It’s hard to watch some you care about when they’re not doing well. You want to help but maybe you don’t know how, and you don’t want to offend them or damage your relationship.
Here are some suggestions on how to help them and ways to approach the topic.
1. Learn more about bipolar disorder
Bipolar disorder is not the same as being moody or unpredictable. It involves a pattern of depressive and hypomanic or manic episodes, where a certain number of symptoms must be present for at least a certain number of days. How these symptoms present themselves and how often varies from person to person.
Only a professional can diagnose someone with bipolar disorder. You’re not trying to diagnose the person you care about, rather gaining knowledge to better understand what they are going through and how you can help them.
You’re off to a great start by reading this article. Another helpful resource is our free book, Healthy Living with Bipolar Disorder.
2. Approach them with support, not judgment
Once you’ve learned about bipolar disorder and still think they might have it, talk to them about it. They might have been thinking the same thing themselves but weren’t sure how to reach out.
There’s also a chance that they might not be aware of what you see as symptoms. Be sensitive when approaching the topic, here are a few things to keep in mind:
“It’s really hard to tell someone that you think they have a mental illness because that person might feel judged or is not ready to come to terms with it. Don’t make it feel like an intervention. Don’t force the person to talk if he/she is not ready to.” – Melanie Luxenberg
“It is more about listening than anything. Especially when dealing with depression, just being with someone, showing them that you are interested in their life, and that you care about their feelings is the best help. Never show that being with that person is an inconvenience to you.” – Steve Comer
“Try to talk calmly with the person about what you've observed and what you think it might mean. Try to be non confrontational. Emphasize that it's manageable.” – S.B.
Some phrases you could use:
- How have you been feeling lately?
- Is there something on your mind?
- I will be here for you if you want to talk
- You’re not alone
- We will get through this together
- I am here for you
- I support you
- You and your life are important to me
- You can tell me if something is wrong, I will help you get through it
3. Encourage them to make an appointment
Let them know that help is available and encourage them to make an appointment with a mental health professional. A diagnosis is the first step for them to learn more about what they have and how to treat it.
Psychiatrist or Therapist? Many see both. Because bipolar disorder varies from person to person, so does the right treatment plan. Where to start depends on the person’s goals, here’s what each works on:
- Psychiatrists will explore medication options and work with you to find the right medication. Medication can reduce the frequency and severity of episodes.
- Therapy helps you learn self-awareness and how to process your emotions. There are many types of therapy including talk therapy or therapies where you learn specific coping skills such as DBT, CBT, and mindfulness.
How you bring this up is important, you don’t want to blame them or make them feel worse than they already do. Focus on wanting to help them feel better, as opposed to treating it as a problem they need to fix. Here are some suggestions:
“Without accusation or judgment, simply encourage your loved one to seek out a mental health professional who can help guide him or her through this challenging time and determine whether it is due to bipolar disorder or something else.” – Danielle Hark
“Go over some information about bipolar disorder and ask if they see themselves in anything that’s said. Do not dismiss the person, Do not ignore them; offer kindness and support.” – Vicki M. Taylor
“Ask how things are going? Listen for the context and tone of the answer. Unusual ebullience and eloquence would indicate a high. Unusual low tone, passive answers and sense of anxiety would indicate a low. Gently engage in conversation as a friend. Ask about their moods and views. Be understanding. Don’t brush them off.” - R.B. Armstrong
Some phrases you could use:
- This is a medical illness and it is not your fault
- There is nothing wrong or bad about seeking help
- There’s no shame in reaching out
- Talking to someone can make a big difference
- I really hope you will consider seeing someone
4. Offer to help them make and prepare for the appointment
Once someone is ready to make an appointment, getting one is not always easy. Figuring out insurance and finding the right doctor can be a complicated and frustrating process. Offer to help them with this. You could help them find the right doctor by looking into how their insurance works and searching doctor reviews online. You could also help them with things like driving them to the appointment, or babysitting while they go to their appointment.
They might be nervous about going to the appointment. Help them prepare by going over things they should talk about. Suggest that they take notes about their symptoms and bring them to the appointment. Use this Mood Disorder Questionnaire as a starting point: http://goo.gl/oGDDkb
Some phrases you could use:
- How can I best support you?
