When Your Loved One Has Bipolar Disorder

If you have a loved one with bipolar disorder, you know that it can be a challenging condition. Those with bipolar disorder, formerly called manic depression, can experience extreme mood fluctuations, from periods of highly elevated highs, known as mania or hypomania episodes, to emotional lows, known as depressive episodes. 

Bipolar disorder can be very disabling. It involves recurrent and sometimes extreme mood disruptions that may undermine your loved one’s ability to carry out day-to-day tasks, maintain relationships, and make sound judgments. Fortunately, there are things that you can do to support your loved one and yourself.

Understand the Condition

Unfortunately, there are many common myths about bipolar disorder that can lead to people dismissing someone’s diagnosis or having misconceptions about what symptoms or causes of bipolar disorder are. This can be very challenging for those with bipolar disorder.

Understanding your loved one’s diagnosis is one of the ways you can support your loved one. The more you know about the condition, the easier it will be for you to identify periods when their symptoms become more severe. You may be better able to deal with the resulting behaviors.

Types of Bipolar Disorder

There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia:

• Bipolar I: This is defined by manic episodes that last at least seven days or by manic symptoms that are so severe that immediate hospital care may be needed. Your loved one may also experience periods of depression. 
• Bipolar II: This is defined by a pattern of hypomanic episodes and depressive episodes. Those with bipolar II do not experience the severity of manic episodes experienced by those with bipolar I. 
• Cyclothymia: This is a relatively rare condition that is defined by periods of hypomanic symptoms alternating with periods of depressive symptoms that last for at least two years in adults and one year in children and adolescents. However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a major depressive episode. 

You can find out more about your loved one's diagnosis through websites, books, and articles published by reputable sources.

Be Alert to Their Symptoms

Make sure you are aware of the symptoms that your child and/or loved one may experience and pay attention to their moods. Being alert to any major changes and understanding what may trigger their symptoms will help you support them when they are going through periods where these symptoms are more severe. 

Manic and Hypomanic Episodes

Manic and hypomanic episodes share largely the same symptoms. However, hypomanic episodes are less severe than manic episodes. During periods of mania, your loved one may:

• Feel very “up,” “high,” elated, or irritable or touchy
• Feel “jumpy” or "wired”
• Have a decreased need for sleep
• Have a loss of appetite
• Talk very fast about a lot of different things
• Feel like their thoughts are racing
• Think they can do a lot of things at once
• Do risky things that show poor judgment
• Feel like they are unusually important, talented, or powerful

If your loved one experiences hypomania, they may be able to get on with day-to-day tasks as their symptoms are not as severe as those who experience mania. You may be more able to spot the changes in their mood than they are.

Even though their symptoms may sometimes not seem so severe, those with hypomania can develop severe mania or depression without proper treatment.

Depressive Episodes

Depressive episodes are characterized by periods where your loved one will feel down, sad, indifferent, or hopeless. During these periods, they may also:

• Feel slowed down or restless
• Have trouble falling asleep, wake up too early, or sleep too much
• Experience decreased appetite and weight loss or increased appetite and weight gain
• Talk very slowly, feel like they have nothing to say, forget a lot
• Have trouble concentrating or making decisions
• Feel unable to do even simple things
• Have little interest in almost all activities, a decreased or absent sex drive, or an inability to experience pleasure, called anhedonia
• Feel hopeless or worthless, think about death or suicide

Children and Teenagers

Be aware that children and teenagers may experience different symptoms from those experienced by adults. For example, during a manic period, your child may show intense or inappropriate happiness or silliness for long periods of time. During depressive periods they may complain a lot about pain, such as stomach aches and headaches.

Make a Plan

Even if you are aware of changes in moods and symptoms, it is a good idea to plan for the times when your loved one's symptoms are severe. Involve them in this planning and speak to them about what to do when they experience a worsening of their symptoms.

Having a plan can help both of you feel less anxious about the future and what might happen if their symptoms are severe.

Do Not Take It Personally

Due to bipolar disorder, your loved one may behave in ways that are unexpected or even hurtful. Remember that it is a biological illness and that your loved one cannot control their symptoms. 

