Helping a Loved One with Bipolar

Introduction

Bipolar Disorder in Children, Teens, and Family Members

If someone close to you has bipolar disorder, your love and support can make a difference in treatment and recovery. You can learn about the illness, offer hope and encouragement, and help with treatment. But caring for a person with bipolar disorder can take a toll, so don’t neglect your own needs.

Helping a family member or friend with bipolar disorder

Dealing with the ups and downs of bipolar disorder can be difficult—and not just for the person with the illness.

The moods and behaviors of a person with bipolar disorder affect everyone around—especially family members and close friends. During a manic episode, they must cope with reckless antics, outrageous demands, explosive outbursts, and irresponsible decisions. And once the whirlwind of mania has passed, it often falls on them to deal with the consequences. During episodes of depression, they may have to pick up the slack for a loved one who doesn’t have the energy to meet responsibilities at home or work.

The good news is that most people with bipolar disorder can stabilize their moods with proper treatment, medication, and support. Furthermore, you can play a significant role in their recovery.

Here are some ways you can help a person with bipolar disorder:

  • Learn about bipolar disorder Educate yourself about bipolar disorder. Learn everything you can about the symptoms and treatment options. The more you know about bipolar disorder, the better equipped you’ll be to help your loved one and keep things in perspective.
  • Encourage the person to get help The sooner bipolar disorder is treated, the better the prognosis, so urge your friend or family member to seek professional help right away. Don’t wait to see if the person will get better without treatment.
  • Be understanding Let your friend or family member know that you’re there if he or she needs a sympathetic ear, encouragement, or assistance with treatment. Remind the person that you care and that you’ll do whatever you can to help.
  • Be patient Getting better takes time, even when a person is committed to treatment. Don’t expect a quick recovery or a permanent cure. Be patient with the pace of recovery and prepare for setbacks and challenges. Managing bipolar disorder is a lifelong process.

The importance of support in bipolar disorder recovery

People with bipolar disorder do better when they have support from family members and friends. Those whose loved ones are involved and supportive tend to recover more quickly, experience fewer manic and depressive episodes, and have milder symptoms.

Bipolar disorder and the family

Living with a person who has bipolar disorder can cause stress and tension in the family. On top of the challenge of dealing with symptoms and their consequences, family members often struggle with feelings of guilt, fear, anger, and helplessness. Ultimately, the strain can cause serious relationship problems. But families can successfully deal with bipolar disorder if they learn to accept and cope with the illness and its difficulties.

When you’re feeling frustrated, confused or guilty, it’s important to remember that
bipolar disorder isn’t anyone’s fault!

Accepting bipolar disorder involves acknowledging that things may never again be “normal.” Treatment can make a huge difference for your loved one, but it may not take care of all symptoms or impairments. To avoid disappointment and resentments, it’s important to have realistic expectations. Expecting too much of your family member is a recipe for failure. On the other hand, expecting too little can also hinder recovery, so try to find a balance between encouraging independence and providing support.

Tips for coping with bipolar disorder in the family

  • Accept your loved one’s limits – People with bipolar disorder can’t control their moods. They can’t just snap out of a depression or get a hold of themselves during a manic episode. Neither depression nor mania can be overcome through self-control, willpower, or reasoning. Telling a person to “Stop acting crazy” or “Look on the bright side” won’t help.
  • Accept your own limits – You can’t rescue a person with bipolar disorder, nor can you force someone to take responsibility for getting better. You can offer support, but ultimately, recovery is in the hands of the person with the illness.
  • Reduce stress – Stress makes bipolar disorder worse, so try to find ways to reduce stress in your family member’s life. Ask how you can help and volunteer to take over some of the person’s responsibilities if needed. Establishing and enforcing a daily routine— with regular times for getting up, having meals, and going to bed—can also reduce family stress.
  • Communicate – Open and honest communication is essentialto coping with bipolar disorder in the family. Share your concerns in a loving way, ask the person how he or she is feeling, and make an effort to truly listen—even if you disagree with your loved one or don’t relate to what’s being said.

