Bipolar disorder, previously known as manic depression, is a brain disorder that causes changes in mood, activity, energy, and daily functioning. Although nearly 6 million adults in the US have this disorder, like most other mental conditions, bipolar disorder is often misunderstood. In popular culture, people may consider someone “bipolar” if they exhibit mood swings. However, the criteria for a diagnosis of bipolar disorder are actually much broader. There are several types of bipolar disorder. While any type of bipolar disorder is serious, it can also be treated, usually through prescription medication and psychotherapy. If you think someone you know has bipolar disorder, read further on this article to find out how to help them.
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Method 1 of 3: Studying Bipolar Disorder
Step 1. Look for intense “mood swinging episodes.”
This term refers to a significant, even drastic, change in a person's general mood. In layman's parlance, people call it a “mood change”. Those with bipolar disorder change quickly in mood, or they may change episodes less frequently.
- There are two basic types of mood episodes: intensely excited, or "mania" episodes, and intensely depressed, or "depressive" episodes. Sufferers may also experience "mixed" episodes, in which symptoms of depression and mania occur at the same time.
- A person with bipolar disorder may experience periods of "normal" mood in between each other episode.
Step 2. Educate yourself about the different types of bipolar disorder
There are four standard types of bipolar disorder that are routinely diagnosed: Bipolar I, Bipolar II, Bipolar Disorder Not Otherwise Specified, and Cyclothymia. The type of bipolar disorder a person has is determined by its severity and duration, as well as how quickly the mood episodes cycle. A mental health professional must diagnose bipolar disorder; You can't do it yourself and you shouldn't try it.
- Bipolar I involves episodes of mixed or mania that last for at least seven days. The person experiencing it may also suffer from episodes of severe mania that require immediate medical attention. He may also have episodes of depression, which usually last for at least two weeks.
- Bipolar II involves milder episodes of mood swings. Hypomania is a milder state of mania, in which a person feels very “on”, extremely productive, and able to function well. If left untreated, this type of manic state can become severe. The depressive episodes in Bipolar II are usually milder than in Bipolar I.
- Bipolar Disorder Not Otherwise Specified (BP-NOS) is a diagnosis when symptoms of bipolar disorder are detected, but do not meet the diagnostic and statistical criteria for the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). These symptoms remain uncommon at a person's "normal" or baseline level.
- Cyclothymic disorder, or cyclothymia, is a mild type of bipolar disorder. His periods of hypomania would alternate with shorter and milder depression. This condition must persist for at least 2 years to meet the diagnostic criteria.
- A person with bipolar disorder may also experience "rapid cycling," which is when he or she goes through 4 or more mood episodes over a 12 month period. Rapid cycles seem to affect more women than men, and these cycles can come and go.
Step 3. Know how to recognize a manic episode
The way a manic episode manifests may vary from person to person. However, these episodes represent a more elevated or "excited" mood state than the person's "normal" or baseline emotional state. Some of the symptoms of mania include:
- Feelings of extreme pleasure, happiness, or excitement. A person experiencing a manic episode may feel so "excited" or happy that even bad news can't mess with his mood. This feeling of extreme happiness persists even if there is no clear cause.
- Excessive self-confidence, feelings of vulnerability, and experiencing delusions of greatness. A person with a manic episode may have a very high ego or a higher sense of self-worth than usual. He probably believed he could achieve more than he imagined, as if nothing could stop him. He may also imagine that he has a special connection to important figures or spiritual phenomena.
- Feelings of anger and irritation that increase suddenly. A person with a manic episode may jolt others, even without provocation. He may be more "sensitive" or irritable than his "regular" mood.
- Hyperactivity. Sufferers may try to do several projects at once, or schedule more things in a day even though it is not realistic. He may also choose to engage in various, seemingly useless activities, instead of sleeping or eating.
- Chat more often, talk stuttering, and think very fast. People who suffer from manic episodes often have difficulty expressing their thoughts, even though they are very talkative. He may quickly switch from one thought/activity to another.
- Feeling offended or uncomfortable. He may feel offended or unsettled. It's also easy to get distracted.
- Increased risk behavior. Sufferers may do things that are unusual and risky to themselves, such as having unsafe sex, shopping heavily, or gambling. Risky physical activities such as speeding or doing extreme sports/athletics – especially those that he is not ready for – are also possible.