Try not to take the individual's behavior personally, even if you do find their behavior challenging. You can help your loved one by supporting them to see they have the ability to cope with and manage their symptoms.

Listen and Communicate

One important way you can support your loved is through listening to them. This shows them that they can talk to you about the challenges that they are dealing with. You don't need to give them solutions to their issues. You just need to listen openly and express your support.

Doing this will also help you understand how they are experiencing their symptoms and will help you to understand other concerns, feelings, or emotions that they might have.

Likewise, communicating openly and honestly with your loved one is important. It is vital to show them that you understand that their illness is causing their symptoms and that you do not blame them for this behavior.

Support Them to Stay in Treatment

Bipolar disorder requires long-term management and appropriate treatment options vary from person to person depending on the severity of the symptoms. Sticking with the treatment plan will increase the chance of a successful recovery. 

Treatment is usually a combination of psychotherapy and prescription medication. If your loved one has severe and persistent manic or depressive episodes it may involve procedures such as electroconvulsive therapy (ECT). As each person will experience different symptoms, your loved one will need a plan created to suit them. 

There may be periods where your loved one may want to stop going to therapy or taking their medication. This may be for lots of reasons, such as due to side effects or because they no longer feel they need their medication. Remind your loved one that they need to continue taking their medication and how important and helpful it is. 

If your loved one is struggling with side effects then encourage them to talk to their healthcare provider. Their practitioner may suggest other medications, alter their dose, or help them manage their side effects.

Treatment for Other Conditions

If your loved one has been diagnosed with bipolar disorder, they may also have another mental health disorder or condition as well. 

It is common for those with bipolar disorder also to have an anxiety disorder and/or attention deficit hyperactivity disorder (ADHD). In some cases, those with bipolar disorder also have an eating disorder, such as binge eating or bulimia. 

Your loved one may also have a substance use disorder, involving the misuse of alcohol or drugs. Substance use disorders can negatively impact their recovery and have been linked to an increased risk of suicide and trauma. Some substances, such as stimulants, can also trigger a worsening of your loved one’s symptoms.

It is important to support your loved one to get and stay in treatment for all other conditions they experience. This will increase the chance of successful recovery.

Take Care of Yourself

Caring for your loved one, including coping with their moods, can be stressful and can challenge any caregiver. Looking after yourself mentally and physically is important, not only for your own well-being but also because it will allow you to give your loved one the best support you can.

Find Support

As well as friends and family, you can also find support through professionals, such as your healthcare provider or a therapist, as well as support groups. One of the aims of therapy is to help you develop positive coping strategies. This will have a positive effect on both yourself and your loved one. 

Having support may be especially important during periods where your loved one is experiencing episodes of mania or depression as your levels of stress may be higher during this period. 

Family Therapy

You may also want to consider approaches such as family-focused therapy (FFT). This type of therapy has been associated with faster recovery and reduced episodes for the person with bipolar disorder.

FFT has been shown to improve positive and decrease negative family communication. It has also been linked with a greater decrease in conflict behaviors, such as being critical and irritable, than for families that go through brief psychoeducation.

Self-Care

Self-care strategies can help your health and well-being and can also help reduce stress and fatigue.

Strategies include:

• Eat a healthy diet
• Exercise regularly
• Get enough sleep
• Effectively deal with minor illnesses and conditions

A Word From Verywell

There may be times when you find it challenging to support your loved one. Remember that bipolar disorder is a biological disorder and your loved one cannot control their symptoms. Likewise, you have not caused them.

Supporting your loved one also involves taking care of yourself. It is not uncommon to feel stressed and worried when your loved one has bipolar disorder. Make sure you get the help and support that you need.

Remember that by finding positive coping strategies yourself, you can help both you and your loved one manage this lifelong condition's symptoms.

If you or a loved one needs help with bipolar disorder or the associated signs and symptoms, contact the SAMHSA National Hotline for treatment and support group referrals at 1-800-662-HELP (4357).