Supporting Someone with Bipolar Disorder

Supporting someone with bipolar disorder means offering stability, consistency, and practical help through mood shifts. In manic phases, maintain a calm environment to avoid overstimulation, and suggest soothing activities like walking together to foster connection and promote rest. In depressive phases, focus on gentle support. Remind your loved one to prioritize self-care, like drinking water and maintaining regular sleep routines to support mood regulation.

Medication is key to managing bipolar disorder, but adherence can be difficult for some people. You can support their treatment by emphasizing the importance of medication, even when they are feeling well. Encourage them to discuss any side effects with their healthcare provider. If you see early signs of mania, such as less sleep or restlessness, alerting both your loved one and their healthcare provider promptly may prevent a full episode.

Understanding Bipolar Disorder

Bipolar disorder is a lifelong condition requiring ongoing care to maintain stability and reduce the risk of intense emotional states, known as mood episodes.

People with bipolar disorder can experience three primary types of mood episodes—manic or hypomanic and depressive—which often alternate.

Manic and hypomanic episodes share largely the same symptoms. However, hypomanic episodes are less severe than manic episodes.

Symptoms may involve:

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

Types of Bipolar Disorder

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

• Bipolar I involves manic episodes lasting at least seven days or that are so severe that immediate hospitalization is required. Bipolar I is often accompanied by periods of depression.
• Bipolar II 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 is a rare form marked by alternating hypomanic and depressive symptoms lasting at least two years in adults or one year in youth, without meeting full criteria for hypomanic or major depressive episodes.

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.

Helping Someone with Bipolar Disorder

Helping someone with bipolar disorder involves being consistent with practical support, patience, and understanding. Your support might look a little different depending on your loved one’s emotional state.

During Manic Episodes

Manic episodes are periods of high energy that can make the affected person do unusual or even hurtful things. While these episodes can be tiring and even scary for loved ones, the person experiencing them may actually enjoy the mania and resist taking their medications.

To help a loved one during a manic episode, you can:

Create a calm environment. Cluttered spaces, background noise from the TV, multiple conversations, and even strong smells can overstimulate your loved one, triggering impulsivity, distress, and other symptoms. Offer a quiet, tidy space where they can relax, and soothing activities like coloring or journaling. Communicate with them in a gentle, reassuring tone, and discourage impulsive plans that might overstimulate them.

Spend quality time together. People experiencing manic episodes often feel isolated and misunderstood. Try to spend quality time with them doing relaxing activities that foster connection and reduce feelings of loneliness. This might include taking slow walks through nature, or doing yoga in the park—grounding activities that help work off their energy while connecting with you.

Have honest conversations. Talk to your loved one about how they are feeling. Use a gentle, steady tone and avoid intense conversations or debates that can escalate their energy. Rather than discussing complex topics that might overwhelm them, try to keep conversations light and speak with a soft tone and straightforward sentences. Be honest with them. Validate their feelings but do not reinforce unrealistic or impulsive ideas.

Prepare easy-to-eat meals. People experiencing mania may have a hard time sitting down to complete a meal. Try preparing easy-to-eat foods and drinks that are ready on demand and don’t take too long to eat. This might include peanut butter and jelly sandwiches, fresh vegetables, and healthy, sugar- and caffeine-free drinks like herbal tea and cucumber water.

Encourage rest. Regular, consistent sleep habits are crucial for mood regulation. Promote rest by discouraging too much screen time, and opting for soft music or reading instead. If your loved one turns down for a nap, protect their rest by keeping their environment quiet and preventing visitors or other distractions. If you notice signs of tiredness, suggest a nap but avoid insisting, which could lead to agitation or arguments.

Set limits on risky behavior. Gently redirect your loved one away from risky or impulsive behaviors, like overspending, substance abuse, or grandiose decisions like quitting their job or other sudden major life changes. If necessary, limit access to credit cards, social media, cars, or other situations that may amplify risk.

Involve professionals if necessary. Learn to recognize signs of danger, like delusional thinking, reckless behaviors, and threats of self-harm, and keep important phone numbers on you at all times. If your loved one’s behaviors become dangerous, contact a mental health professional or crisis hotline to provide the support and intervention your loved one needs.

