Supporting someone with bipolar

It can be tough to see someone you care about dealing with bipolar disorder. But you can help them in many ways and still take good care of yourself. 

Be transparent about bipolar disorder

Being open to talking and listening to someone’s experiences can make them feel supported and accepted. You could try to:

• Focus on listening instead of offering advice.
• Make it clear you’re keen to understand their situation rather than attempting to resolve their problems for them.
• Pose open-ended questions to gain a deeper insight into their feelings. For instance, ‘what’s it like to live with bipolar disorder?’ or ‘what do you need me to grasp about it?’
• Avoid belittling their experiences. Saying things such as ‘everyone faces difficult times’ might lead them to believe you do not grasp the severity of their struggles. ​

Understand their signs and triggers

Many individuals have certain warning signs indicating an impending mood episode. Additionally, triggers like stress can often precipitate such episodes. You could attempt to:

• Inform them if you’ve observed behaviours that typically precede an episode. For instance, you might mention, ‘I’ve noticed you’ve been getting less sleep, and I’m concerned it may be a sign you’re heading into an episode’.
• Identify their triggers and figure out ways you can assist in either avoiding or handling them.
• Discuss with them their warning signs to understand what these might be.

Prepare for challenging moments 

When they’re feeling well, it’s a good idea to talk about the support you can provide during a mood episode. This can make both of you feel more secure and in control.

You might consider actions like:

• Assisting with their finances when they’re unwell, should they wish for your help.
• Establishing code words or signals for when they’re finding things tough. For instance, you could agree on specific words or symbols to represent different emotions, offering them a swift way to signal for help when they’re unable to articulate their feelings.
• Providing a second opinion on their projects or commitments to help them assess if they’re overextending themselves.
• Creating a crisis plan together. For suggestions on what to include, you might refer to guidance on planning for a potential crisis.
• Supporting them in maintaining a routine, including consistent meal times and sleep schedules.
• Keeping track of what has or hasn’t helped in the past, perhaps by jotting notes in a diary, on your phone, or making voice recordings.

It’s also useful to discuss how they’d like to be treated as they recover from a period of illness. Try to respect their preferences regarding how much they wish to discuss the events that occurred while they were unwell.

Address difficult behaviours in discussion

Talking about behaviours you find challenging can be hard when supporting someone with their mental health. There may be times when it feels overwhelming, frustrating, or even scary.

If the person you’re supporting experiences hallucinations, such as hearing or seeing things that aren’t there for you, they might react with anger, annoyance, or confusion if you don’t agree with what they’re experiencing. Remember, what they’re experiencing feels very real to them at that moment. If this occurs:

• Try to remain calm.
• Offer to help them with breathing exercises or relaxation techniques if they’re willing.
• Support them by acknowledging their feelings, without necessarily agreeing with or disputing what they believe is happening. Let them know you understand their experience feels very real to them, even though you might not share the same perspective.

In the midst of a manic episode, they might behave in ways that seem embarrassing, odd, or distressing to you. In such cases, consider:

• Discussing your feelings calmly with them when they’re in a better state.
• Being specific about how certain actions have affected you, rather than making broad comments about their behaviour.
• Avoiding judgement or criticism, and letting go of hurtful comments made during their illness, particularly if they have apologised or said they didn’t mean them.

For further information, you might look into resources on psychotic experiences and supporting someone experiencing psychosis.

During a depressive episode, the person might withdraw and stop responding to attempts at communication, which can be tough to deal with. You might feel worried or feel as though they’re rejecting you. To manage this:

• Try not to take their actions personally.
• Continue to reach out, even if they don’t reply.
• Send brief messages that don’t require much effort to respond to.

When they’re feeling better, it could be useful to talk about strategies for handling similar challenges in the future. For example, you might agree on a code word, emoji, or picture they can use to indicate they’re okay but aren’t up for talking at the moment.

Refrain from jumping to conclusions

It’s natural to be on constant alert for indications of a bipolar episode beginning. While this comes from a place of concern, it may not always be the most beneficial approach to providing support. Consider the following:

• Acknowledge that individuals vary greatly. It’s entirely possible for someone to exhibit a wide range of emotions and behaviours and still maintain overall wellness.
• Avoid jumping to conclusions that any mood shift signifies illness. Everyone’s journey with their mental health is distinct. If in doubt, have a conversation with them to understand their current state better.
• Remember that experiencing setbacks is part of the process. They might be managing their symptoms successfully for a while before encountering a tougher phase.
• Don’t make assumptions about their capabilities. If you believe they need assistance, offer your support, but ensure you’re not taking over tasks without confirming they want or need your help.