Helping a Loved One with Bipolar Disorder

Respect to you! It can be a nightmare caring for a loved one with bipolar disorder! Trust me, I’m bipolar…

During the extremes of our bipolarity, we are incapable of seeing things from your perspective. We are relentlessly inconsiderate of your feelings. It’s 10 steps up, 20 down with us. We’re exhausting. And the worst of it is: when we’re wrapped up in the chaotic irrational thinking that heralds our extreme mood states, believe me – you and your feelings don’t enter our minds for a nanosecond. Not when we’re so far removed from our own personalities. And what you don’t understand scares you. Sometimes, you’re frantically trying to protect us by predicting our thoughts (you’re not even close, Mystic Meg), tortured by premonitions of worst case scenarios that haven’t happened yet, and probably never will. You’ve been tippy-toeing on eggshells around us for soooo long in your own home, you now have a permanent limp and secretly fear you’re the crazy one. And by the way, if you think you’re “normal”, you could probably use some therapy yourself…

Whether we’ve retreated into our second womb (our bed) for days, or we’re bouncing off the ceiling, caring for a bipolar loved one during the extremes of bipolarity can be strenuous. If your own mental health is in jeopardy, it’s time to step back from the fire. Sacrificing yourself to support us is the last thing either of us need. While your support is invaluable to our recovery, we need YOU to be healthy and strong, not pretending to be healthy and strong, like a bad vaudeville actor. We’re bipolar, we’re not stupid.

So, how can you realistically help us without damaging yourself?

The first way you can help yourself is to research our disorder. It won’t make you an expert on what’s going on in our minds, but it will clarify that it’s not personal, it’s a mood disorder.

The second most important thing you can do for us (my own bipolar point of view, of course) is offer us endless hope and encouragement by believing in the hope and encouragement you proffer. With bipolar disorder, it’s a mathematical certainty that any abnormal psychology we’re experiencing will pass, so you can be utterly genuine in reminding us we won’t be feeling this way for ever, while retaining your own healthily detached perspective – and you can be absolutely certain that you are right. (Just don’t keep reminding us in a running commentary loop of I-told-you-so’s.)

If you’ve got the time and energy to do so without sacrificing your own needs, you can also help by keeping a track of our moods – how long they last and the symptoms. By doing this, you become a partner in our treatment, without becoming a nag. This is reassuring for both of us. We’ve all got our limits and your limits will be entirely different to your friend’s limits or another family member’s limits. Don’t think “Ooh, maybe I should be doing more?” Set healthy realistic personal boundaries based on your own limits. We want you to be healthy and well, so we have someone to turn to, even aspire to. Despite what we may say, we want you to support us, but not as malfunctioning robots.

We need you to encourage us to seek support and continue our treatment, even when we’re feeling miraculously “cured”. If it sounds too good to be true, then it is. Because when we’re psychotically euphoric about how amazing our life is, how well we are, and how enthusiastic we are about everything and everyone, the last place you are likely to find us is sat in a doctor’s surgery, waiting patiently for a check up, or a repeat prescription of meds. We need you to be our emotional compass. Preferably without pissing on our enthusiasm, because we’ll remember your sarcasm the next time we’re “GOING DOWN!!!” to depression. I’m a rapid cycler, so you may find it helpful to think of me as a high-speed elevator. Got the picture? Okay, good. But whether we’re elevators, or take the stairs, it’s the same old shit we experience over and over again.

NEVER wait to see if we get better. If we’re suicidal, or doing the loop da loopy, encourage us to see a doctor and get treatment straight away. It may just be our regular dysfunctional personality shining through, but if you’re concerned, don’t take risks. With severe bipolar depression and ‘mixed episodes’ (when we’re simultaneously manic and depressed), there is always a risk of suicide. Be as patient and as soothing as you can, without driving yourself to a nervous breakdown.

If you can’t afford to pay for your loved one to see an expensive psychiatrist, there are other free, hugely beneficial things you can do to help. You can find out the nearest bipolar support group in your area, drive your loved one there yourself, call the Samaritans, find your nearest bipolar charity. You can cook them a delicious meal full of naturally mood-stabilizing ingredients, suggest vitamins, and you can encourage us to get outdoors. We need Vitamin D. Even if we’re weeping and wailing, or lashing out verbally (if we’re being violent, call a healthcare specialist immediately), we’ll be humbled by your selfless support once our extreme mood state stabilizes. And they will stabilize. Having bipolar disorder does not mean constant yo-yoing from one end of the bipolar spectrum to the other. That really would be exhausting. We generally experience long periods of mood stability, where we’re more grounded than you are, between our extreme ups and downs. This is one of the main difficulties we face in achieving an accurate early diagnosis.

You’re not responsible for your loved one’s mood, but you can help us to help ourselves. Support groups are our chance to open up about our struggles, experiences and “enthusiasms” to a sympathetic bunch of people who have been there, done that, bought the T-shirt. Ok, they’re not clones of your loved one with identical personalities and experiences of bipolarity, but they still have a far greater chance of being able to offer constructive advice and support than you do. And even if your loved one’s not in some kind of therapy, the chances are they are. We also offer 121 peer mentoring, where we grab a coffee (ironically, since caffeine’s bad for us) once a month and speak on the phone. Family members of a loved one who is struggling with bipolar disorder are also invited to attend our monthly support group meetings. Together, we can help your loved one manage mood swings and offer any crisis support.

To summarize, dealing with our bipolar ups and downs can be hugely testing, traumatic, and extremely difficult when we’re experiencing extremities of mood. The important thing is not to do it all on your own. Encourage your loved one to take advantage of all the support he/ she can get their hands on without bankrupting yourself, or them. (There is a good chance we’ll have already bankrupted ourselves thanks to our irrational impulses to spend, spend, spend when manic.) Make sure you are kind to yourself; set responsible healthy boundaries based on your own limits, and encourage us to do the same. Don’t be our emotional crutch. Help us to help ourselves. You’re only as stressed as you allow yourself to get. Accept our illness for what it is and don’t confuse our character with our moods. It’s not personal, it’s an illness. Resist the temptation to denounce our enthusiasm, or tell us it’s not real, even when it isn’t. If you trample on our hopes, we will become hopeless. Encourage us to lead active, fulfilling lives, but don’t force us to smell the roses. (We’ll smell them when we’re ready to smell them – and not everybody enjoys the stink.)

When we’re coping, we’re coping: trust us to manage our moods without you. Don’t waste your time wondering what’s going on in our minds. Be mindful of your own mind. Be our encourager, not our jailer. The past is history. Yes, our illness, especially pre-diagnosis, is likely to mean we’ve behaved reprehensibly, shamefully, deeply hurtfully, perhaps unforgivably (that’s your choice to decide, not ours) at times. But the future is a mystery. If we’re already accepting treatment, don’t worry endlessly about things that haven’t happened yet and probably never will. It’s up to all of us individually to mend, build or burn bridges. The present as a gift.

You may not feel it deeply enough, but on behalf of myself and your bipolar loved one, WE ARE SO ETERNALLY GRATEFUL FOR ALL YOUR LOVE & SUPPORT!

Mania warning signs and symptoms:

Sleeping less
Inexplicable elevated mood (though if the person with bipolar disorder’s a natural optimist, this can be tricky)
Restlessness
Speaking rapidly (yackety-yak-yak-yak) and more loudly than usual
Increase in activity level
Behaving inappropriately and irrationally
Irritability or aggression
No appetite

Depression warning signs and symptoms: