Peer support for mood disorder: Characteristics and benefits from attending the Depression and Bipolar Support Alliance mutual-help organization

Abstract

Background: Mood disorders (MDs) are pervasive and debilitating psychiatric conditions. Many helpful psychological and psychopharmacological treatments exist, but MD's prevalence and chronicity often means relying purely on professional care can create financial strain on individuals and healthcare systems. Also, many individuals respond only partially to professionally-delivered medical/pharmacological interventions or are unable to tolerate or adhere to them. Peer-led mutual-help organizations (MHOs) have emerged and grown in the U.S. to extend and potentiate professional efforts or otherwise address needs unmet by professional care. The Depression and Bipolar Support Alliance (DBSA) is the largest of these, but beyond observational evidence, little is known about participation or benefits. Greater knowledge could inform the field regarding clinical and public health utility of peer-driven efforts.

Method: Community-based cross-sectional comparative investigation of MD individuals attending (N = 202) or not attending (N = 105) DBSA. Measures included demographics, clinical characteristics and clinical service use, and indices of symptomatology, functioning, quality of life (QOL), and psychological well-being.

Results: Compared to non-DBSA participants, DBSA participants were more likely to be male and white and trended toward greater religious affiliation (p = 0.05). DBSA participants attended meetings about twice per month with two-thirds attending for more than one year. The DBSA cohort had a much higher proportion with bipolar I disorder and reported more lifetime and past 90-day use of acute, intensive, medical services and medications. There were no between-group differences on indices of QOL or psychological well-being, but within the DBSA group, greater DBSA attendance and involvement was associated with greater QOL and well-being, and less functional impairment.

Limitations: Cross-sectional design and regional sampling frame with unknown generalizability to national DBSA membership.

Conclusion: Given the grave impact of MDs and that DBSA is freely available it may fill an important clinical and public health need by attracting and engaging MD individuals with greater functional instability and impairment. The positive association found between greater active DBSA participation and improvements in functioning and well-being, while promising, requires longitudinal investigation to formally establish the causal direction of effects.

Keywords: Bipolar disorder; Major depression; Mood disorder; Mutual aid; Mutual help; Peer support.