8 Ways to Help Your Bipolar Loved One Cope

Tips and tools for being there through the ups and downs of bipolar disorder

Depression and bipolar disorder are family diseases. Everyone who shares a kitchen and a bathroom is affected. In fact, in his book Understanding Depression, J. Raymond DePaulo Jr., M.D., writes, "Depression...has a much greater impact on marital life than rheumatoid arthritis or cardiac illness. One study found that only severe forms of cancer affected a family as adversely as depression or bipolar disorder."

My manic depression could have easily wrecked my marriage and my relationships with my two children. Instead, we emerged as a tighter, stronger unit. How? Here are eight ways my husband Eric helped me cope-tips for families on how, exactly, to hang in there with a loved one who has been diagnosed with bipolar disorder.

1. Educate Yourself

I remember the afternoon of my first severe panic attack. I phoned Eric at work as my breath grew shallow and my heart pounded. I was sure I was dying of a heart attack. As soon as he walked through the door, Eric stared at me suspiciously. My limbs were in place, and I seemed to be functioning just fine. What was the problem?

What quickly convinced my spouse that my bipolar disorder was an illness, not a weakness, was research. The reams of paper that I printed out and asked him to read. The psychiatric evaluations he witnessed. The group therapy and family sessions he attended. And the conversations with other spouses of those with bipolar disorder.

Education is always the starting point. Because until the spouse or daughter or friend of a manic-depressive understands the illness, it is impossible for them to to say or do the right thing to be supportive. Do your own research by going online to NAMI.org (National Alliance of Mental Illness) or dbsalliance.org (Depression and Bipolar Support Alliance), or by doing a Google search on the words "bipolar disorder."

2. Learn How--and When--to Talk

Eric doesn't say much when I'm clutching tissues, crying my eyes out. And he's hesitant to speak when I'm manic (not that I would let him get a word in). But when I don't want to get out of bed in the morning, he reminds me why I need to. And when I'm revved up, he's the voice of reason telling me why, for example, a spontaneous trip to New York isn't smart.

Anna Bishop, wife of fellow blogger James Bishop (findingoptimism.com) has some wonderful advice for the loved one of a manic depressive on what to say and when:

"When James becomes ill he turns into a different person. I say goodbye to my husband, so to speak, and hello to bipolar James. In a depressive episode he becomes highly irritable and usually itches for a fight. He will often make comments to bait me.

At this point I have two options:
1. Take the bait, have a messy fight, and accelerate his downswing, or
2. Grit my teeth and say, "it's the illness speaking." If I can do that, then I have a much better chance of diffusing the situation. A comment like, "You sound stressed about work - let's talk" has better results and sometimes can even stop the mood swing.

3. Make Some Rules

You know all the fire drills in primary school you prayed would happen during your pop math quiz? All those times the school administrators rehearsed what, exactly, would happen in the case of an emergency? Families of bipolar persons need those as well: plans of action for those times when the bipolar person is sick.

In order to design a such a strategy, the manic depressive and her loved one must compile a list of symptoms-the equivalents of the smoke and burning smell of a fire-and what action should accompany each, like "call the doctor." Each family will have a different list of symptoms and a different model of recovery, because no two illnesses are exactly alike.

Eric and I have agreed that I will call my doctor after two consecutive night's sleep under five hours, or after three days of crying spells. A friend of mine told me that he and his wife have agreed that she will see her psychiatrist if she hasn't gotten out of bed for three days.

4. Plan Even More

As part of your plan of action, you should consider what should happen when the bipolar person is very ill. "When you are dealing with a disease that has the potential to become life-threatening, the last thing you want is an improvised response to an emergency situation," writes Francis Mark Mondimore, M.D. in his book Bipolar Disorder: A Guide for Patients and Families.

Part of your plan should include a list of people you can call for help. Of course, it is recommended that the bipolar person be working closely with a psychiatrist, and that he knows how to get in touch with the psychiatrist after hours or in case of emergencies. It's also a good idea to know which hospital the psychiatrist works with, or if the doctor will work with any hospital in the area. Ask friends, doctors, and family members for their recommendations about hospitals and mental-health practitioners.

Also, the red tape of insurance is often too overwhelming to process at the time of an emergency, so get familiar with the details of your medical insurance coverage for psychiatric illnesses right now. Know the terms of hospital coverage, especially, and how much the patient is expected to pay out of pocket for various services.

5. Listen

When people are talking," writes Rachel Naomi Remen, "there's no need to do anything but receive them. Just take them in. Listen to what they're saying. Care about it. Most times caring about it is even more important than understanding it."

When I think back to the days when I was very ill, crying and shaking at the dinner table and at preschool functions with my kids, no response was as appreciated as when someone simply listened. Suggestions came off as condescending, even though I know they were meant to be helpful. Advice was annoying. Many times I just needed to be heard, to be validated. Don't hesitate to say nothing. Because silence often speaks the most loving message.

6. Go Gentle

I can't count all the times I have tried Eric's patience with the reckless highs and debilitating lows of my bipolar disorder. When I get manic and want to sign up for 60 new activities-not to mention losing my car keys, cell phone, and purse-it's difficult for him not to get annoyed. But because he places my exasperating behavior in the proper context of an illness, and sees them as mere symptoms of a disease (rather than careless and self-absorbed actions), he is better able to go gentle with me.

Moreover, a little kindness and gentleness toward your loved one-especially at those times when the bipolar person feels incapable of affection and care-- go a long way to aid recovery.

7. Laugh Together

Humor heals in so many ways. It combats fear as it loosens anxiety's death grip on your heart and every other living organ. It comforts and relaxes. And recent studies indicate that humor also reduces pain and boosts a person's immune system.

"Laughter dissolves tension, stress, anxiety, irritation, anger, grief, and depression," says Chuck Gallozzi of personal-development.com. "Like crying, laughter lowers inhibitions, allowing the release of pent-up emotions. After a hearty bout of laughter, you will experience a sense of well-being. Simply put, he who laughs, lasts. After all, if you can laugh at it, you can live with it. Remember, a person without a sense of humor is like a car without shock absorbers."

Humor also aids communication, and if there is one thing besides education that is absolutely essential for a healthy relationship with a bipolar loved one, it's strong communication.

8. Support Yourself

Caregiving is draining. Even when you are protecting yourself with the armor of regular sleep, healthy meals, and essential time-outs from your bipolar loved one, caring for a person still takes a toll on both physical and mental health.

"It can be exhausting to live with a hypomanic person and frustrating to deal with a seriously depressed person day after day," says Dr. Mondimore. "The changes and unpredictability of the moods of someone with bipolar disorder intrude into home life and can be the source of severe stress in relationships, straining them to breaking point."

That's why you need support as much as your loved one. You need to talk to people who have lived with a manic-depressive, and be validated by their experiences. Spouses and family members of bipolar people should consider therapy for themselves, as a way of processing all the stress. You may also benefit from checking out support programs for spouses and loved ones of the mentally ill, like from the National Alliance for Mental Illness.

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