Towards an integrated treatment approach for manic depression

Abstract

Manic Depressive (MD) illness is a severe, chronic and disabling illness; the psychological consequences of which often results in profound distress. For the individual the treatment offered has typically involved pharmacotherapy only, with little or no attention to the cognitive aspects of MD, or the psychological needs of the individual. This paper describes how a similar picture existed in the area of schizophrenia some years ago. It traces the concepts, ideas and model that directed the multimodal approach to the treatment of schizophrenia, and the now widely accepted use of psychosocial interventions. The paper then looks at the problems found in manic depression, the similarities and differences between the two serious mental illnesses, and considers how the adoption of a stress-vulnerability and cognitive model informed the developments in schizophrenia. Consideration is then given to how the application of these models can inform the development of psychosocial interventions for manic depression. A range of interventions are first described separately before the author considers how the different psychosocial interventions can be brought together into an integrated treatment approach for those with manic depression.