Bipolar disorder is widely recognised to have the potential to impact significantly on a person's sense of self, social and occupational functioning, and life expectancy. There is considerable evidence that people who first experience bipolar disorder during adolescence face a number of additional challenges compared to those who develop the disorder at a later age. These include increased comorbidity with other disorders, more marked symptom severity, longer recovery times and higher rates of suicidal behaviour. While there is a growing literature on psychological interventions for bipolar disorder, we believe that young people require a specialised intervention, which focuses on four key areas. These are:
- Assisting engagement, which can be particularly difficult in early episodes, due to disorganisation inherent to the disorder, stigma, and issues relating to insight
- The importance of developmental issues, particularly managing the impact of the disorder on the person's developmental trajectory and formulating individual interventions with an awareness of the person's developmental stage.
- The involvement of family members or significant others in the intervention, including family communications styles, psychoeducation and relapse prevention work
- Functional recovery, as this has been noted to be poor in people with bipolar disorder, and there is evidence that outcome is better if this is addressed early.
This paper will address the specific challenges and opportunities for early intervention presented by young people with bipolar disorder. In addition, a psychological intervention designed specifically for work with young people with bipolar disorder will be described, with emphasis on preliminary findings from a trial currently being conducted.