This chapter focuses on the philosophy and role of self-management programmes for bipolar disorder (BD). The term "self-management" came to prominence in the 1960s and 1970s, reflecting the rise of the "self-help" movement. The latter evolved partly as a consequence of dissatisfaction with traditional models of medical care that assumed patients would comply without question with the advice and instructions proffered by health professionals. Many people with long-term physical or mental disorders found more acceptable approaches to their health problems and took greater control of their lives through sharing experiences and seeking support from their peers instead of relying on organised health-care systems. In some instances, this idea was taken to the extreme, and individuals sought to cope without any professional input. In other settings, the user-led self-help groups and the professionally led mental health services worked side by side. Although their interactions spanned the spectrum from the truly harmonious to the overtly antagonistic, the ensuing dialogue and negotiation between service users and service providers created an environment in which self-management programmes became a reality for many individuals with persistent health problems.

Self-management has now come to mean any programme that gives people with a long-term health problem the information and skills to help them actively manage some or all of the key aspects of their disorder. The underpinning philosophy of self-management programmes is to enable individuals to make informed choices about the treatments and approaches they wish to pursue to manage their health and well-being. The added benefit is that they gain confidence about their capacity to take control of their lives. The expertise and experience of both professionals and service users have been pivotal in the recent development of self-management programmes for BD. Before we review these programmes, an outline of the contemporary literature about individual responsibility for health risks and the associated political context will be discussed. There are obvious advantages in an approach that promotes the idea that individuals with a serious health problem can and should be

Mood Disorders: A Handbook of Science and Practice. Edited by M. Power. © 2004 John Wiley & Sons, Ltd. ISBN 0-470-84390-X.

actively involved in the process of managing their disorder. However, this chapter will also highlight that there are potential dangers in giving individuals too much responsibility for their state of health or in promoting unrealistic expectations of what they can control or achieve through their own efforts.

Understanding And Treating Bipolar Disorders

Understanding And Treating Bipolar Disorders

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