How to Best Support a Loved One with Bipolar Disorder
Bipolar disorder is a difficult illness. For Arden Tucker, an episode of depression can be especially debilitating. Like many who experience bipolar disorder, Tucker fears she won’t recapture the essence of who she really is, the person she was before the depression began.
“My bipolar depression can feel insidious,” she said.
That’s because even though Tucker takes medication, her depression is cyclical, so it’ll return “again, and again, and again.”
Her partner of 35 years is a tremendous support. One of the most important ways Tucker’s partner supports her is by checking on her when she starts to get depressed. She asks Tucker if she’d like to share how she’s feeling, and if she can identify the trigger for her sinking mood.
Colleen King’s wife knows her warning signs well, and they have an agreement that her input is always welcome. “She expresses her concern about my well-being, and will talk with me about any behavioral or emotional changes she’s observed.”
King noted that her wife is like her barometer. Because she feels emotionally safe with her, King regularly shares how she’s doing, and requests her wife’s feedback.
Sometimes, Tucker’s partner makes suggestions. For instance, when Tucker is feeling anxious, her partner asks if her anti-anxiety medication may help to calm her and minimize the emotional pain. King’s partner does the same. She encourages King to reduce her stress and use her coping skills, which include exercising, meditating and working in the garden.
Tucker’s partner also motivates her to get out of the house when she becomes depressed—which is vital so she doesn’t isolate herself even more. For instance, she might invite Tucker to the dog park. “She knows that I particularly like and often miss the other regular dogs and their owners.” Her partner also looks for events they can attend together, along with making plans with their close friends. Anything outside is especially helpful. “The fresh air and distraction from the ruminations in my mind always come as a welcomed treat,” Tucker said.
Of course, everyone is different, which means that your loved one might need a different kind of support. They might balk at suggestions and get defensive. They might feel like you’re telling them what to do. Both Tucker and King are psychotherapists who specialize in treating people with bipolar disorder. Below, both experts shared tips that are important and helpful for supporting anyone with the illness.
Have a written plan. “It can be a huge challenge for support people to get a positive response from someone while they’re in a manic, depressed, or mixed state episode when there isn’t good communication and a pre-existing plan on how to support them back to stability, said King, LMFT, who also specializes in treating depression and anxiety at her private practice in Sacramento, Calif.
She suggested sitting down together and writing out a plan that: spells out what would feel supportive for your loved one and help them to get stable; along with specific signs unique to them that indicate the start of an episode (e.g., “they no longer go grocery shopping and forget to eat; they begin multiple home projects and work on them until 3 a.m. without being tired the next day”).
For instance, Therese Borchard and her husband have several critical rules. As she writes in this piece, “I call the doctor after three days of incessant crying or no sleep. I tell him when I’m suicidal. He stays with me when I’m a danger to myself. However, the most important rule is this: I have promised him that I will take my meds.”
King also suggested readers ask their loved ones about the kind of language that feels supportive and non-judgmental to them. This helps to reduce defensiveness and conflict. For instance, she said, instead of telling your loved one, “You’re being…,” you might say, “I’ve noticed you seem…” This “can get the message across in a direct yet gentle and encouraging manner.”
Lastly, include suggestions for self-care and coping strategies to manage symptoms, and involvement of their doctor and therapist, King said.
Genuinely listen to your loved one. Validate how they’re feeling, and listen with compassion and empathy, said Tucker, AMFT, who provides culturally diverse psychotherapy services for individuals, couples, and adolescents who may be dealing with depression, stress, anxiety, grief and loss, relationship issues, or transitions through life.
“We are each unique individuals and our feelings are our ‘truths.’ Feelings are neither right or wrong.” So accept your loved one’s reality, without interjecting your own views or beliefs, without judging their feelings, thoughts or desires, she said.
Don’t mistake emotions for a crisis. King’s clients often say that they feel like they need to hide their emotions from their loved ones, because they automatically assume they’re having an episode. But really they’re just experiencing normal emotional responses to life.
“So while communicating your concern is appropriate, understand that people with bipolar disorder are going to have bad days, get frustrated, excited, or sad just like everyone else,” King said.
Don’t encourage a brighter outlook. Tucker stressed the importance of not telling your loved one to stop attaching such importance to their struggles and simply adopt a brighter perspective. “Many, many well-meaning people suggest that one’s religion and closeness with their respective God can deliver them from suffering.”
The problem? People who are very devout may see themselves as failures because they haven’t been able to heal or feel better, she said. They may feel great guilt and shame.
Help your loved one find good resources. Help them find a support group or a program of peers, Tucker said. It’s incredibly important for your loved one to surround themselves with other people who have bipolar disorder because they can provide understanding and empathy, she said. After all, they’ve been there, too. They get it.
You might start your search at your state’s behavioral health department, or ask for additional resources when contacting an agency, organization or non-profit, Tucker said.
The Depression and Bipolar Support Alliance offers in-person support groups and online groups. NAMI Peer-to-Peer is a free, 10-session educational program for adults with mental illness to help them understand their condition and get better. NAMI Connection is a free, peer-lead support group for people living with mental illness.
Care for yourself. It’s also critical for you to have your own support and self-care plan, in addition to knowing your personal warning signs that you’re becoming over-stressed, King said. For instance, you might consider joining a support group for loved ones of people with bipolar disorder. Maybe you, too, work with a therapist.
Ultimately, Tucker’s clients tell her that when their family and friends show them that they matter—regardless of the barriers they’re facing—they feel “held and loved.” “This unconditional love and support provides a desperately needed foundation for clients who too often identify themselves as ‘feeling lost.’”
Her clients also are grateful for the patience their loved ones show them, particularly the ones who are closest to them “who witness or experience behaviors or symptoms of bipolar disorder that are not considered normative by people who do not understand these challenges.”
While it’s not always easy, you too can show your loved one that they are undoubtedly and unconditionally held and loved. And maybe you can do the same for yourself.