- Decreased sleep habits. He may sleep very little, but claims to feel refreshed. He may also experience insomnia or feel the need to sleep.
Step 4. Know how to recognize a depressive episode
If a manic episode makes a person with bipolar feel as if he or she is “on top of the world,” a depressive episode is a feeling of being crushed at the feet of the world. The symptoms that appear may vary from person to person, but there are some general signs that you should pay attention to:
- Intense feelings of sadness or hopelessness. Just like feeling happy or excited in a manic episode, these feelings have no apparent cause. A person may feel worthless or hopeless, even if you try to comfort them.
- Anhedonia. It is a sophisticated term that indicates that a person is no longer interested in or enjoying the things he used to like. His sex drive may also decrease.
- Fatigue. People who suffer from major depression often feel tired all the time. He may also complain that he feels achy or sick.
- Disturbed sleep patterns. A person's "normal" sleep habits will be disturbed in several ways. Some of these sufferers will sleep too much, while others will sleep too little. To be sure, these people's sleep patterns are very different than the “normal/normal” for them.
- Changes in appetite. People with depression may experience weight gain or loss. They may eat too much or too little. This varies from person to person, and represents a change from what was "normal" for the person before.
- Difficulty concentrating. Depression can make it difficult for a person to focus or even make small decisions. He may feel almost paralyzed during a depressive episode.
- Suicidal thoughts or actions. Don't assume that all things suicide is done "to get attention". Suicide is a very real risk for people with bipolar disorder. Call 112 or other emergency services if your loved one expresses suicidal thoughts or thoughts.
Step 5. Read all material regarding bipolar disorder
You are already doing the right thing by reading this article as a first step. However, the more you know about bipolar disorder, the more you will be able to support loved ones. Here are some resources to consider (if you live in the US or speak English):
- The National Institute of Mental Health is a good place to start learning information about bipolar disorder, its symptoms and causes, treatment options available, and how to live with the disease.
- The Depression and Bipolar Support Alliance offers a variety of resources for people with bipolar disorder as well as other loved ones.
- Marya Hornbacher's memoir Madness: A Bipolar Life. This memoir talks about the author's lifelong struggle with bipolar disorder. Memoirs of Dr. Kay Redfield Jamison, An Unquiet Mind, discusses the author's life as a scientist suffering from bipolar disorder. While everyone's experience is different and unique to each of them, these two books can help you understand what your loved one is going through.
- Bipolar Disorder: A Guide for Patients and Families by Dr. Frank Mondimore can be a great resource for learning how to care for loved ones (and yourself).
- The Bipolar Disorder Survival Guide by Dr. David J. Miklowitz was designed to help people with bipolar disorder and their loved ones deal with this illness.
- The Depression Workbook: A Guide for Living with Depression and Manic Depression by Mary Ellen Copeland and Matthew McKay was written to help people with bipolar disorder maintain mood balance by using a variety of self-help exercises.
Step 6. Dispel some of the common myths about mental illness
Mental illness has generally been stigmatized as something that is “wrong” to a person. Mental illness may also be considered as “curable” if the sufferer “try seriously” or “think more positively”. However, in fact, these ideas are not true. Bipolar disorder is the result of a complex interplay of factors including genetics, brain structure, chemical imbalances in the body, and sociocultural stress. A person with bipolar disorder cannot simply “stop” experiencing it. However, this disorder can also be overcome with medical measures.
- Consider how you would talk to someone who has another disease, such as cancer. Would you ask him, “Have you ever tried to stop having cancer?”. Telling a person with bipolar disorder to “try harder” is not right.
- There is a common misconception that bipolar is a rare condition. In fact, about 6 million adults in the US suffer from some type of bipolar disorder. Even famous people like Stephen Fry, Carrie Fisher, and Jean-Claude Van Damme have been open about being diagnosed with bipolar disorder.
- Another common myth is that episodes of mania or depression are "normal," or even good. While all humans do have good and bad days, bipolar disorder causes mood swings that are much more extreme and damaging than the usual "mood swings," or on their "normal" days. All of these changes cause significant dysfunction in the sufferer's daily life.
- Another common mistake is to confuse schizophrenia with bipolar disorder. These two illnesses are not the same, although they share some of the symptoms (such as depression) in common. Bipolar disorder is unique in that it changes between episodes of intense mood. Meanwhile, schizophrenia generally causes symptoms such as hallucinations, delusions, and disorganized speech. All of these things do not usually appear in people with bipolar disorder.
