Bipolar disorder is a mental health condition marked by changes in mood, including periods of mania and depression. While many people manage their bipolar disorder effectively, bipolar disorder may impact their relationships with friends, family, and partners. For some, bipolar disorder symptoms are pervasive, even when taking medication. For this reason, having a good support system is key for leading a healthy life.
If you’re part of such a support system for a loved one, here are six ways to support someone with bipolar disorder.
1. Learn as much as you can about bipolar disorder
Supporting someone with bipolar disorder begins by understanding what bipolar disorder is, including its symptoms and treatment options. Bipolar disorder is a mental health condition whose symptoms include marked mood changes that lead to impairments or negative interruptions in daily living. More than simple mood swings, bipolar disorder symptoms like mania or depression can last for days or even months. When not treated effectively, people with bipolar disorder may find that their symptoms lead to interferences in their work or school performance, as well as conflicts in their relationships and a decreased ability to take care of themselves.
While research continues to examine the origins of bipolar disorder, many people believe that the mental health condition may have a genetic component. There are several bipolar disorder risk factors, like trauma or substance use, that can also correspond with its development. Bipolar disorder symptoms tend to present themselves in an individual’s teenage years or in their early adulthood, though this varies from person to person.
There are four types of bipolar disorder, including Bipolar I Disorder, Bipolar II Disorder, Cyclothymia, and unspecified or other types of bipolar disorder. Diagnosis depends on the type of mood episodes experienced, and mental health professionals place mood episodes within these four categories:
- Mania: Individuals experiencing mania feel an elevated mood and increased energy. They may experience racing thoughts, appear distracted, and talk quickly. They may engage in impulsive behaviors and make quick decisions about important life matters like finances or their careers.
- Hypomania: Hypomania, as the name implies, is a mood episode that is similar to but less intense than mania. Individuals who experience hypomania feel an elevated mood. Some feel energetic and productive when hypomanic; others may feel anxious. Their mood may not inhibit their day-to-day routines, but they may still experience impulsivity.
- Depression: During a major depressive episode, individuals can feel overwhelming hopelessness, sadness, and emptiness. They may lack the energy required to complete basic routines, affecting their personal hygiene, executive functions, and relationships. Depression can impact cognition, leading to brain fog and inability to focus.
- Mixed: People who experience mixed mood episodes experience symptoms of multiple mood episodes concurrently. They may be highly irritable and anxious, prone to insomnia, or emotionally reactive.
Often, bipolar disorder is misdiagnosed, as its symptoms can be similar to other health or mental health conditions. On top of knowing the key symptoms of bipolar disorder, it can be helpful to also know about common treatments for bipolar disorder. Commonly, people with bipolar disorder work with a psychiatrist to find the right medication and dosage to manage their moods and symptoms. Many people with bipolar disorder also regularly meet with a therapist and benefit from therapy approaches like Cognitive Behavioral Therapy (CBT). A cure for bipolar disorder has not yet been discovered, but many evidence-based strategies and medications can lessen the severity of symptoms — allowing individuals with bipolar disorder to live stable, happy and fulfilling lives.
2. Be involved and compassionate
Because bipolar disorder can have lifelong impacts, it’s important to learn how best to support a loved one with a bipolar disorder diagnosis. Being involved and compassionate is a powerful way to support your loved one and to show them that you care for them and appreciate their presence in your life.
The type of support you provide should depend on the needs of your loved one and the nature of your relationship. To find a good way to support your loved one with bipolar disorder, explore a few of these options:
- Check in with them, whether that’s in-person, on the phone, or over text. Make sure that these check-ins are regular, as your loved one may experience changes in their mood and appreciate consistency.
- Learn how your loved one best receives support. Similar to love languages, support comes in many forms and some may click better than others. What is supportive for one person might not be helpful for another person, so finding the most effective way to care for your loved one can make a huge difference. For example, bringing food over might be how you like to be supported, but your loved one might prefer to read your sticky note affirmations on their fridge.
- Be mindful of space. The symptoms of bipolar disorder may mean that sometimes your loved one will want to spend a lot of time with you and other times they may want space. If they want space, try not to take it personally — it’s how they’re choosing to cope with their emotions.
- Listen with empathy and limit how many solutions you offer. Active listening means listening to understand, not to fix. With bipolar disorder, there is no easy “fix” — which is not to say that your loved one will never find happiness or comfort in their lives, but your offer of solutions might not be helpful in that moment. Instead, they might need someone to listen to them and to be present no matter what mood episode they’re in.
