Caring for someone with bipolar disorder can be very hard, whether you’re a partner, parent, child, or friend of someone who has this condition. It’s stressful for everyone it touches.
It’s tough to strike a balance. You want to be supportive and empathetic, because you know the person with bipolar disorder isn’t to blame for their illness. But their behavior may affect you, and you have to take care of yourself and your needs, not just theirs.
Very often in bipolar disorder, people with hypomania may not realize it's a problem. They may even enjoy it, finding it to be a productive time. Or they may fear that taking medicine will make them depressed and they'll miss feeling good. Others struggle with depression, not getting the help that could relieve their suffering.
Although there's no easy solution, these tips may help.
Learn. Read information from reputable websites, books, and articles that explain the condition. The more you know, the better.
Listen. Pay attention to what your loved one has to say. Don't assume that you know what they are going through. Don’t dismiss all of their emotions and feelings as signs of their illness. Someone with bipolar disorder may still have valid points.
Notice their symptoms. They may not be able to see it as clearly as you do when their bipolar symptoms are active. Or they may deny it. When you see the warning signs of mania or depression, you can try to make sure they get help ASAP.
Do things together. People who are depressed often pull away from others. So encourage your friend or loved one to get out and do things they enjoy. Ask them to join you for a walk or a dinner out. If they say no, let it go. Ask again a few days later.
Make a plan. Because bipolar disorder can often be an unpredictable illness, you should plan for bad times. Be clear. Agree with your loved one about what to do if their symptoms get worse. Have a plan for emergencies. If you both know what to do and what to expect of each other, you'll feel more confident about the future.
Stick to a schedule. If you live with someone who has bipolar disorder, encourage them to stick to a schedule for sleep and other daily activities. Some research shows that it’s helpful to have a regular routine. The person will still need medicine and counseling, but look for everyday things, like exercise and a healthy diet, that supports their overall health.
Express your own concerns. Since your loved one's behavior can have a huge effect on you, it’s OK to discuss. Don’t blame the other person or list all of their mistakes. Instead, focus on how their actions make you feel and how they affect you. Since this can be really hard to do, you might find it easiest to talk about it together with a therapist.
Take care of yourself. As intense as your loved one’s needs may be, you count, too. It’s important for you to stay healthy emotionally and physically.
Do things that you enjoy. Stay involved with other people you’re close to -- social support and those relationships mean a lot. Think about seeing a therapist on your own or joining a support group for other people who are close to someone who has bipolar disorder.
Getting Someone to Seek Help for Bipolar Disorder
For a variety of reasons, people with bipolar disorder won't go to a doctor for help. They shrug off a friend or family member's concern. Others view their illness as a distraction or a weakness, and they don't want to give in to it. Still others put their health at a very low priority compared with other things in their lives.
Often, fear is the reason for not seeing a doctor. That's especially true if there is a family history of emotional problems. People in denial are protected from their worst fears. They can stay comfortable in their everyday routines -- even though relationships and careers can be at stake.
If you're concerned about a loved one who could have bipolar disorder, talk to them about seeing a doctor. Sometimes, simply suggesting a health checkup is the best approach. With other people, it works best to be direct about your concern regarding a mood disorder. Include these points in the discussion:
- It's not your fault. You have not caused this disorder. Genetics and stressful life events put people at greater vulnerability for bipolar disorder.
- Millions of Americans have bipolar disorder. It can develop at any point in a person's life -- though it usually develops in young adulthood -- and is responsible for enormous suffering.
- Bipolar disorder is a real disease. Just like heart disease or diabetes, it requires medical treatment.
- There's a medical explanation for bipolar disorder. Disruptions in brain chemistry and nerve cell pathways are involved. The brain circuits -- those that control emotion -- are not working the way they should. Because of this, people experience certain moods and energy levels more intensely, for longer periods of time, and more frequently.
- Good treatments are available. These treatments have been tested and found to be effective for many, many people with bipolar disorder. Medications can help stabilize your moods. Through therapy, you can discuss feelings, thoughts, and behaviors that cause problems in your social and work life. You can learn how to master these so you can function better and live a more satisfying life.
- By not getting treatment, you risk having worse mood episodes -- and even becoming suicidal when depressed. You risk damaging your relationships with friends and family. You could put your job at risk. And your long-term physical health can also be affected, since emotional disturbances affect other systems in the body. This is very serious.
Trust is crucial in shaking someone's denial and in motivating them to get help. Trust is also important once treatment for bipolar disorder starts. Through the eyes of a trustworthy friend or family member, a person with bipolar disorder can know when treatment is working -- when things are getting better, and when they're not. If your interest is sincere, you can be of great help to your friend or family member.
How to Help Someone Stay on Their Bipolar Medication
Just like someone with type 1 diabetes will always need insulin, a person with bipolar disorder will likely need to take medication for their whole life. Research shows that many of those who stop often find their symptoms return within a year.
As important as it is, people often don't stay the course with their medication. There are some common reasons why someone might skip doses or stop taking drugs. If you have a friend or family member with bipolar disorder, you can help them stick with it. And knowing the reason the person quits using the medicine can help.
Make sure you tell them that you care about them, that you believe medication is key to their being well, and that you'll be there to support and help them along the way.
The reason: The drugs don't seem to be working.
Encourage patience. Many medications can take up to 8 weeks to kick in. So it's not unusual to think they're not working at first. Sometimes, they and their doctor may need to experiment for months or even years before settling on the right drugs and doses. Reassure them that most people are eventually glad they stuck with the process because they end up feeling a lot better.
The reason: They just forget.
If your friend or loved one frequently misses doses because they're "too busy" or "just forgot," encourage them to find a way to make it part of their daily routine. Taking pills at the same time every day, such as before bed or with breakfast, can help. So may downloading a pill reminder app or using a pill box organizer. Ask if you can remind them with a phone call or text message. Offer to pick up their refills from the pharmacy.
The reason: They hate the side effects.
Encourage them to tell their doctor. Adjusting the dose or changing when they take it may help ease side effects. Their doctor might also have suggestions on how to deal with the side effects so they're less of an issue. If that doesn't work, their doctor may change their medication.
The reason: They just refuse.
There could be a number of reasons someone refuses to take a medicine. They might have a concern they're not willing to talk about. Or they may not want to accept that they have a mental illness or that they need medicine.
If your loved one is taking medication but talking about stopping, urge them to discuss it with their doctor. Warn them of the dangers of stopping abruptly. Their symptoms could become more severe, and they might have unpleasant side effects.
If your loved one isn't taking their medication, try to get a handle on their current state of mind. A person who seems relatively stable might be OK without medication for a while. But try to get them to agree to seek treatment if their condition gets worse. They might be willing to discuss the downsides of stopping medication and what's at stake.
Sometimes, a person who is manic or severely depressed may still refuse treatment. You may need to take matters into your own hands and contact their doctor. Your loved one might need to be hospitalized. While this can be a hard step to take, it may serve as a wake-up call that makes them understand how serious their condition is.