliance Monitor the patient's psychiatric status Provide education regarding bipolar disorder Enhance treatment adherence Promote regular patterns of activity and wakefulness Promote understanding of and adapatation to the psychosocial effects of bipolar disorder Identify new episodes early Reduce all morbidity and sequelae of bipolar disorder Promote acceptance of the diagnosis Promote emotional wellbeing

This is crucial for managing severe episodes and maintaining adherence. This is necessary for early detection of recurrence. Discussion on an ongoing process, use of educational brochures, and use of literature written by peers is useful for patient. Monitor ambivalences about treatment and use of psychological defense of denial. These factors have an effect on mood. Discuss the cascade effect of the illness in all psychosocial spheres. This enhances mastery and reduces morbidity. Early treatment, management of stressors, and adherence are critical. Reduce stigmatization, promote a sense of “control” through medication, promote avoidance of siubstances. Enhance self esteem, resolve interpersonal difficulties, and promote vocation.