A major challenge facing families of bipolar patients is the formation of realistic expectations of the mental health system and of the ill member.

When families bring their ill member for medical help they often expect a firm diagnosis and a clear-cut treatment regime which will quickly and permanently cure the illness.  They then expect the relative to resume a normal life immediately following treatment.

It is usually only after several experiences of trial medications, many disappointments at hospital and home over unfulfilled expectations that the family starts to appreciate the somewhat nebulous nature of bipolar disorder.  This illness have no clear-cut beginning or end.  There are often residual impairments and ongoing vulnerabilities (weakness) after acute treatment.  The family must start taking into account the limitations of the mental health system both in terms of knowledge base and resources.

Some of the residual symptoms of an ill relative can experience after acute treatment include social withdrawal, poor grooming, aggression and lack of motivation.  A family must try to sort out what a relative is and is not capable of doing.  Unrealistically high expectations may lead to frustration and tension and finally, relapse, while too low expectations may lead to prolonged symptoms and increased depression in the relative and a sense of helplessness in the family.  It may be necessary to give a helping hand or at at times, to completely take over the regular duties of an ill member.  As he or she recovers, the responsibilities should be returned at a comfortable pace.