How to Live with a Loved One Who Has Bipolar Disorder

Living with a loved one who has bipolar disorder is not easy and requires patience as well as compassion. To live in harmony with your loved one's condition, it is important to offer them support, take care of your own physical and mental well-being, and learn about bipolar disorder.

Understand that your loved one's behaviors are linked to their condition. For example, if someone talks excessively about themselves in a selfish or arrogant manner, they are often seen as being narcissistic or self-centered. For someone with bipolar disorder, this behavior is a sign of mania, along with other risky behaviors that may frustrate you. Recognizing that these are symptoms of the disorder and not intentional actions on the part of your loved one will help you understand their situation better. However, it is important not to connect all of your loved one's emotions to the illness; people with bipolar disorder can still experience highs and lows in a healthy way.

• To better understand your loved one's condition and offer support, simply ask about their experiences with the disorder. However, before attempting to intervene, you should carefully consider whether they feel comfortable discussing this with you. If this seems dangerous, just check in with them and gather as much information as you can about what they are going through.

Supporting a Loved One in Mental Health Treatment. Bipolar disorder can be effectively treated with medication and therapy, so it's essential to assist your loved one during their treatment process by participating in their therapy sessions. Family therapy is a key way to support someone with bipolar disorder.

• Communicate with your loved one's psychiatrist. If your loved one has signed a release to allow you to speak with their doctor, you can share concerns or issues that arise. Additionally, you may learn more about how to best support your loved one.
• If your loved one has not yet pursued psychiatric treatment, you can encourage or help them seek treatment. PsychologyToday.com and the American Psychological Association (APA) are useful resources. You can find therapists or psychiatrists locally who specialize in bipolar disorder. However, do not force treatment on your loved one unless they are at risk of self-harm or harming others, as this could make them fearful and damage your relationship.

Monitoring Treatment Adherence. People with bipolar disorder often resist taking medication because the euphoria of mania can make them feel good. If you notice that your loved one is skipping their medication, the first thing you should do is inform their doctor as soon as possible. The doctor will speak with the patient and guide you on how to proceed. If you are unable to contact the doctor, you can encourage your loved one to take their medication or offer incentives (such as a special gift or doing something they enjoy) if they agree to follow the treatment plan.

Following the Treatment Plan. Remember that adhering to a treatment plan goes beyond just taking medication. Medications used to treat bipolar disorder can have significant side effects such as forgetfulness, drowsiness, digestive issues, excessive sweating, weight gain, hair loss, rashes, sexual problems, and other uncomfortable or severe symptoms.

• If your loved one has stopped their medication or expresses a desire to discontinue it, ask them why. In addition to the simple reason of 'I feel better and don’t need the medication,' they may have other valid reasons. Some people enjoy the manic high and don’t want to end the euphoria by taking medication.
• Severe side effects often occur when the patient starts a new medication or increases their dose, but they can happen at any point during treatment, causing significant discomfort or frustration. If your loved one is not adhering to their medication due to side effects, encourage them to speak with their doctor to adjust the dosage or switch to a different medication that may alleviate these issues or reduce them to a manageable level.

Helping Your Loved One Through a Manic or Hypomanic Episode. If you recognize that your loved one is experiencing this phase, it’s important to intervene to reduce the risk of potential harm.

• Talk to the patient to minimize damage from risky behaviors (gambling, overspending, drug abuse, reckless driving).
• Separate the patient from children, the disabled, and other vulnerable individuals to avoid causing them distress.
• Contact the doctor or call an emergency or suicide hotline if your loved one is at risk of harming themselves or others.

Plan for Potential Crises. You need to develop an action plan for emergencies to help prevent a crisis from escalating. Keep contact information for important people who can assist in times of need, along with your doctor’s phone number and the nearest hospital’s address. Do not store this information only on your phone in case the battery dies; always write down the phone numbers on paper and carry them with you (for example, in your wallet or bag). Write it down for your loved one as well. You can plan this with your loved one when they are in a stable state.

Help Your Loved One Avoid Bipolar Disorder Triggers. Triggers are behaviors or situations that lead to negative consequences, in this case, the onset of mania, hypomania, or depression. Potential triggers can include substances like caffeine, alcohol, and drugs. Emotional stress, poor diet, sleep disturbances (too much or too little sleep), and personal conflicts can also be triggers. Your loved one may have specific triggers, and you can assist by preventing these behaviors or prioritizing stress-reducing activities.