The best way to know how to support your loved one with bipolar disorder is to have an open conversation or regular conversations about the topic. Being involved means that you aren’t afraid to engage in conversations — including difficult conversations — about bipolar disorder. Being compassionate means being patient and actively showing your acceptance. It’s important to find a good balance between supporting your loved one and honoring their independence, so talking through what effective support looks like is a good way to establish what your loved one needs.
3. Discuss how to have hard conversations before they need to happen
Discussing how best to support your loved one — and how to help them to manage bipolar disorder — is best done before a crisis occurs. Talking proactively about crises and clearly articulating your own boundaries can help you to prepare for difficult episodes.
Here are a few prompts to help start this conversation:
- “If I see that you’re struggling with your symptoms, what’s the best way to point this out to you?”
- “How can I best encourage you to get help when you need it?”
- “Let’s say you take some actions during manic episodes that have difficult consequences. How can I help you manage that?”
- “I wanted to talk to you about my boundaries when it comes to support. I want to be supportive but I know that I have needs too and can only help you out when I’m respecting those needs. Can we talk about what support looks like and what is out of my comfort zone?”
- “If one of my boundaries gets crossed, what is the best way I can mention this to you so I can maintain that boundary?”
Your loved one’s needs and preferences may change over time, so these conversations may need to happen on a regular basis. It can be helpful to explicitly state that these are hard conversations and to affirm that you’re there to support them, which is why you want to talk about these important topics. They might appreciate hearing that it isn’t their fault they have bipolar disorder and that they are not defined by their mental health. These conversations can be a good time to ask them questions about their symptoms, from a place of curiosity, so you can better understand how their mental health impacts them.
4. Collaborate with them on action plans
When talking with your loved one about support, it can be helpful to collaborate with them on an action plan. This action plan might be for when they’re experiencing mania or when they’re in a depressive mood episode. By having a plan, you’ll know exactly what to do when your loved one needs help so you won’t need to panic or worry about what’s right or wrong.
Not sure what to include in your action plan? Here are a few items to talk about with your loved one:
- What to do when they’re manic or depressed
- What to do when they’re starting to feel the onset of a manic or depressive episode
- What to do when they stop taking their medication
- How to contact their treatment team and what information is useful to share with them
- What emergency services are available in your area for mental health crises and what services your loved one prefers
- What to do if they have suicidal ideation or thoughts of hurting themselves
Their safety is the most important thing. By having a plan, you take the burden of decision off your plate and take swift steps to ensure their safety.
5. Be an extra set of eyes
The nature of bipolar disorder means that your loved one might not have insight into what’s happening with their mood. They might not notice their symptoms, particularly at the beginning of an episode. As their friend, you may even notice changes to their mood before they do.
If you notice symptoms of a particular mood episode, consider bringing it up with your loved one. They might take certain medications based on their mood episode, which they can only do when they realize that’s what’s happening. By sharing your honest observations, you can start a conversation with your loved one about how they’re currently feeling, and if they need additional support to take care of themselves.
6. Find ways to take care of yourself
When it comes to supporting a loved one with bipolar disorder, you might feel a wide range of emotions. It’s normal to feel sad when you see a friend in pain. When a loved one experiences bipolar symptoms for the first time, you may find yourself grieving for a time when they didn’t have to experience these difficult symptoms; you may also feel anxious about their well-being and safety. If a loved one has been hurtful to you during an episode, or violated your boundaries, it’s normal to feel frustrated and overwhelmed. These feelings can arise, even if you’re well-educated on bipolar disorder, and even if you understand that their words and actions shouldn’t be taken personally during an episode. Supporting your loved one doesn’t mean that you’re solely responsible for them. Communicating your needs and honoring your boundaries can help you sustain a healthy, reciprocal relationship with your loved one, even during difficult periods.
Find ways to take care of yourself, both on an ongoing basis and after particularly stressful periods of care. Your own mental health is equally important and you can only care for your loved one if you’re taking care of your own well-being. Coming to a place of acceptance — of your loved one’s diagnosis and of your position in their care — can be a helpful way of looking at the situation and give you perspective on your own limitations.
Speaking with a therapist is a great way to incorporate self-care into your daily life. It’s important to have a support system in place for yourself as well, especially if you’re in a care-taking position. A therapist will not only be able to help you through your own experiences, but they can also provide you with additional context for what your loved one might be going through and provide you with the tools to maintain your mental health while supporting someone else.
Everyone needs a support system, and by intentionally supporting your loved one with bipolar disorder, you can set up a sustainable and compassionate way to help them through the highs and the lows.