Helping During Outpatient Treatment
When your friend or family member begins seeing a doctor or therapist, show that you support their decision to seek treatment and ask how you can be most helpful. Learn about your loved ones symptoms. Each person needs different kinds of help keeping symptoms under control. Learn about medications and what side effects to expect.
Some people find it helpful to write down mania and suicide prevention plans, and give copies to trusted friends and relatives. These plans should include:
- a list of symptoms that might be signs the person is becoming suicidal or experiencing mania
- a list of stressful events that may be contributing to their symptoms
- things you or others can do to help when you see these symptoms occurring
- a list of helpful phone numbers, including health care providers, family members, friends, and a suicide crisis line such as 273-TALK
- a promise from your friend or family member that they will call you, other trusted friends or relatives, one of their doctors, a crisis line, or a hospital when manic or depressive symptoms become severe
- encouraging words such as My life is valuable and worthwhile, even if it doesnt feel that way right now. and
- reality checks such as, I should not make major life decisions when my thoughts are racing and Im feeling on top of the world. I need to stop and take time to discuss these things with others before I take action.
Helping A Family Member With Bipolar Disorder: Dont Say This
Along with what you can do to help someone with bipolar disorder, there are things you should avoid saying and doing. As mentioned above, people with bipolar already have a difficult time feeling wanted and accepted, and there are definitely things that can make them feel worse. Dont say: You seem down today. Remember that people with bipolar go through periods of tough depression. They usually know how they feel and also dont need someone to tell them that they seem down. Dont say: Arent you taking your medication? Bipolar disorder cant be simply cured with a pill. Even with medication, theyre going to have some rough patches. Asking this question might make the person feel as if their treatment isnt working. Dont say: Quit acting ridiculous. Even though its true that some bipolar people exhibit behavior that is outrageous, its not something that they can help. This is the type of language that isolates and hurts rather than helps. Dont say: Dont take things personally. Bipolar people often struggle with self-esteem issues. They may take something like a forgotten promised phone call much more seriously than others. From their perspective, it might look like you have stopped caring about them.
Listen And Be Supportive
If someone is refusing treatment, resist the urge to walk away. This is someone you care about, so continue to provide support as long as it makes sense for your own wellness. Listen to what they have to say about treatment and their reasons for refusing. You may find that when you sit back, listen, and just provide support, your loved one will open up and give you some clues that could help you push treatment more effectively.
For example, consider the story shared by Mark K., who eventually agreed to residential treatment for his bipolar disorder after being pushed by family:
For a while my family thought that I just didnt realize I was sick. I always knew something wasnt right. The truth was that I hated the idea of having a label, of being mentally ill. I did not want to go to treatment, because it meant admitting that there was something wrong with me, so I denied it for a long time.
My brother really pushed me, and it only made me push back. My mom listened, though. She stopped pushing and just asked me questions. She listened, and that made such a big difference. One day when we were talking, I just broke down. And while I felt like a failure and weak at first, getting that off my chest also felt like a relief. She talked to me about experiences she had with depression when she was younger. I had no idea, and it really made me feel less alone. That was the real push I needed to get help.
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The Importance Of Self
It can be incredibly frustrating, exhausting and confusing to deal with someone who is experiencing bipolar disorder. The only way you can be there to support your friend is if you look after yourself first.
Dont give up the things you enjoy
Make sure you still have time to yourself to do your favourite things and to work towards your own goals.
Set boundaries
You arent always going to be able to be there at every moment, and you cant let helping someone take over your life. Set some limits on the things youre willing, and unwilling, to do. For example, let your friend know that you wont take calls in the middle of the night or while youre at work. Plan with them what they can do if you arent available.
Make time to relax
Relaxation is a great way to deal with stressful situations.
Ask for support
Make sure youre getting your own emotional support. Talk to people you trust about how youre feeling. You might also want to talk about it in counselling or join a support group.
