How Can Caregivers Help Individuals Who Have Serious Mental Illness
Family members and caregivers often play a large role in helping and supporting a loved one who has serious mental illness . A 2016 study by the National Alliance for Caregiving, in partnership with Mental Health America and the National Alliance on Mental Illness, estimated that more than 8 million Americans provide care to an adult with an emotional or mental health issue, mainly related to SMI.7The term caregiver may also extend beyond an individuals family. This includes friends, teachers, neighbors, coworkers and others in the community. Hence, the term caregiver can refer to anyone who gives emotional, financial, or practical support to a person with SMI.
Caregivers can help loved ones who have SMI in many ways. Yet it is often a learning process, as every person with a mental health condition experiences it in a slightly different way. Caregivers may:
The 2016 study also highlights some of the challenges that caregivers may face. Four in 10 caregivers struggled to find an accurate diagnosis for their loved one. Families reported that it took 11.8 years, on average, for their loved one to receive an accurate diagnosis. Caregivers noted several barriers to accessing health care services and long-term services and supports. This includes day programs, peer support, case managers, inpatient treatment centers, and low availability of services in rural areas.
Both Types Should Be Properly Treated
Since hypomania that occurs in bipolar II is less severe than the mania that occurs in bipolar I disorder, bipolar II is often described as “milder” than bipolar Ibut this is not completely accurate. Certainly, people with bipolar I can have more serious symptoms during mania, but hypomania is still a serious condition that can have life-changing consequences and therefore, should be properly addressed.
In addition, research suggests that bipolar II disorder is dominated by longer and more severe episodes of depression. In fact, over time, people with bipolar II become less likely to return to full functioning between episodes.
Proper treatment should be pursued for all types of bipolar disorders, and you should work closely with your healthcare team to figure out the best treatment for you.
What’s It Like Living With Bipolar Disorder
In this video, Laura, Steve and Joe talk about their experiences of living with bipolar disorder.
In this podcast, Siobhan talks about her experiences of bipolar disorder.
Content warning: this podcast mentions suicide, but it doesn’t include details on methods.
Find out more about or subscribe to our podcast on iTunes or Audioboom.
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How Did The Definition Of Serious Mental Illness Evolve
The line between serious mental illness and other mental health concerns can at times be confusing. Several national efforts to define SMI came to similar conclusions and arrived at similar estimates of the number of people that SMI affects.
In the early 1990s, the Center for Mental Health Services had to define serious mental illness when it was created.They had to do this in order to distribute mental health block grants that were proportional to the number of cases of SMI in each state. They defined SMI as mental illnesses listed in the DSM that resulted in functional impairment which substantially interferes with or limits one or more major life activities. To calculate how many adults in each state had SMI, CMHS had to define functional impairment. After doing that, CMHS noted that 90% either have a severe disorder like schizophrenia or bipolar disorder, or a disorder and work impairment, or a disorder and report being suicidal.
In 2008 data, the National Institute of Mental Health concluded that serious mental illness affects 4.4% of the population over 18.2 It defined SMI to include:
- A subset of major depression called severe, major depression
- A subset of bipolar disorder classified as severe
- A few other disorders
Diagnosis Of Bipolar Disorder And Schizophrenia
Health professionals cannot use blood tests to diagnose bipolar disorder or schizophrenia. Instead, they will usually conduct a physical and psychological exam. During the exam, theyll ask about their patients personal or family history of mental disorders and inquire into what symptoms they may have been experiencing.
On occasion, a blood test, MRI, or CT scan of the brain will be needed to help rule out other conditions. At times, a drug and alcohol screening may also be necessary.
It may take several visits before the final determination is made. These visits are necessary and allow health professionals to get a full picture of a persons symptoms. They may also ask patients to keep a daily record of mood and sleep patterns. This will help them spot patterns that point to manic and depressive episodes.
Treatment for bipolar disorder and schizophrenia can involve both therapy and medication.
For bipolar disorder, psychotherapy may include:
- learning about changes in mood and how to effectively manage them
- educating family members about the disorder so they can be supportive and help address episodes
- exploring how to improve relationships with friends and co-workers
- understanding how to avoid possible triggers, such as stress or a lack of sleep
A healthcare professional may prescribe medication that controls mood and helps with other symptoms. Examples
In addition, anyone living with bipolar disorder or schizophrenia may consider:
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Bipolar Disorder And Stigma
Many of us have heard of bipolar disorder, but this doesn’t mean we all fully understand the diagnosis.
You might find that some people have:
- Misconceptions about you
- A negative or inaccurate image of bipolar disorder
This can feel very upsetting. Especially if the person who thinks this way is a friend, colleague, family member or healthcare professional.
Remember: you are not alone and you don’t have to put up with people treating you badly.
You might want to think about the following options:
- Show people this information. It might help them better understand what your bipolar disorder diagnosis means.
- Get more involved in your treatment. You can have a say in your treatment, make your voice heard, and take steps if youre not happy with your care.For guidance, see our pages on.
