Caring for Someone with Bipolar Disorder

Bipolar disorder happens to individuals, and once they receive a diagnosis nothing will ever be the same. It is not necessarily a lifetime sentence, but it is a reality that must be dealt with and overcome before a sense of normalcy can be restored.

But bipolar disorder doesn’t just affect the sufferer. It also affects family and friends, in particular partners, parents, children, siblings, or extended family members who share a household with the individual with the condition. No one’s life is ever the same, and if there is recovery it will mean a brighter day for everyone.

The encouraging news is that like bipolar sufferers themselves, loved ones are not helpless in the face of the disorder. Bipolar can be managed, and those closest to the bipolar sufferer can play a vital and constructive role in that ultimate victory.

The most common emotional state associated with bipolar disorder is depression, and just as a case of clinical depression can alter daily reality so, too, can bipolar depression turn sufferers’ lives upside down.

Ideally, treatment will help people with bipolar disorder reduce their depression symptoms to a manageable level. But even in the best of circumstances it can take a considerable amount of time—and a number of different bipolar medications—before the sufferer is finally able to get a handle on their bipolar depression. This can make things difficult on family members in the home, who hope for progress and can easily get discouraged if they don’t see it.

This type of frustration is understandable. But regardless of what stage of depression someone is experiencing, loved ones can make a positive impact on the healing process in a number of ways.

Here’s how family and friends can help:

1. Adopt an optimistic attitude. No happy talk or rah-rah speeches are needed. Loved ones can emphasize how good the odds of ultimate success are, as long as the individual with bipolar disorder follows their treatment regimen to the letter.
2. Support the bipolar sufferer’s efforts with positive affirmations. Praise and encouragement should be given regularly, in response to successful efforts and steady improvements.
3. Take what the depressed person says with a grain of salt. People with clinical depression often express feelings of hopelessness, fatalism, or despair. But this is only their bipolar disorder talking, and it doesn’t mean treatment or the family’s attempts to help are failing.
4. Urge their depressed loved one to do things that once brought them pleasure. Starting small, with simple activities that can bring moments of joy, will help bipolar depression sufferers reverse the trends that help reinforce their depression. Even if enjoyment is fleeting, taking baby steps toward wellness is still progress.
5. Set a daily routine that involves chores or tasks the depressed person must complete. Loss of motivation is easier to overcome if daily activities are at least partially scheduled, and the person has no choice but to get up and get things done.
6. Take threats of suicide seriously. Suicide risk is elevated for bipolar sufferers (up to 50 percent will attempt it) when they are trapped in deep depression. If they start talking about suicide they should be taken to see a mental health professional immediately, and other members of the family should be contacted to offer their support.

It is important to recognize that bipolar depression symptoms are not a sign of sadness or disappointment. They indicate the presence of a serious mental health condition that requires trained medical attention, plus plenty of unconditional love at home.

When individuals with bipolar develop the symptoms of mania, it may seem like a benign state. In some instances it can be, and sufferers exhibiting these signs of bipolar may be able to manage their lives without much assistance.

But it is dangerous to assume mania is harmless, because it often is not. Bipolar mania can be severe enough and hazardous enough to require hospitalization in some instances, and its symptoms should never be treated lightly.

Here are a few tips for family members and friends who are forced to deal with a bipolar disorder sufferer undergoing a manic episode:

1. Don’t leave them alone. Manic episodes have unpredictable outcomes, and those experiencing them should not be isolated.
2. Stay patient. The euphoria, rapid speech, and hyperactivity associated with manic states can be stressful to observe, since the person exhibiting these bipolar symptoms may seem out of control. But attacks of manic symptoms call for calm and patience on the part of family members and friends; that is the best way to keep the situation from escalating further.
3. Listen to what they say and be careful when responding. Bipolar sufferers tend to say whatever comes into their heads, and much of it may not make sense. In these circumstances it is best to just listen, and to not argue, criticize, or correct. In these instances, tolerance is constructive, while attempting to assert control is not.
4. If an individual with bipolar disorder is experiencing delusions or hallucinations, get help quickly. Psychotic symptoms are sometimes associated with bipolar mania, and when that happens it is necessary to seek medical attention immediately.
5. Don’t let them do anything risky or dangerous. Bipolar mania can lead to impulsive behavior, and that can put a bipolar sufferer at risk of injury. In this instance it is acceptable to assert control, since failing to do so can result in tragedy.

