Helping Someone with Bipolar Disorder

How can you help someone 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. It can put a strain on your relationship and disrupt all aspects of family life.

During a manic episode, you may have to cope with reckless antics, outrageous demands, explosive outbursts, and irresponsible decisions. And once the whirlwind of mania has passed, it often falls on you to deal with the consequences. During episodes of depression, you 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. Your patience, love, and understanding can play a significant part in your loved one’s treatment and recovery. Often, just having someone to talk to can make all the difference to their outlook and motivation.

But caring for a person with bipolar disorder can also take a toll if you neglect your own needs, so it’s important to find a balance between supporting your loved one and taking care of yourself.

Other ways to help someone with bipolar disorder

You can also support your loved one by:

Learning 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.

Encouraging the person to get help. The sooner bipolar disorder is treated, the better the prognosis, so urge your loved one to seek professional help right away. Don't wait to see if they will get better without treatment.

Being understanding. Let your friend or family member know that you're there if they need a sympathetic ear, encouragement, or assistance with treatment. People with bipolar disorder are often reluctant to seek help because they don't want to feel like a burden to others, so remind the person that you care and that you'll do whatever you can to help.

Showing patience. 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. They 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 home. On top of the challenge of dealing with your loved one's 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 there are better ways to cope.

The first step to successfully dealing with bipolar disorder is for families to learn to accept the illness and its difficulties. When you're feeling frustrated or guilty, 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 can be a recipe for failure. On the other hand, expecting too little can also hinder their recovery, so try to find a balance between encouraging independence and providing support.

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Tips for coping with bipolar disorder in the family

Accept your loved one's limits. Your loved one 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. So telling your loved one to “Stop acting crazy” or to “Look on the bright side” won't help.

Accept your own limits. You can't rescue your loved one with bipolar disorder, nor can you force them 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 loved one'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 openly. Open and honest communication is essential to coping with bipolar disorder in the family. Share your concerns in a loving way, ask your loved one how they're 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

What you can say that helps:

• “You're not alone in this. I'm here for you.”
• “I understand that it's your illness that causes these thoughts and feelings.”
• “You may not believe it now, but the way you're feeling can and will change.”
• “I may not be able to understand exactly how you feel, but I care about you and want to help and support you.”
• “You are important to me. Your life is important to me.”

Convincing a person with bipolar disorder to see a doctor

Aside from offering emotional support, the best way to help your loved one with bipolar disorder is by encouraging and supporting treatment. Often, that can be more of a challenge than it sounds. Since people with bipolar disorder tend to lack insight into their condition, it's not always easy to get them to a doctor. When your loved one is manic, they feel great and don't realize there's a problem. When your loved one is depressed, they may recognize something's wrong, but often 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 them, so be sensitive. Suggest a routine medical checkup instead, or a doctor's visit for a specific symptom, such as insomnia, irritability, or fatigue—then privately call ahead to tell the doctor of your concerns about bipolar disorder.

[Read: How to Help Someone with Mental Illness Accept Treatment]

Things you can say that might help:

• “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.”

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 their treatment success, so offer to be involved in any way your loved one 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 go along.
• Offer your insights to the doctor.
• Monitor your loved one's moods.

• Learn about their medications.
• Track treatment progress.
• Watch for signs of relapse.
• Alert the doctor to problems.

Encourage your loved one 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 yet 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 your loved one stay on track by emphasizing the importance of medication and making sure they take all prescriptions as directed. Also encourage your loved one to speak to their 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 your loved one that abruptly stopping medication is dangerous.

Watch for warning signs of bipolar disorder relapse

Even if your loved one with bipolar disorder is committed to treatment, there may be times when their 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.

Mania warning signs and symptoms:

• Sleeping less
• Elevated mood
• Restlessness

• Speaking rapidly
• Increase in activity level
• Irritability or aggression

Depression warning signs and symptoms:

• 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 it's not possible to prevent your loved one relapsing, 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, your loved one 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 your loved one's 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 them 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 when it occurs. Having a crisis plan can help. Make sure to include a list of emergency contact information for doctors, therapists, and other friends or family members who will help. Also include the address and phone number of the hospital where you'll take your loved one if necessary.

Call 911 (or your country's emergency services number) in an emergency. If your loved one 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 your loved one is suicidal, don't leave them alone. Call for an ambulance and stay with your loved one until it arrives.

Supporting someone who is manic

• Spend time with your loved one. People who are manic often feel isolated from other people. Spending even short periods of time with them helps. If your loved one has a lot of energy, walk together. This allows your loved one to keep on the move but still share your company.
• Answer questions honestly. However, do not argue or debate with someone during a manic episode. Try to avoid intense conversation.
• Don't take any comments personally. During manic episodes, your loved one may say or do things that are out of character, including focusing on negative aspects of others. Try to avoid arguments.
• Prepare easy-to-eat meals and drinks. It's often difficult for someone who is manic to sit down to a meal, so try offering them sandwiches, apples, cheese crackers, and juices, for example.
• Avoid subjecting your loved one to a lot of activity and stimulation. It's better to keep surroundings as quiet as possible.
• Allow your loved one to sleep whenever possible. During periods of high energy, sleeping is difficult but short naps taken throughout the day can help. Sometimes a person who is manic may feel rested after only a few hours of sleep.

Taking care of yourself when a loved one has bipolar disorder

It's easy to neglect your own needs when you're supporting someone with a mental illness. But if you don't take care of yourself, you run the risk of burnout—and that won't help you or your loved one. When you take care of yourself both emotionally and physically, you'll be able to better cope with the stress of caring for someone with bipolar disorder and have the energy you need to support your loved one's recovery.

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 a bipolar disorder support organization.