Prepare For Manic Episodes
Its a good idea to make a plan for manic episodes, says Buckley. When your friend or family member is feeling well, try talking to them about how you can support them at these times.
You could discuss ideas such as: being creative together, helping to reduce stress, relaxation exercises, helping to manage money while theyre unwell, helping them keep a routine, and discussing how they can keep on top of regular meals and a good sleep pattern.
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Anyone Can Develop Bipolar Disorder Including Children And Teens However Most People With Bipolar Disorder Develop It In Their Late Teen Or Early Adult Years The Illness Usually Lasts A Lifetime
Bipolar mood episodes include unusual mood changes along with unusual sleep habits, activity levels, thoughts, or behavior. In a child, these mood and activity changes must be very different from their usual behavior and from the behavior of other children. A person with bipolar disorder may have manic episodes, depressive episodes, or mixed episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two or sometimes longer. During an episode, the symptoms last every day for most of the day.
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Brain Structure And Function
Researchers are learning that the brain structure and function of people with bipolar disorder may be different from the brain structure and function of people who do not have bipolar disorder or other psychiatric disorders. Learning about the nature of these brain changes helps doctors better understand bipolar disorder and may in the future help predict which types of treatment will work best for a person with bipolar disorder. At this time, diagnosis is based on symptoms rather than brain imaging or other diagnostic tests.
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Setting Healthy Boundaries With A Borderline Loved One
One of the most effective ways to help a loved one with BPD gain control over their behavior is to set and enforce healthy limits or boundaries. Setting limits can help your loved one better handle the demands of the outside world, where schools, work, and the legal system, for example, all set and enforce strict limits on what constitutes acceptable behavior.
Establishing boundaries in your relationship can replace the chaos and instability of your current situation with an important sense of structure and provide you with more choices about how to react when confronted by negative behavior. When both parties honor the boundaries, youll be able to build a sense of trust and respect between you, which are key ingredients for any meaningful relationship.
Setting boundaries is not a magic fix for a relationship, though. In fact, things may initially get worse before they get better. The person with BPD fears rejection and is sensitive to any perceived slight. This means that if youve never set boundaries in your relationship before, your loved one is likely to react badly when you start. If you back down in the face of your loved ones rage or abuse, youll only be reinforcing their negative behavior and the cycle will continue. But, remaining firm and standing by your decisions can be empowering to you, benefit your loved one, and ultimately transform your relationship.
Reign Back In The Things That Are In Excess
Perhaps in the episode plan, you agreed to hold your loved ones credit cards in a safe place so that they wouldnt be tempted to overspend. Both over shopping and gambling can be a serious problem in a manic episode.
Or maybe there are certain websites or social media sites theyd prefer to stay off of during a manic episode.
If you agreed to this previously, you could help by keeping their phone, computer, or tablet in a safe place out of sight, or facilitating a temporary password change until their symptoms subside.
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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 ones 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 youre feeling frustrated or guilty, remember that bipolar disorder isnt anyones 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, its 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.
Normal Feelings Vs Bipolar Disorder
It’s normal to experience a range of emotions and feelings in our lives. How we feel can be affected by the things going on around us, our friends or family, stressful events, or sometimes by nothing at all. Ups and downs, or changes in mood are normal and generally dont cause too many problems.
Young people in particular can experience changes in mood as part of normal adolescence and this can make it difficult to know when your young person might need help.
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Helping Someone Living With Depression Or Bipolar
Your loved ones condition is not your fault . You cant make your loved one well, but you can offer support, understanding, and hope. Each person experiences a mood disorder differently, with different symptoms. Depression may cause someone to have feelings of unbearable sadness, guilt, worthlessness, and hopelessness. The person does not want to feel this way but cant control it. The best way to find out what your loved one needs from you is by asking direct questions, but also respecting the individuals personal space when they dont want to talk.