Manic episodes aren’t usually hazardous to a person’s health, but caution is still called for. Family members who have the slightest doubt about the health and welfare of a loved one showing the symptoms of bipolar mania should contact a mental health professional right away for advice on how to proceed.

Supervised treatment programs developed by mental health professionals can help bipolar sufferers escape the depression/mania cycle. Residential treatment centers offer concentrated therapy and other essential services, but bipolar sufferers will eventually return home to transition to outpatient care, and this is when family members have a vital role to play in the recovery process.

Here’s what family members caring for someone with bipolar disorder can do to help in treatment and recovery:

1. Speak to the patient’s doctors to learn more about the treatment program. Knowledge is power, and the more information family members have the easier it will be to provide guidance and support.
2. Monitor medicine consumption closely. Bipolar sufferers may be tempted to take too much bipolar medication, or they may not take it at all because they’re worried about the side effects. Loved ones should monitor drug consumption closely to make sure neither happens.
3. Attend family therapy sessions. This should begin during inpatient treatment and continue indefinitely during outpatient treatment and aftercare. If family members make it clear they are serious about helping the bipolar sufferer get better, their words and actions will have more effect.
4. Offer assistance with daily activities. Individuals suffering the disabling effects of bipolar depression may have trouble completing the simplest of tasks (going to the store, managing their money, making it to medical appointments, attending family events, etc.). Loved ones can contribute by helping them complete these duties, either by going with them or reminding them if they forget.
5. Be honest yet constructive in communications. Bipolar sufferers don’t need to be coddled, patronized, or shocked into wellness with “tough love.” Family members should be honest about the progress (or lack of progress) they see during recovery and give feedback to the individual with bipolar that includes meaningful insights and advice.
6. Create a calm, peaceful, and consistent home environment. Keep the music and the TV turned down, but the drapes open to let the sunlight in as much as possible. No one in the family should argue or otherwise air their “dirty laundry” in front of the person with bipolar disorder. The living environment should remain predictable and pleasant.
7. Help the bipolar sufferer keep accurate medical records. People with bipolar disorder are instructed to keep a daily diary of their bipolar disorder symptoms, treatment activities, setbacks, small victories, and general feelings about their lives, so they can make accurate progress reports to their doctors. Family members can contribute by discussing these issues and helping the bipolar disorder sufferer remember everything that happens.
8. Have weekly family meetings for those involved in providing care. These are perfect opportunities to discuss progress, suggest changes, express frustrations, and negotiate care schedules that work for everyone. These meetings should not be a secret, and from time to time the bipolar sufferer can be invited to offer their thoughts and make suggestions.
9. Have an emergency plan prepared. Every family member who lives or spends time with the bipolar sufferer should know who to call and how to proceed in case of an emergency (and how to classify what, exactly, constitutes an emergency). Mental health professionals should be consulted and included in the creation of this plan.

One of the most important things for loved ones caring for someone with bipolar disorder is to not get discouraged. They must realize that the path to recovery from bipolar disorder will have peaks and valleys; that is inevitable and unavoidable. Recovery from bipolar disorder is a long-term process, and daily ups and downs are to be expected and are no cause for panic, doubt, or alarm.

Caregivers living with someone with bipolar disorder can experience many highs and lows themselves, and it is important that they do what is necessary to protect their own mental health. They should never take on too much responsibility for too long, and if feelings of stress and anxiety are constant they should take some time away to rest and regain their bearings.

Spouses, children, parents, brothers, sisters, and others most deeply involved in caring for someone with bipolar disorder sufferers can often benefit from counseling and therapy. Attendance at bipolar family support groups is also highly recommended, and general mental health support groups can also be a source of relief and inspiration.

These groups are active in most communities, and mental health professionals or bipolar disorder websites can put family caregivers in touch with the people and organizations that sponsor them.