Supporting a person with bipolar disorder

Some people trivialise depression (often unintentionally) by dropping a platitude on a depressed person as if that is the one thing they needed to hear. While some of these thoughts have been helpful to some people, the context in which they are often said mitigates any intended benefit to the hearer. Platitudes don’t cure depression.

Sticks and stones can break bones, but words hurt, too. Talking carelessly can shatter self-esteem and stifle a person’s motivation to have a life again. Instead, use statements that are more likely to strengthen relationships and support recovery. Often it’s the smallest, insignificant comments that make the most impact on someone with a mental disorder, you might not have even noticed you said something, yet it could have had a deep and far-reaching effect on the individual.
Things you can say that might help:

  • You are not alone in this. I’m here for you.
  • I understand you have a real illness and that’s what causes these thoughts and feelings.
  • You may not believe it, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel, but I care about you and want to help.
  • You are important to me. Your life is important to me.
  • Bipolar disorder is a real illness, like diabetes. It requires medical treatment.
  • You’re not to blame for bipolar disorder. You didn’t cause it. It’s not your fault.
  • You can feel better. There are many treatments that can help.
  • When bipolar disorder isn’t treated, it usually gets worse.
Things you should not say:

You sound a little down today.

That’s what a friend said to me within the first 30 seconds when she phoned the other day. No kidding! Since I live with bipolar disorder, of course I don’t always feel 100 percent up to par. I just don’t need my symptoms constantly gauged or continually evaluated. It’s like having a never-ending physical. Most people with a mental illness know how they feel. Being told you are not sounding well is not constructive, nor is it a substitute for true compassion.

I thought you were taking your medication.

Dealing successfully with bipolar disorder cannot be reduced to whether or not someone has taken a pill. There are no quick fixes. Confronting a chronic, serious illness is an ongoing process, and there are bound to be ups and downs. The more you take the time to learn about bipolar disorder, the more you will understand how difficult managing such a condition can be. There are countless resources—books, videos, support groups, etc.—that address and reduce the mystery and misunderstanding surrounding bipolar disorder.

You’re too smart to have bipolar disorder.

When I first heard that remark, I felt so horrible, as if I could have prevented what had happened. Even worse, I felt that someone, such as a homeless person, was somehow more “deserving” of such an illness than I. The brain, like any organ in the body, is subject to having problems. It is cruel to say something that suggests that bipolar disorder doesn’t exist, isn’t legitimate, or isn’t as significant as any other medical condition.

You know he’s ‘bipolar,’ don’t you?

Reducing someone to the illness he faces is destructive. In fact, it is cruel to see a person only through the lens of a diagnosis. Unfortunately, it happens all too often. A person who has bipolar disorder should not be defined by that with which he might struggle. Guard your tongue. Focus on the person you know and love, and dwell on all that makes that individual special. Your friend or family member still has a life.

Stop acting like a fool!

Granted, some conduct associated with bipolar disorder can be very difficult to contend with. When you realize, however, that a particular behavior is actually symptomatic and born of the illness, it makes accepting and dealing with it much easier. I see families who think that their situation is unmanageable, until they meet other families facing the same circumstances. With education and patience, these families come to realize that there is an explanation for what they’ve been witnessing.

It doesn’t take much to set you off!

Those of us who have bipolar disorder are often more vulnerable and responsive to what happens around us. When you make careless statements, your tongue becomes a trigger that can rouse a reaction and escalate symptoms. You unnecessarily incite a mood change in the person you really want to help.

You’re lazy and don’t have a life anymore.

Are you pushing someone who has bipolar disorder to get on with life? Doing so might create stress, counteract recovery techniques, and worsen overall health. If you have a family, a job, social engagements, etc., consider yourself not only lucky, but also far apart from the typical individual who deals with bipolar disorder. Such a person has often dealt with a radical departure from any sense of a normal routine. Recovery takes time and work, and the role you play is critical. Help by using constructive dialogue that acknowledges progress. Don’t push too hard and don’t expect everything to happen overnight.

We used to have high hopes for you.

I sat at a support group and heard a mother say: “My son was going to be a doctor and have a wonderful family, but now he has bipolar disorder.” As I listened, I watched the young man’s face just drop. He was crushed by his mother’s words. Such a statement is not healthy, because it does not convey unconditional love. What you say does matter. Remember that we are all human beings, not human “doings;” the more you acknowledge our being, the more we can end up doing. There is no need to squash hope or diminish dreams.

Don’t take everything so personally.

With bipolar disorder, there are obvious physical symptoms, such as changes in appetite or sleep; the mind, as well as the brain, are impacted. The patient’s self-esteem also takes a tremendous hit. That’s why a promised phone call that never comes may be taken much harder than you might imagine. Likewise, saying things that ignore or make light of someone’s sense of self-esteem should be avoided.

You seem a little overly enthusiastic.

Remember that someone who has bipolar disorder is still entitled to a personality. Before I had bipolar disorder, I was outgoing, happy-go-lucky and quick-witted. Now even though I have this illness, those same personality traits still exist. At a support group recently, a young man was very energetic and expressive. Someone accused him of being manic. Fortunately, a psychiatrist was present. He said that the young man was displaying no manic symptoms whatsoever and that it was cruel to strip a person of his personality merely because he has a diagnosis. The doctor added that anyone is entitled to a full, normal range of emotions.

Convincing a person with bipolar to see a doctor

Aside from offering emotional support, the best way to help someone with bipolar disorder is by encouraging and supporting treatment. However, people with bipolar disorder tend to lack insight into their condition, so it’s not always easy to get them to a doctor. When they’re manic, they feel great and don’t realize there’s a problem. When they’re depressed, they may recognize something’s wrong, but lack the energy to seek help.

If your loved one won’t acknowledge the possibility of bipolar disorder, don’t argue about it. The idea may be frightening to the person, so be sensitive. Suggest a routine medical checkup instead, or a doctor’s visit for a specific symptom, such as insomnia, irritability, or fatigue (you can call ahead to tell the doctor of your bipolar disorder concerns).

Supporting a loved one during bipolar disorder treatment

Once your friend or family member agrees to see a doctor, you can help by being a partner in treatment. Your support can make a big difference in treatment success, so offer to be involved in any way the person with bipolar disorder wants or needs.

Things you can do to support a loved one’s bipolar disorder treatment:

  • Find qualified doctors and therapists
  • Set up appointments and going along
  • Offer your insight to the doctor
  • Monitor your loved one’s moods
  • Learn about the person’s medications
  • Track treatment progress
  • Watch for signs of relapse
  • Alert the doctor to problems

Encourage the person to take bipolar disorder medication

Medication is the cornerstone of treatment for bipolar disorder, and most people need it to regulate their moods and avoid relapse. Despite the need for medication, many people with bipolar disorder stop taking it. Some quit because they’re feeling better, others because of side effects, and still others because they enjoy the symptoms of mania. People who don’t think they have a problem are particularly likely to stop taking medication.

You can help a person with bipolar disorder stay on track by emphasizing the importance of medication and making sure all prescriptions are being taken as directed. Also encourage the person to speak to the doctor about any bothersome side effects. Side effects can be very unpleasant if the dose of the medication is too low or too high, but a change in medication or dosage may solve the problem. Remind the person that abruptly stopping medication is dangerous.

Watch for warning signs of bipolar disorder relapse

Even if a person with bipolar disorder is committed to treatment, there may be times when symptoms get worse. Take action right away if you notice any troubling symptoms or mood changes. Point out the emerging bipolar symptoms to your loved one and alert the doctor. With swift intervention, you may be able to prevent an episode of mania or depression from developing fully.

