When a family member, partner or friend has Bipolar disorder knowing how to provide the right kind of support, without losing sight of your own needs, can be challenging.
Bipolar disorder is a mood disorder characterised by periods of low mood (depression) and high or elevated mood (mania or hypomania).
The defining mood is the manic or elevated one. Common symptoms include feeling excessively elated, euphoric or irritable, overabundant energy, increased activity and drive and a reduced need to sleep. Those with the disorder may also engage in high-risk behaviours such as sexual risk-taking, abusing drugs and alcohol, or spending large amounts of money. There may also be associated psychotic symptoms including delusions and hallucinations.
There are 2 distinct types of bipolar - a person diagnosed with bipolar I, is more likely to experience drawn out and severe periods of mania, to have psychotic episodes and to require hospitalisation. With Bipolar II, an individual’s elevated mood is not generally as long or intense (hypomania) as with Bipolar I and they are less likely to experience a psychotic episode. However the impairment can be equally severe.
At the other end of the scale, periods of depression can be long and severe.
When someone you love has bipolar
Living with someone with Bipolar can be very scary and difficult.“I think it’s important for people to understand that a Bipolar diagnosis shouldn’t define the individual, or indeed the family,” says Epworth's Professor David Castle.
“Bipolar is something which an individual has a vulnerability to, but it’s pretty manageable in the main. For family members and friends, it’s about helping the person they love manage these vulnerabilities and marshal their strengths.”
Implementing general health strategies can be helpful for everyone. These may include establishing a good sleep/wake cycle; going to bed at a set time each night and getting up at the same time, doing some sort of exercise together every morning like taking a walk, and sharing regular healthy meals.
People with bipolar should avoid drugs and alcohol, but this can be pretty challenging if those around them don’t make a reasonable attempt to do the same. Family and friends can help by abstaining or, at the very least, establishing healthy habits around consumption. Learning how to recognise early warning signs for both depressive and manic states may alleviate some of the worry for family and friends around relapse.
Sleep disturbance, irritability and over-talkativeness are all common early signs of mania or hypomania, whilst withdrawal and loss of interest in things can signal that a person is experiencing a depressive relapse. Non-adherence to medication and the use of illicit substances are also common precipitants to being unwell.
“It’s not about getting hooked up in a blame game,” says Prof Castle. “The focus should be on emulating the circumstances when things have gone well, but if things go wrong, being able to identify them and implement appropriate action.”
It’s useful for families, friends and carers to remember that the best approach to managing Bipolar is one that focuses on mutual obligation. Doctors, patients and loved ones all have responsibilities and the best results will come from working together.