- Many people believe that people with bipolar disorder or depression are dangerous to their fellow human beings. The news media is primarily responsible for promoting this bad idea. In fact, research shows that people with bipolar disorder do not engage in a higher number of violent acts than those who are healthy. However, they are more likely to consider or attempt suicide.
Method 2 of 3: Talking to Loved Ones
Step 1. Avoid hurtful language
Some people may say they are "a little bipolar" or "schizo" when joking about describing themselves. In addition to being inaccurate, this type of language demeans people who do have bipolar disorder. Be respectful when discussing mental illness.
- You have to remember that what people are is much more important than the disease they have. Don't use definite phrases like, "I think you have bipolar." Instead of saying something like that, say something like, "I think you might have bipolar disorder."
- Defining a person “as” the disease he suffers from will reduce one element of himself. This action then promotes the stigma that often surrounds mental illness, even if you don't mean it that way.
- Trying to calm the other person down by saying "I'm a bit bipolar too" or "I know how you feel" is more likely to cause problems than benefits. These things may make him feel as though you are not taking his illness seriously.
Step 2. Discuss your concerns with loved ones
You may worry about talking to a loved one because you don't want to upset them. However, it is actually very useful and important. Talk to him about your concerns. Avoiding talking about mental illness promotes stigma and supports sufferers to incorrectly believe that they are “bad” or “worthless” or should feel ashamed of their illness. When approaching loved ones, be open and honest. Show affection.
- Reassure the patient that he is not alone. Let him know that you will be there to support him and want to help as much as possible.
- Realize that the illness your loved one is suffering from is real. Trying to suppress her symptoms isn't going to help her feel better. Instead of trying to tell him that his illness is “no big deal”, admit that the condition is serious but treatable. For example: “I know you have a real illness. This disease makes you feel and do things that are not normal. We can find help together.”
- Express your love and acceptance to him. Especially in a depressive episode, he may believe that he is worthless or completely broken. Counter these negative beliefs by expressing your love and acceptance of him. For example: “I love you, and you are important to me. I care about you, that's why I want to help.”
Step 3. Use “I” statements to express feelings
When talking to other people, you should appear not to be offensive or judgmental. People suffering from mental illness may feel the world is against them. Therefore, show that you are there to provide support.
- For example, say things like, “I care about you and am worried about some of the things I realize about you.”
- There are some statements that sound defensive. Avoid these statements. For example, avoid saying things like “I was just trying to help” or “Listen to me first.”
Step 4. Avoid threats and blame
You may be concerned about the health of a loved one, and want to make sure they are helped “in every way”. However, never exaggerate anything, use threats, take advantage of feelings of guilt, or make accusations to convince them to seek help. All of this will only lead people to believe that you are aware that something is “wrong” with them.
- Avoid statements like “You worry me” or “You are behaving strangely.” These statements sound accusatory and may cause the sufferer to shut down.
- Statements that try to take advantage of the sufferer's guilt will also be of no use. For example, don't try to use your relationship with him to get him to seek help, by saying something like, "If you really loved me, you would seek help" or "Think about what you did to our family." People with bipolar disorder often struggle to cope with feelings of shame and worthlessness. Statements like this will only make their feelings worse.
- Avoid threats. You can't force other people to do what you want. Saying things like, "If you don't seek help, I'll leave" or "I won't pay your car payments again if you don't seek help" will only make the sufferer more stressed. Then, this stress can trigger episodes of bad mood.
Step 5. Package your discussion as a health concern
Some people may be reluctant to admit that they have a problem. When a person with bipolar disorder goes through a manic episode, he or she often feels so “excited” that he or she will not easily admit that there is a problem. When he has a depressive episode, he may feel as if he has a problem but has no hope of being treated. You can package your concern as a medical alert. This can help.
- For example, you could convey the thought that bipolar disorder is a disease, such as diabetes or cancer. Just as you would support another person to seek treatment for his cancer, make sure he does the same for this disorder.
- If the sufferer is still reluctant to admit that he or she has a problem, consider suggesting a visit to the doctor to get checked for a symptom that you are aware of, rather than "a disorder." For example, you may find that suggesting that someone else see a doctor for insomnia or fatigue can be helpful in persuading him to seek help.