Encourage medication adherence. People experiencing manic episodes may have trouble sticking to their treatment plan due to factors like side effects, feeling good, or enjoying the manic episode. Remind your loved one that medication is critical for helping them feel stable and balanced, even when they feel well. If they experience uncomfortable side effects, suggest reaching out to their healthcare provider, as a dose adjustment may help them feel better.

During Depressive Episodes

Some evidence suggests that depressive episodes may be more common than manic episodes in people with bipolar disorder. These episodes can be much more distressing than mania, and due to the risk of suicide, they can be much more dangerous.

To help a loved one during a depressive episode, you can:

Listen and communicate. Support your loved one by actively listening to them without trying to solve their problems. Show them they can share their challenges with you. Open, honest communication helps you understand their symptoms and emotions while reassuring them that you don’t blame them for behaviors caused by their illness.

Encourage small steps in self-care. Kindly remind your loved one to take small, manageable steps toward self-care, such as eating, drinking water, and brushing their teeth. Avoid pushing them or insisting them to take these steps, as this can drive them away.

Reduce external stressors. Ask your loved one if you can take a load off their shoulders by helping with household tasks or other responsibilities. Try to create a calm and clean environment where they can relax and focus on self-care. Offer them a reassuring voice, listening ear, and soothing presence to help them feel less isolated.

Suggest low-energy activities. See if you can engage them in low-energy, comforting activities that foster connection. This could include watching a light-hearted movie together or taking a short walk through a nature park. Be patient with their pace; avoid pressuring them to move too quickly toward recovery. Be sure to celebrate small victories, like getting out of bed or completing an exercise routine.

Monitor for signs of crisis. Be alert for signs of suicidal behaviors and ideations. This include expressions of hopelessness, saying they feel like a burden, or talking about self-harm. If you notice these signs, take immediate action and call a mental health provider or crisis hotline services for support.

Encourage professional care. During these low-energy periods, it can be especially hard for your loved one to adhere to their treatment plan. Gently remind them to take their prescribed medication and attend therapy sessions. If they seem resistant, don’t push them. Instead, encourage them to discuss their feelings with their therapist or healthcare provider.

Taking Care of Yourself

Caring for your loved one, including coping with their moods, can be stressful and can challenge any caregiver. Before you can take care of anyone else, you must first take care of yourself. This may involve:

Set boundaries. Set limits for unacceptable behaviors by clearly explaining to your loved one how these behaviors challenge you. Make sure to show them that you do not blame them by concentrating on how you are feeling. Set consequences for overstepping these boundaries and follow through on them. However, do not use these boundaries as a form of punishment.

Don’t take things personally. Bipolar disorder can cause your loved one to behave in ways that are unexpected or even hurtful. Remember that it is a biological illness and your loved one cannot control their symptoms. Try not to take these behaviors personally. Express your feelings clearly in a way that is gentle but firm. If you need to take a break, explain that you feel overwhelmed, and that some time apart to recharge would be good for both of you.

Find support. In addition to friends and family, support from healthcare providers, therapists, and support groups can help you develop positive coping strategies for both you and your loved one. This is especially important during manic or depressive episodes, when stress levels may be higher.

Seek family therapy. Consider family-focused therapy (FFT), which can lead to faster recovery and fewer episodes for the person with bipolar disorder. FFT improves family communication, reduces conflict, and decreases negative behaviors like criticism and irritability more effectively than brief psychoeducation.

Practice self-care. Self-care strategies can improve your health, well-being, and help reduce stress and fatigue. Key strategies include eating a balanced diet, exercising regularly, and getting enough sleep. These practices support both physical and mental wellness.

Summary

Supporting someone with bipolar disorder can look different depending on your loved one’s emotional state. During manic phases, support might involve creating a calm environment to avoid overstimulation, preparing easy-to-eat meals, and encouraging brief naps. During depressive phases, it might involve encouraging basic self-care like drinking water, and offering low-energy activities like watching a movie together.

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.