• Criticism and people who are overly critical are common bipolar disorder triggers.
• If you live with your loved one, you can remove harmful substances like alcohol from the house. You can also create a relaxing environment by adjusting the lighting, music, and energy levels in the space.

Show Compassion. The more you understand bipolar disorder, the more empathy and acceptance you can offer. Living with a loved one who has the condition is not easy, but showing tender care can provide significant support.

• One way to demonstrate concern is by letting your loved one know you are always there for them and want to help with their recovery. You can also listen if they wish to talk about their condition.

Show Empathy. Put yourself in your loved one's shoes to better understand their behaviors and minimize negative emotional responses or reactions to their mental health. Allow yourself to imagine waking up not knowing if today will bring a depressive or manic episode.

Take Care of Your Own Mental Health. Caring for a loved one with bipolar disorder can sometimes lead to stress and depressive symptoms. Remember that you can only help others if you maintain your own physical and mental well-being. Be aware of your behaviors and the underlying emotions you may have toward your loved one.

• Let go of controlling behaviors. Remind yourself (either verbally or in thought) that you cannot control your loved one's actions. They are dealing with a condition that you cannot fully resolve.
• Shift your focus to your own needs. For instance, you could create a list of personal goals and start working on them.
• Utilize various resources to cope with the situation. Coping resources are strategies to handle specific issues, and they are important for self-care. Coping strategies can include activities you enjoy, such as reading, writing, painting, listening to music, outdoor activities, or exercising. Therapeutic activities also support self-care, such as relaxation techniques (like progressive muscle relaxation), meditation, journaling, mindfulness, and art therapy. Other problem-solving methods include distancing yourself or escaping stressful situations when they arise.

Consider seeking professional assistance. If you are struggling to cope with your loved one's bipolar disorder symptoms, it is important to explore treatment options. Evidence suggests that family therapy, in addition to self-education, can support individuals (especially caregivers/parents) in living with a loved one diagnosed with bipolar disorder.

Understand that bipolar disorder is a biologically-based condition. This means that the disorder has a genetic component and often runs in families. Therefore, your loved one is not to blame for their condition. Bipolar disorder is something that cannot be controlled by sheer willpower alone.

Understand the symptoms of bipolar disorder. There are two main types of bipolar disorder: Bipolar I and Bipolar II. Identifying the type of bipolar disorder your loved one is experiencing will help you understand the specific symptoms and behaviors involved.

• Bipolar I is characterized by frequent manic episodes lasting a week or more. Some symptoms of mania include heightened mood, excessive self-confidence, insomnia, rapid speech, distractibility, increased goal-directed activity, and risky behaviors such as gambling or unsafe sexual activity.
• Bipolar II involves severe depressive episodes accompanied by at least one hypomanic episode (similar to mania but less severe and lasting up to four days).

Explore treatment options for bipolar disorder. Bipolar disorder is typically treated through a combination of medication and therapy. A psychiatrist or specialist may prescribe mood-stabilizing medications, such as lithium, to alleviate symptoms of the disorder. Psychologists, Marriage and Family Therapists (MFT), and clinical doctors can help individuals with bipolar disorder manage and cope with their symptoms. Treatment methods include Cognitive Behavioral Therapy (CBT), family therapy, and individual therapy.

Learn about the typical impact of bipolar disorder on families. Families with a member affected by bipolar disorder often experience feelings of being overwhelmed and drained. Furthermore, spouses of individuals with this condition may feel unsupported, and in many cases, they do not seek help.

• If a family member believes that the individual with bipolar disorder can control their condition, it may lead to overwhelming feelings and dissatisfaction in the relationship.

• Understand privacy rights. Keep in mind that you can communicate with the psychiatrist of a minor or someone under your care if they have signed a release form for information disclosure. However, if neither of these conditions is met, the doctor will refuse to discuss the case in order to protect the patient's privacy rights.

• If possible, during a crisis, it's best to call a mental health professional or a suicide hotline before contacting the police. There have been cases where police intervention in a mental health crisis has resulted in injury or death. When appropriate, you should contact specialists trained in mental health crisis management or psychology.
• If you or someone close to you is having thoughts of harming themselves or others, please call emergency support services at 113. You can also contact a hospital, doctor, or suicide prevention hotline.