Ongoing treatment -- both psychotherapy and medication -- is essential to
controlling the mood swings of bipolar disorder. How can family members help
their loved one stick with treatment?
"Learn as much as you can about the disease," says Kay Redfield
Jamison, PhD, professor of psychiatry at John Hopkins University School of
Medicine and author of An Unquiet Mind. "Read and read some more.
Join support groups. You'll get emotional support and information you
Mixed episodes in bipolar disorder are a form of mental illness. In most forms of bipolar disorder, moods alternate between elevated and depressed over time. A person with mixed episodes experiences both mood "poles" -- mania and depression -- simultaneously or in rapid sequence. Technically, mixed episodes are described only in people with bipolar I disorder (not bipolar II disorder), although this distinction is expected to change as the psychiatric diagnostic classification system is currently...
Also, learn to watch for early signs of mania, especially insomnia.
"Sleep deprivation is the easiest way for someone to become manic,"
Jamison tells WebMD. "Families and friends need to keep on top of that. If
a patient is having sleep problems, get treatment for it."
The Depression and Bipolar Support Alliance offers these suggestions to
families and friends, to help a loved one with bipolar disorder stay with
Find the right doctor. Help them find a psychiatrist and other health
providers who take time to listen closely. Encourage second opinions, if you
feel it's necessary. Help by making appointments.
Make doctor appointments stress-free. Put together a list of
questions to ask the doctor. Offer to go along to appointments. Get to know the
doctors, nurses, and other practitioners involved in
Learn about bipolar disorder drugs. You should know about dosages,
possible side effects, and what to do.
Relieve fears. Explain the role of medications -- that they greatly
relieve symptoms without altering personality.
Gently remind. Little "medication reminders" can help ensure
sticking with the prescribed treatment plan. Ask for permission to make these
Chart progress and problems. Help in keeping records of symptoms,
treatment, and setbacks. A journal or calendar works well for this.
Relieve daily stress. Establish a daily routine that your bipolar
loved one can easily handle. Help with everyday chores, like running errands.
Identify triggers that make symptoms worse.
Use words of support. These will help: "I'm here for you."
"You can get through this." "Don't give up." "Your brain is
lying to you right now; it's part of the illness."
Encourage positive self-talk. Here's one example: "My life is
valuable and worthwhile, even if it doesn't feel that way right now."
Write down "reality checks." These words can help your loved
one through a tough time. An example: "I should not make major life
decisions when my thoughts are racing and I'm feeling on top of the world. I
need time to discuss these things with others before going through with
Prepare for crisis. If depressive or manic symptoms become severe,
your bipolar friend of family member must promise to call you, another trusted
person, a doctor, crisis line, or hospital. Ask that they make that promise to
Write a crisis plan. List symptoms of mania, depression, and suicide
risk -- and what to do. List helpful phone numbers, including health care
providers, family members, friends, and a suicide prevention crisis line: (800)
273-TALK. Give copies to trusted friends and family members.
Call the doctor about mood changes. A simple change in treatment
could prevent a full-blown episode. It's best to call the doctor immediately
when symptoms of depression or mania begin to appear.
Stay positive about bipolar disorder treatment. Medications and
psychotherapy do work. Most people with bipolar disorder can return to stable,
productive lives. Keep working to find the treatment that works best -- and
provide the support your loved one needs to get there.