- How can I help you to get the help that you need?
- Do you want me to start looking for doctors in the area?
- Do you want me to drive you to appointments?
- Is there anything else I can help with?
- Is there a specific reason that you don’t want to make an appointment? How can I help you with that?
5. If they’re not ready for an appointment, try these smaller steps
Sometimes the idea of going to an appointment is too daunting, and the person is just not ready. They might know they need help, but be afraid of having a label of a mental illness. They could have had a bad experience with a previous psychiatrist or therapist that keeps them from wanting to try again. Or their condition might make them afraid to leave the house or drive to the appointment.
They could also be ready and wanting the appointment, but have to wait several months to be seen.
In the meantime, there are options available to start addressing mental health before they are able or ready to see a professional. Of course, these can also be used in conjunction with professional treatment.
1) Mental Health Apps
There are several apps out there ranging from mood tracking to meditation. These are helpful for all types of people, but for those who aren’t ready to make an appointment it’s a simple way to start thinking about mental health.
Encourage them to just download the app first. Then to just try it once. Apps like Headspace can introduce you to the concept of mindful meditation, and are designed for beginners.
Mood tracker apps like Pacifica are also helpful for recognizing any patterns and gaining self-awareness. Mood tracking will also be helpful when they do see a doctor, as it will make it easier to explain their symptoms.
2) Support Groups
Many support groups are free and no appointment is required, which makes it easier for some people to try first if they’re not ready or can’t afford to see a doctor.
Support groups allow attendees to meet others that are going through the same thing as them. Some people may have never met someone else with the same experience. Being able to talk and connect with someone who truly understands you is invaluable. You can also learn from each other about what has worked and what hasn’t, and learn more about the available local resources.
There are also support groups for friends and family of those with mental illness. Here are a few organizations that offer free support groups.
- US: NAMI and DBSA
- Canada: The Mood Disorders Society of Canada
- UK: Bipolar UK
- Australia: Black Dog Institute
If you need help finding a group in your area, search for “bipolar support groups” or “mental illness support groups” and your location, or email firstname.lastname@example.org for help.
3) Online support
If a support group is not available in your area, or the person doesn’t want to attend one, online support is also available. The website www.7cups.com connects you with a trained listener. Many people use Facebook and other social media as a way of online support, either by joining private Facebook groups or reading blogs or articles like this one and joining the discussion in the comments.
6. Encourage healthy lifestyle choices
Lifestyle factors like sleep, nutrition, and exercise can have a big impact on mood. Sometimes people are surprised by this, but it makes sense if you think about it. Your mental and physical health are connected. Taking care of your body will also be better for your brain, which is part of your body after all.
Sleep in particular is incredibly important for bipolar disorder, as there is a strong connection to circadian rhythms. Not only is the amount of sleep important, but the timing matters too. It’s best to go to bed and wake up at the same time every day (although easier said than done). Many people who are living well with bipolar disorder stress the importance of a strict sleep schedule. For some, missing a night of sleep could trigger a manic episode.
7. Get support for yourself
Mental illness is sometimes referred to as a “no casserole disease.” When someone gets cancer or has heart surgery, friends, family, and neighbors are quick to show their support. It’s common to bring food because they know how hard it is to cook dinner when you are coping with a serious health issue.
This doesn’t happen as often when a family is dealing with mental illness. People might be afraid to even tell others what is going on, and when they do, they are rarely given the same type of understanding that someone struggling with a physical health condition is.
But things are getting better. Stigma for mental illness is decreasing, and more people recognize that it should be treated equally as physical health.
Don’t be afraid to reach out to your support system when you need help. Ask for help with things like doing the dishes, laundry, or getting dinner.
You might also want to try attending a support group for friends and family members. It’s helpful to connect with others in a similar situation. And if you are having a particularly rough time encouraging your loved one to get help, then you might meet people with ideas you hadn’t thought of yet.
Your health is also important, and you will be best able to help others when you take care of yourself as well.
The information contained in or made available through this article cannot replace or substitute for the services of trained professionals in the medical field. We do not recommend any specific treatment, drug, food or supplement. International Bipolar Foundation is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional advice or delay in seeking it because of something you have read or received from International Bipolar Foundation.