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The support from family and friends, as well as mental health services, is “hugely important” for people with bipolar disorder, says Stephen Buckley, from mental health charity, Mind. But knowing how to show support can be hard.
Kim Kardashian West’s statement in response to media speculation about Kanye West’s mental health was a candid reflection on what it’s like to watch someone you love struggle from the sidelines. “People who are unaware or far removed from this experience can be judgmental and not understand that the individual themselves have to engage in the process of getting help no matter how hard family and friends try,” she wrote.
The rapper has previously spoken about life with bipolar disorder, saying if he didn’t keep on top of his medication, there was potential to “ramp up” and end up in hospital. He explained that for him, “ramping up” – or experiencing an episode of psychosis – can mean he is “hyper-paranoid about everything”.
Bipolar disorder affects a person’s mood, meaning they will often fluctuate from one extreme to another. They will experience periods of mania, feeling very high and overactive, which are then followed by periods of depression. Some people might also experience hallucinations or delusions, known as psychosis.
Supporting loved ones with bipolar can be a challenge, says Emma Carrington, advice and information manager at Rethink Mental Illness. “Even though you might have their best intentions at heart, they might resist care, either because they don’t feel they are ill, or because they are feeling ashamed,” she explains.
As with any relationship or friendship, there are highs and lows – but bipolar disorder can add another layer of complexity to the mix. We asked mental health charities Mind, Rethink Mental Illness and Bipolar UK for their advice on the best ways to show support.
1. Talk with them about their experiences
The stigma and misrepresentation of bipolar disorder can mean people with the illness can be reluctant or embarrassed to seek help. As someone they trust, let them talk to you about their experiences, so they feel supported and accepted, says Mind’s Stephen Buckley. Ask how they are and be open about your own mental health, so it feels like a safe space.
Patience is key, says Carrington. “Experiencing a manic or depressive episode can be scary, especially if that person is new to the illness and hasn’t accessed help yet,” she explains. “You might not understand what they’re going through, but the act of trying to understand can be very helpful.”
2. Educate yourself on bipolar disorder
A good way to understand how your friend or family member might be feeling is to read about the experiences of those who have the diagnosis. Bipolar UK recommends An Unquiet Mind by Kay Redfield Jamison, as well as talking to people who have bipolar disorder and their families and friends.
It runs support groups which are open to family and friends of people with bipolar, as well as people with the condition themselves. You can find out where your nearest group is on the charity’s website, or by calling 020 7931 6480.
3. Learn their triggers
It can help to learn your loved one’s warning signs and triggers, says Buckley. That way, if you notice certain behaviours that normally happen before a manic episode, you can gently let them know. Common early warning signs of mania include increased energy, less sleep, and spending more money than usual.
Some possible triggers include: physical illness; sleep disturbances; overwhelming problems in everyday life, with money, work or relationships; the death of a loved one; relationship breakdowns; physical, sexual or emotional abuse.
4. Prepare for manic episodes
“It’s a good idea to make a plan for manic episodes,” says Buckley. “When your friend or family member is feeling well, try talking to them about how you can support them at these times.”
You could discuss ideas such as: being creative together, helping to reduce stress, relaxation exercises, helping to manage money while they’re unwell, helping them keep a routine, and discussing how they can keep on top of regular meals and a good sleep pattern.
5. Discuss challenging behaviour
It might seem like the last thing you want to do, but Buckley says don’t be afraid to discuss behaviour you find challenging. For example, someone might become disinhibited during a manic episode – meaning they say things or do things you don’t agree with. Sometimes they can seem rude or offensive.
It helps to talk about this, but choose your time wisely – don’t bring it up during an episode. “Calmly discuss your feelings with them when they’re feeling more stable,” he explains.
6. Find a balance between support and control
It’s not uncommon for people with the diagnosis to experience overly controlling and critical behaviour from family and friends.
Finding a balance between being supportive, but not controlling, can be difficult if you want to look after someone you care about – but it’s crucial you find this balance. This requires requires ongoing communication and acceptance of each other’s feelings, says Bipolar UK.
7. Remain calm, and provide comfort
If someone you love is seeing or hearing things you aren’t, it can be scary and confusing for them. Do you disagree and say it’s not happening, potentially causing more upset, or do you agree and fuel the belief further?
“It’s helpful to stay calm, and let them know you understand that it feels real for them,” says Buckley. It might be helpful to focus on supporting them with how they are feeling, rather than confirming or challenging their perception of reality, which will feel incredibly real for them in those moments.
Providing comfort can help the person feel seen and heard. If you disagree or argue, it may make them feel more alienated.
8. Seek professional help
“If you’re worried about the behaviour of a loved one, try to organise a meeting with their GP to discuss next steps, and go with them to that meeting in a show of support,” says Carrington.
It might help to make a list of specific examples of behaviours you’re concerned about, as this can help the GP fully understand what’s happening – especially if your loved one doesn’t believe they’re ill. “If they already have a care plan, have a copy of it yourself so you know how and when to assist them,” she adds.
Early diagnosis and treatment is important. The best treatment for bipolar disorder is usually a combination of medication, counselling and self-management, although getting therapy on the NHS can sometimes mean a lengthy wait.
If you’re worried about a loved one, contact their healthcare provider and be clear about your concerns – you can ask for a home visit. Or, if the person is attending an outpatient department, contact their psychiatrist by phone, advises Bipolar UK.
9. Look after yourself
It can be all too easy to put your own mental health on the back-burner when you’re supporting a loved one with a mental illness. Both Carrington and Buckley urge friends and family members to look after themselves, too.
“You may feel very worried about your loved one, but making sure you stay well will enable you to continue to offer support,” says Buckley. You might feel guilty you’re not as able to help them as you might want, or you might give up on other aspects of your life to help care for them better.
It can sometimes be difficult to separate the illness from the person and this can make you feel angry and alone. “If this is the case, there will likely be carer support groups available in your local area,” says Carrington.
“These groups are a chance for carers experiencing similar situations to help support each other, as well as a chance to de-stress for a little while.”
Useful websites and helplines
Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).