Step 6. Encourage the sufferer to express his feelings and share his experience with you
You may subconsciously change a conversation to express concern as a lecture session with a loved one. To avoid this, invite him to express his thoughts and feelings. Remember: while you may be affected by the distraction, it's not you that matters here.
- For example, after you share your concerns with him, say something like, "Would you like to share your thoughts right now?" or “After hearing what I have to say, what do you think?”
- Don't assume you know how he feels. You may be able to simply say something like "I know how you feel" to reassure him, however, this can actually make him feel slighted. Instead of saying something like that, say something that acknowledges the sufferer's feelings without claiming them to be your own: "I now know why it made you feel sad."
- If your loved one rejects the idea of admitting they have a problem, don't argue with them. You can encourage him to seek treatment, but you can't force him to.
Step 7. Don't dismiss your loved one's thoughts and feelings as "unreal" or unnecessary
Even if feelings of worthlessness are caused by a depressive episode, they will be very real to the person experiencing it. Dismissing someone's feelings outright will make him or her not want to talk to you later. Instead of belittling, acknowledge the person's feelings and challenge them to overcome their negative ideas at the same time.
For example, if he's expressing the idea that no one loves him and he's a “bad” person, say something like: “I know you feel that way, and I'm sorry for that. I want you to know that I love you. I think you are friendly and caring.”
Step 8. Encourage your loved ones to take the screening test
Mania and depression are the hallmarks of bipolar disorder. The Depression and Bipolar Support Alliance website offers secret online screening tests to detect states of mania and depression.
Taking a secret test in a private situation at home may be a more stress-free way for a person to understand their treatment needs
Step 9. Emphasize the need for professional help
Bipolar disorder is a very serious illness. If left untreated, even mild forms of this disorder can get worse. Encourage your loved ones to seek treatment immediately.
- Visiting a GP is usually an important first step. Doctors can determine whether a person should be referred to a psychiatrist or other mental health professional.
- Mental health professionals will usually offer psychotherapy as part of their treatment plan. There are many different types of mental health professionals who offer therapy, including psychiatrists, psychologists, psychiatric nurses, licensed clinical social workers, and certified professional counselors. Ask your doctor or hospital to suggest parties in your area.
- If medication is needed, you may need to take your loved one to see a doctor, psychiatrist, psychologist, or licensed psychiatric nurse for a prescription. LCSW and LPC can offer therapy but cannot prescribe medication.
Method 3 of 3: Supporting Your Loved One
Step 1. Understand that bipolar disorder is a lifelong illness
The combination of medication and therapy can be very beneficial for your loved one. With treatment, many people with bipolar disorder experience significant improvements in their function and mood. However, there is really no "cure" for bipolar disorder, and symptoms can reappear throughout a person's life. Be patient with the people you love.
Step 2. Ask how you can help
Especially during a depressive episode, the world may feel overwhelming for someone with bipolar disorder. Ask sufferers what will be of benefit to them. You can even offer specific suggestions if you can guess what affected him the most.
- For example, you might say something like, “You seem to be under a lot of stress lately. Do you want me to help take care of your kids and give you some 'self time'?"
- If someone has major depression, offer a pleasant distraction. Don't treat him as someone who is fragile and unapproachable just because of his illness. If you're aware that he's struggling with symptoms of depression (mentioned elsewhere in this article), don't make a big deal out of it. Just say something like, “You seem to be feeling down this week. Would you like to go to the cinema with me?”
Step 3. Watch for symptoms
Paying attention to the symptoms your loved one is experiencing can help within a few days. First of all, it can help you learn the warning signs of a certain mood episode. This fact can even provide useful information for doctors or mental health professionals. You can also more easily learn about potential triggers for a depressive or manic episode.
- Warning signs of mania include: sleeping less, feeling "excited" or interested, being more easily distracted, unable to rest, and increased activity levels.
- Warning signs of depression include: tiredness, disturbed sleep patterns (sleeping longer or shorter), difficulty focusing or concentrating, lack of interest in things you normally enjoy, social withdrawal, and changes in appetite.
- The Depression and Bipolar Support Alliance has a personal calendar for recording symptoms. This calendar may be useful to you and your loved ones.
- Some common triggers of mood episodes include stress, drug abuse, and sleep disturbances.
