How Can I Help Someone Who Has Bipolar Disorder?

Your support can make a difference to a friend or family member who has bipolar disorder. Small gestures count.

One of the simplest things you can start with is to try to accept them — and their condition — just like you would if they had a physical health challenge.

Cynthia Last, a therapist in Boca Raton, FL, didn’t know for a long time that she had bipolar disorder. Her husband, Barry Rubin, didn’t believe at first, either. But soon the couple decided to take Last’s diagnosis as a first step to needed changes. Together, they adjusted.

Walk Your Talk

You can model good physical and emotional health by taking good care of your own sleep, exercise, diet, medical care, and relationships. That makes it easier for your loved one to do the same.

Love the Clock

People with bipolar disorder often do better when they’re on a schedule. Don’t fuss about 10 minutes here and there. But encourage your loved one to stick to a bedtime and wakeup time each day, even on weekends. For instance, Last and Rubin leave events early so that Last can stick to her bedtime.

Work, meals, and group get-togethers are other things to plan ahead.

Keep Vacations Simple

A week by a lake or ocean, where your loved one can keep up a sleep and meal-time routine, is easier than a tour where you visit a different place every day or an action-packed weekend in Las Vegas or New York City.

Stay in your time zone, since jet-lag disrupts sleep. Last likes cruises. The ship “takes me to different places, without my having to change hotel rooms,” she says, and she can stick to her usual hours.

Check In

Alicia Smith, a retired entrepreneur who has bipolar disorder, lives in Bozeman, MT. Her friends have motivated her at times to do things she wouldn’t have done on her own.

“Just having someone get me out of the house is helpful, sometimes,” Smith says. Other times, when she’s racing around, she says she needs a friend to ask, “Is there one thing you’d like to accomplish today?” and do it with her.

Your loved one may appreciate it sometimes more than others.

“Ask how you can help,” Smith says. “Back off if you get a bad response.”

Make an Appointment to Learn More

Ask for a “family education” session with your loved one’s therapist. “It’s no different than what you’d do with someone diagnosed with cancer or heart disease,” says David Miklowitz, PhD, director of the Integrative Study Center in Mood Disorders in Los Angeles.

It’s best if your loved one comes, too. Ask which friends and family members should be there. You might also want a separate appointment with just you and the therapist, if needed.

One key thing to do that this meeting is to make a list of the early signs of a manic spell or depression, so that you know what to look for and what to do about it.

Make an Action Plan

If you’re very close to someone with bipolar disorder — such as a family member, partner, or very close friend — agree with them on what you will do if you see that their symptoms are flaring up, such as if they seem like they’re manic or depressed.

The first step on the plan might be to ask if they’ve changed or stopped their medication. It’s common for people to quit or cut the dose, though they shouldn’t do that without talking to their doctor first. “They’ll usually ‘fess up if you ask,” Last says.

Tell their therapist or psychiatrist if you think your loved one doesn’t take medications as prescribed. Some people won’t give their doctors permission to talk to other people about their case. But you can still reach out to let a doctor know your concerns. You should get a response that your message was received and can watch to see what happens next.
Help Them Handle Side Effects

Whether the problem is acne, weight gain, or something else, encourage them to talk to their doctor.

Remove Threats

Have you noticed signs of mania, such as fast talking, risky behavior, getting very little or no sleep, and having a lot of energy? Then you may need to take away their car keys, money, credit cards, and alcohol or illicit drugs. If there are guns or other weapons in the home, make sure they are not accessible to your friend or loved one, and consider removing them from the home to keep them in a safer place.

Do this quietly. “Don’t confront, ever,” says Jim Klein, a retired college English teacher in New Jersey who has bipolar disease.

You may also need to do the same if he or she becomes severely depressed, especially if they or someone in their family has attempted suicide in the past.

Ask for a Mental Health Wellness Check

If you have even a slight worry that your loved one may attempt suicide or hurt others, call 911. You can ask the police for a “mental health wellness check.”

Collect proof of their manic behavior for the police. You may need this if they seem normal when they arrive, says Jim’s wife, Zorida Mohammed, a social worker at a community mental health center. “Find a way to keep them safe while you’re waiting for the treatment,” she says.

If your loved one is a dear friend, an adult child, or older parent living separately, arrange a check-in routine and ask for a set of keys if they have ever attempted suicide, Miklowitz says.

Stay Loving

Dusty Sklar, a writer in Fort Lee, NJ, attended therapy sessions with her adult son, Joey, who had bipolar disorder. “I knew he wasn’t responsible for what was happening to him and tried very hard to be supportive,” she says. “I didn’t back off at all,” she says.

Some people called her an “enabler,” Sklar says. “I broke off those friendships.”

Still, you’ll want to have healthy boundaries. You have your own life to live, and you can’t let your loved one absorb all your attention.

So you may want to talk to a counselor and join a support group. And make sure you keep doing the things that you love. When you take care of yourself, you’ll be better prepared to help your loved one when needed.

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