  • Sleeping less
  • Elevated mood
  • Restlessness
  • Speaking rapidly
  • Increase in activity level
  • Irritability or aggression
  • Fatigue and lethargy
  • Sleeping more
  • Trouble concentrating
  • Loss of interest in activities
  • Withdrawing from others
  • Change in appetite

Coping with mania and depression: Tips for family and friends

If relapse can’t be prevented, there are things you can do to cope during a manic or depressive episode.

  • Don’t take bipolar symptoms personally. When in the midst of a bipolar episode, people often say or do things that are hurtful or embarrassing. When manic, they may be reckless, cruel, critical, and aggressive. When depressed, they may be rejecting, irritable, hostile, and moody. It’s hard not to take such behaviors personally, but try to remember that they’re symptoms of a mental illness, not the result of selfishness or immaturity.
  • Be prepared for destructive behaviors. When manic or depressed, people with bipolar disorder may behave in destructive or irresponsible ways. Planning ahead for how to handle such behavior can help. When your loved one is well, negotiate a treatment contract that gives you advance approval for protecting him or her when symptoms flare up. Agree on specific steps you’ll take, such as removing credit cards or car keys, going together to the doctor, or taking charge of household finances.
  • Know what to do in a crisis. It’s important to plan ahead for times of crisis so you can act quickly and effectively with it occurs. Having a crisis plan can help. Make sure to include a list of emergency contact information for doctors, therapists, and other loved ones who will help. Also include the address and phone number of the hospital you will take the person to if necessary.
  • Call 911 in an emergency. If a person with bipolar disorder is suicidal or violent, don’t try to handle the situation alone. If you’re worried that your loved one may hurt you, get to safety and then call the police. If the person is suicidal, don’t leave him or her alone. Call 911 and stay with the person until an ambulance arrives.

Supporting someone who is manic

  • Spend time with the person. People who are manic often feel isolated from other people. Spending even short periods of time with them helps. If the person has a lot of energy, walk together, which allows the person to keep on the move but share your company.
  • Answer questions honestly. However, do not argue or debate with a person during a manic episode. Avoid intense conversation.
  • Don’t take any comments personally. During periods of high energy, a person often says and does things that he or she would not usually say or do, including focusing on negative aspects of others. If needed, stay away from the person and avoid arguments.
  • Prepare easy-to-eat foods and drinks (such as peanut butter and jelly sandwiches, apples, cheese crackers, and juices), because it is difficult for the person to sit down to a meal during periods of high energy.
  • Avoid subjecting the person to a lot of activity and stimulation. It is best to keep surroundings as quiet as possible.
  • Allow the person to sleep whenever possible. During periods of high energy, sleeping is difficult and short naps may be taken throughout the day. Sometimes the person feels rested after only 2 to 3 hours of sleep.

Taking care of yourself when a loved one is bipolar

It’s easy to neglect your own needs when you’re supporting someone else. But if you don’t take care of yourself, you run the risk of burnout. To cope with the stress of caring for someone with bipolar disorder, you have to take care of yourself both emotionally and physically.

  • Focus on your own life. Supporting your loved one may involve some life adjustments, but make sure you don’t lose sight of your own goals and priorities. Don’t give up friendships, plans, or activities that bring you joy.
  • Seek support. Dealing with a loved one’s mental illness can be painful and isolating. Make sure you’re getting the emotional support you need to cope. Talk to someone you trust about what you’re going through. It can also help to get your own therapy or join a support group.
  • Set boundaries. Be realistic about the amount of care you’re able to provide without feeling overwhelmed and resentful. Set limits on what you’re willing and able to do, and stick to them. Letting bipolar disorder take over your life isn’t healthy for you or your loved one.
  • Manage stress. Stress takes a toll on the body and mind, so find ways to keep it in check. Make sure you’re eating right and getting enough sleep and exercise. You can also keep stress under control by practicing relaxation techniques such as meditation.
  • Ask for help. If your friend or family member needs more assistance than you can give, ask for help from others. Turn to other relatives or close friends, or contact one of the organizations listed under Resources and References.