Step 4. Ask if your loved one has taken medication
Some people may find it helpful to be gently reminded, especially if they are having a manic episode that makes them forgetful or restless. A person may also believe that he or she is feeling better and so can stop taking the drug. Help him to keep taking the necessary action, but don't sound judgmental.
- For example, a subtle statement like, "Have you taken your medicine today?" is a nice thing to say.
- If your loved one replies that he's feeling better, you might want to remind him of the benefits of medicine: “I'm glad to hear that you're feeling better. I think it's partly because your treatment worked. You'd better not stop taking it then, correct?"
- Treatment may take a few weeks for it to take effect, so be patient if your loved one's symptoms don't seem to be improving.
Step 5. Encourage the patient to stay healthy
In addition to taking regular prescription medications and seeing a therapist, staying physically fit can also help reduce symptoms of bipolar disorder. People with bipolar disorder are at higher risk for obesity. Encourage your loved ones to eat right, exercise regularly in moderation, and maintain a good sleep schedule.
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People with bipolar disorder often report unhealthy eating habits, including not eating regular meals or eating unhealthy foods. Encourage your loved ones to eat a diet of fresh vegetables and fruits, complex carbohydrates such as nuts and whole grains, and low-fat meats and fish.
- Taking omega 3 fatty acids can help relieve bipolar symptoms. Some studies show that omega 3s, especially those found in cold-water fish, can help reduce depression. Fish such as salmon and tuna, as well as vegetarian foods such as walnuts and flaxseed, are good sources of omega-3s.
- Encourage your loved ones to avoid excess caffeine. Caffeine may trigger unwanted symptoms in people with bipolar disorder.
- Encourage loved ones to avoid alcohol. People with bipolar disorder are five times more likely to abuse alcohol and other substances than those without the disorder. Alcohol is a depressant and can trigger major depressive episodes. Alcohol can also interfere with the effects of some types of prescription medications.
- Regular moderate exercise, especially aerobics, can help improve mood and general function in people with bipolar disorder. You should encourage your loved ones to exercise regularly; People with bipolar disorder often report that they are not used to exercising well.
Step 6. Take care of yourself too
Friends and family members with bipolar disorder should ensure that they are also taking care of themselves. You cannot provide support when you are tired or stressed.
- Studies even show that when your loved one is stressed, people with bipolar disorder may find it much more difficult to follow a treatment plan. Taking care of yourself directly can also help.
- Social support groups can also help you learn to adjust to a loved one's illness. The Depression and Bipolar Support Alliance offers online support groups as well as local support groups. The National Alliance on Mental Illness also has programs that can help.
- Make sure that you get enough sleep, eat well, and exercise regularly. Maintaining these healthy habits can also support your loved ones to stay healthy.
- Take action to reduce stress. Know your limits and ask others for help when needed. Some activities such as meditation or yoga are useful for reducing feelings of anxiety.
Step 7. Watch for suicidal actions or thoughts
Suicide is a very real risk for people with bipolar disorder. They are more likely to consider or attempt suicide than people who have major depression. If your loved one is showing signs of suicidal ideation, even casually, seek help immediately. Don't promise to keep his thoughts or actions secret.
- If someone is in immediate danger, call 112 or emergency services.
- Advise loved ones to call mental health services at 500-454.
- Reassure your loved one that you love them and believe that their life has meaning, even if it doesn't seem that way to that person right now.
- Don't tell your loved one not to feel a certain feeling. All the feelings he felt were real, and he couldn't change them. Instead of acting like this, focus on actions that he can control. For example: “I know this is difficult for you, and I'm glad you talked to me about it. Continue. I will listen to you.”
Tips
- Just like any other mental illness, bipolar disorder is nobody's fault. This annoyance is not the fault of your loved ones, or yourself. Be friendly and loving towards him and yourself.
- Don't just focus on the disease. You may easily get caught up in treating the sufferer like a child, or focusing solely on the illness. Remember, it is more than the disease. He has hobbies, passions and feelings. Have fun and support him in his life.
Warning
- People with bipolar disorder are at high risk of committing suicide. If a friend or family member has this condition and starts talking about suicide, take them seriously and make sure they get psychiatric treatment right away.
- If possible, try to contact a health professional or mental health service before involving the police. There have been several incidents involving police intervention and ending in the trauma or death of people suffering from mental crises. If you can, involve someone you believe has experience and has had training to deal with a specific mental health or psychiatric crisis.