- Know your rights. The law can help you in certain situations. For more information, see our pages on.
- Take action with Mind. For details of ways you can get involved in helping challenge stigma, see our page oncampaigning.
For more information, see our page on .
What helps me the most is the ongoing realisation and acceptance that the way in which my bipolar disorder manifests itself, and the symptoms I display, are not personality traits or ‘bad behaviour’.
What does bipolar mean?
The word bipolar has two parts:
- Bi meaning ‘two’
- Polar meaning ‘completely opposite’
What Are The Treatments For Bipolar I Disorder
Manic episodes in bipolar I disorder require treatment with drugs, such as mood stabilizers and antipsychotics, and sometimes sedative-hypnotics which include benzodiazepines such as clonazepam or lorazepam .
Mood Stabilizers
Lithium : This simple metal in pill form is especially effective at controlling mania that involves classical euphoria rather than mixtures of mania and depression simultaneously. Lithium has been used for more than 60 years to treat bipolar disorder. Lithium can take weeks to work fully, making it better for maintenance treatment than for sudden manic episodes. Blood levels of lithium as well as tests to measure kidney and thyroid functioning must be monitored to avoid side effects.
Valproate : This antiseizure medication also works to level out moods. It is faster acting than lithium for an acute episode of mania. It is also often used “off label” for prevention of new episodes. As a mood stabilizer that can be used by a “loading dose” method — beginning at a very high dose — valproate allows the possibility of significant improvement in mood as early as four to five days.
Some other anti-seizure drugs, notably carbamazepine and lamotrigine , can have value in treating or preventing manias or depressions. Other antiseizure medicines that are less well-established but still sometimes used experimentally for the treatment of bipolar disorder, such as oxcarbazepine .
Antipsychotics
Benzodiazepines
Electroconvulsive Therapy
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What Are Bipolar Disorders
Bipolar disorder is a brain disorder that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic or depressive . People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.
People without bipolar disorder experience mood fluctuations as well. However, these mood changes typically last hours rather than days. Also, these changes are not usually accompanied by the extreme degree of behavior change or difficulty with daily routines and social interactions that people with bipolar disorder demonstrate during mood episodes. Bipolar disorder can disrupt a persons relationships with loved ones and cause difficulty in working or going to school.
Bipolar disorder is a category that includes three different diagnoses: bipolar I, bipolar II, and cyclothymic disorder.
People with bipolar I disorder frequently have other mental disorders such as anxiety disorders, substance use disorders, and/or attention-deficit/hyperactivity disorder . The risk of suicide is significantly higher among people with bipolar I disorder than among the general population.
What Is Rapid Cycling
Some people with bipolar disorder develop rapid cycling where they experience four or more episodes of mania or depression within a 12-month period. Mood swings can occur very quickly, like a rollercoaster randomly moving from high to low and back again over a period of days or even hours. Rapid cycling can leave you feeling dangerously out of control and most commonly occurs if your bipolar disorder symptoms are not being adequately treated.
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Bipolar Disorder Can Be Manageddont Lose Hope
Trying to manage a new diagnosisor an existing onecan be challenging. The following may be helpful to make it seem less overwhelming.
- Stick to the treatment process it may take some time to achieve meaningful progress, but its worth it
- Keep all appointments and talk to your doctor about all questions and concerns, especially as they relate to the treatment process
- Take all medications as directed and talk to your doctor if you need a change in treatment
- Build a routine and stick to it this includes exercise, sleeping, and eating
- Try to be patient improvement takes time and having strong social support can help
- Stay away from alcohol and drugs as their use can influence brain connections, leading to mood swings
Even though bipolar disorder is a lifelong illness, treatment for it is effective. With management of the condition, people can both control their symptoms and live healthy lives.
McLean offers world-class bipolar disorder care. If you or a loved one are struggling with mental illness, call us today at to learn more about treatment options.
What Are The Symptoms Of Bipolar I Disorder
During a manic episode in someone with bipolar disorder, elevated mood can manifest itself as either euphoria or as irritability.
Abnormal behavior during manic episodes includes:
- Flying suddenly from one idea to the next
- Rapid, “pressured” , and loud speech
- Increased energy, with hyperactivity and a decreased need for sleep
- Inflated self-image
- Substance abuse
People in manic episodes may spend money far beyond their means, have sex with people they wouldn’t otherwise, or pursue grandiose, unrealistic plans. In severe manic episodes, a person loses touch with reality. They may become delusional and behave bizarrely.
Untreated, an episode of mania can last anywhere from a few days to several months. Most commonly, symptoms continue for a few weeks to a few months. Depression may follow shortly after, or not appear for weeks or months.
Many people with bipolar I disorder experience long periods without symptoms in between episodes. A minority has rapid-cycling symptoms of mania and depression, in which they may have distinct periods of mania or depression four or more times within a year. People can also have mood episodes with “mixed features,” in which manic and depressive symptoms occur simultaneously, or may alternate from one pole to the other within the same day.
