© Cambridge University Press 2012. The general issues around diagnosis and communication about diagnosis are well put in model 1 (Chapter 17). The involvement of family members can make a lot of sense, although I think one has to be sensitive to where the diagnosis is a cause of tension between them. At the end of the day, the relationship of the doctor is with the patient, if necessary without the family. I now find the educational experience of mood monitoring an important means whereby patients find out what their diagnosis means, so I am close to model 2 (Chapter 18) in its emphasis on education. But I think I am a little lighter now on the didactic presentation of the illness and its prognosis unless I am asked. My ability to predict what will really happen is rather poor, so I stick with what has already happened. It is indeed depression that is the lever to accepting that something is wrong and further that highs may make depression more likely. I think it is difficult often to distinguish hypomania from the hyperthymia that is common in BP II.