Conditions That Can Co
Many people with bipolar disorder also may have other mental health disorders or conditions such as:
- Psychosis. Sometimes people who have severe episodes of mania or depression also have psychotic symptoms, such as hallucinations or delusions. The psychotic symptoms tend to match the persons extreme mood. For example:
- Someone having psychotic symptoms during a manic episode may falsely believe that he or she is famous, has a lot of money, or has special powers.
- Someone having psychotic symptoms during a depressive episode may believe he or she is financially ruined and penniless or has committed a crime.
Some bipolar disorder symptoms are like those of other illnesses, which can lead to misdiagnosis. For example, some people with bipolar disorder who also have psychotic symptoms can be misdiagnosed with schizophrenia. Some physical health conditions, such as thyroid disease, can mimic the moods and other symptoms of bipolar disorder. Street drugs sometimes can mimic, provoke, or worsen mood symptoms.
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Outline Benefits And Have A Plan Ready
As long as your loved one is still in a position to have a rational conversation about treatment, you can engage them and have a serious discussion. Talk about the benefits treatment could bring. For example, if your loved one is struggling to live the life they want to, talk about how treatment can help them make changes and set and achieve goals.
Hone in on specific things about their life that they dont like. Maybe your loved one has a hard time maintaining a long-term relationship or keeping a job they enjoy. Talk about how untreated bipolar disorder is probably getting in the way of achieving a healthy relationship and a rewarding career.
It also helps to have a plan already in place when you start this conversation. Be prepared with a few options for rehab, therapy, and treatment plans. This makes it easier for your loved one to take the concrete step to get help, but also gives them a choice and a say in where their treatment goes from here.
Bipolar Disorder And Changing Expectations
A major challenge facing families of manic-depressive patients is the formation of realistic expectations both of the mental health system and of the family member with bipolar.
a) Mental Health SystemWhen families bring their ill member for medical help, they often expect a firm diagnosis and a clear cut bipolar treatment regimen, which will quickly and permanently cure the illness. They then expect the relative to resume normal life immediately following treatment.
It is usually only after several experiences of trial medications, many disappointments at the hospital and at home over unfulfilled expectations that the family starts to appreciate the somewhat nebulous nature of the manic-depressive illness. The illness has no clear cut beginning or end. There are often residual impairments and ongoing vulnerabilities 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.
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How To Help A Loved One With Bipolar Disorder
Caring for someone with bipolar disorder can be very hard, whether youâre a partner, parent, child, or friend of someone who has this condition. Itâs stressful for everyone it touches.
Itâs tough to strike a balance. You want to be supportive and empathetic, because you know the person with bipolar disorder isnât to blame for their illness. But their behavior may affect you, and you have to take care of yourself and your needs, not just theirs.
Although there’s no easy solution, these tips may help.
Learn. Read information from reputable websites, books, and articles that explain the condition. The more you know, the better.
Listen. Pay attention to what your loved one has to say. Don’t assume that you know what they are going through. Donât dismiss all of their emotions and feelings as signs of their illness. Someone with bipolar disorder may still have valid points.
Encourage them to stick with treatment. Your loved one needs to take their bipolar medication and get regular checkups or counseling.
Notice their symptoms. They may not be able to see it as clearly as you do when their bipolar symptoms are active. Or they may deny it. When you see the warning signs of mania or depression, you can try to make sure they get help ASAP.
Take care of yourself. As intense as your loved oneâs needs may be, you count, too. Itâs important for you to stay healthy emotionally and physically.
How Can I Help Someone Who Has Bipolar Disorder
Your support can make a difference to a friend or family member who has bipolar disorder. Small gestures count.
One of the simplest things you can start with is to try to accept them — and their condition — just like you would if they had a physical health challenge.
Cynthia Last, a therapist in Boca Raton, FL, didnât know for a long time that she had bipolar disorder. Her husband, Barry Rubin, didnât believe at first, either. But soon the couple decided to take Lastâs diagnosis as a first step to needed changes. Together, they adjusted.
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