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What Risks And Complications Can Bipolar Disorder Cause
There can be complications and risks for people who live with bipolar disorder. But these risks can be lessened with the right support and treatment.
What about suicide and self-harm?
You might have an illness where you experience psychosis, such as schizophrenia or bipolar disorder. Your risk of suicide is estimated to be between 5% and 6% higher than the general population.
You are more likely to try to take your own life if you have a history of attempted suicide and depression. It is important that you get the right treatment for your symptoms of depression and have an up to date crisis plan.
There is also research that suggests you are 30% – 40% more likely to self-harm if you live with bipolar disorder.
What about financial risk?
If you have mania or hypomania you may struggle to manage your finances. You may spend lots of money without thinking about the effect that it may have on your life.
You could make a Lasting Power of Attorney. This is a legal process. This means that you pick someone that you trust to manage your finances if you lack mental capacity to manage them by yourself.
You can work with your carer and mental health team. You can form an action plan. This can say what they can do if you have a period of mania or hypomania and you start to make poor financial decisions.
What about physical health risk?
What about alcohol and drugs risk?
If you want advice or help with alcohol or drug use contact your GP.
What about driving risk?
Bipolar Disorder Symptoms In Women Vs Men
Men and women are diagnosed with bipolar disorder in roughly equal numbers. However, the main symptoms of the disorder may vary, depending on both sex you were assigned at birth and your gender.
Women with bipolar disorder tend to receive diagnoses later in life, often in their 20s or 30s. In some cases, they might first notice symptoms during pregnancy or after childbirth. Theyre also more likely to be diagnosed with bipolar II than bipolar I.
Additionally, women with bipolar disorder tend to experience:
- milder episodes of mania
- more depressive episodes than manic episodes
- rapid cycling, or 4 or more episodes of mania and depression in 1 year
- more co-occurring conditions
Women with bipolar disorder may also experience relapse more often, which may happen in part due to hormone changes related to menstruation, pregnancy, and menopause. In terms of bipolar disorder, relapse means having a mood episode after not having one for some time.
Men with bipolar disorder, on the other hand, may:
- get a diagnosis earlier in life
- experience less frequent but more severe episodes, especially manic episodes
- be more likely to also have a substance use disorder
- show more aggression during episodes of mania
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Information For Family Carers And Friends
How can I get support?
You can speak to your GP. You should be given your own assessment through NHS mental health services to work out what effect your caring role is having on your health. And what support you need. Such as practical support and emergency support.
These are some other options for you:
- Join a carers service
- Join a carers support group
- Ask your local authority for a carers assessment
- Read about the condition
- Apply for welfare benefits for carers
Rethink Mental Illness run carers support groups in some areas. You can also search for groups on the Carers Trust website:
- Rethink Mental Illness: www.rethink.org/about-us/our-support-groups
- Carers Trust: www.carers.org/search/network-partners
How can I support the person I care for?
You might find it easier to support someone with bipolar disorder if you understand their symptoms, treatment and self-management skills.
You should be aware of what you can do if you are worried about their mental state. It can be helpful to know contact information for their mental health team or GP.
You could find out from your relative if they have a crisis plan. You could help your relative to make a crisis plan if they dont have one.
As a carer you should be involved in decisions about care planning. But you dont have a legal right to this. The medical team should encourage the person that you care for to allow information to be shared with you.
You can find out more information about:
Myth : Mood Swings Always Mean Bipolar Disorder
Mood swings happen for many different reasons, including the weather, the menstrual cycle, common medications like steroids, and substance use, says Dr. Anand.
Moodiness can also occur with medical illnesses such as hormone disorders, autoimmune diseases and neurological problems.
And mood swings occur with other brain illnesses, such as attention-deficit hyperactivity disorder and certain personality disorders.
What sets bipolar disorder apart? The illness represents a change from the usual self, explains Dr. Anand. Also, depression lasts for several weeks at a time, and mania lasts for several days at a time. We look for a season of summer not one hot day.
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Key Points About Mood Disorders
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A mood disorder is a mental health class that health professionals use to broadly describe all types of depression and bipolar disorders.
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The most common types of mood disorders are major depression, dysthymia , bipolar disorder, mood disorder due to a general medical condition, and substance-induced mood disorder.
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There is no clear cause of mood disorders. Healthcare providers think they are a result of chemical imbalances in the brain. Some types of mood disorders seem to run in families, but no genes have yet been linked to them.
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In general, nearly everyone with a mood disorder has ongoing feelings of sadness, and may feel helpless, hopeless, and irritable. Without treatment, symptoms can last for weeks, months, or years, and can impact quality of life.
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Depression is most often treated with medicine, psychotherapy or cognitive behavioral therapy, family therapy, or a combination of medicine and therapy. In some cases, other therapies, such as electroconvulsive therapy and transcranial stimulation may be used.