Both in my profession and as a mother of a 22 year-old daughter who has been living with bipolar disorder since age 12, I have personally seen the difficulties experienced by both the loved one and those who care about him/her, particularly at the outset. My hope is to is to share some highlights from my years of experience to help get you on the right path.
The Challenges are Natural and Expected
It is only natural for us to find it difficult to believe our loved one has a serious illness because it can be scary. You may be asking yourself “What does this all mean?”, “How will this impact his/her life?”, “How will this affect our relationship, and the future?” There is reason for hope, and I commend you for caring, and wanting to prepare yourself to best have a conversation about a possible bipolar diagnosis.
Support is Available
Reaching out for information, resources and advice can help sort through your questions, deal with your concerns and set you up for a helpful, if not pivotal conversation with the person you care about.
Conversation Starts with a Good Relationship
I am assuming that you are a key figure in your friend or loved one’s life. This is important because having a candid and caring conversation about bipolar disorder, ie urging someone to accept the diagnosis or get help will be most successful coming from somebody that the person already trusts, respects and has a close relationship with.
By making sure your voice will be heard because of the strength of the relationship, you are setting the stage for your loved one to listen to you and consider that he/she may need help.
Respect, trust, non-judgment, compassion and knowledge/information are keys to a successful conversation.
Right-size your expectations
a) Be prepared for your loved one to express a range of emotions. This is a delicate subject and chances are that he/she has a sense already that something is wrong, but is afraid or in denial.
b) This may not be the only conversation needed. It may be one of a series. Your friend/loved one may need to let this information sink in, or percolate. Whether you are first planting a seed or are able to convince the person to get help right away, you are being tremendously helpful. Acceptance can take a while- your loved one can really use your patience and support throughout this process.
Education is the Foundation
You can’t spot a complicated condition such as bipolar without a good understanding of the disorder. Make sure you are getting your information from a credible source. IBPF and various other mental health organizations offer comprehensive information regarding signs and symptoms, resources, next steps and referrals. There is a wealth of information about bipolar disorder online. Reading up on Bipolar disorder helps you feel more confident that you are informed as well as that you have some control over the situation.
Signs and symptoms of Bipolar Disorder-
Everyone’s illness is different and can manifest differently. Signs and symptoms of bipolar disorder can appear gradually or suddenly. Most of us are not very familiar with mental illness. You may have a sense that something is wrong and want to learn more, or you may be pretty sure your loved one has bipolar disorder. The diagnosis may have already been given or suggested. The good news is there are professionals and resources that can help.
Learn about Common Signs and Symptoms of Bipolar Disorder
Many mental health conditions have similar symptoms. Identify the symptoms that distinguish bipolar disorder from other conditions (ie BOTH a history of depression and mania or hypomania, and getting very little sleep yet feeling quite energized, confident, poor judgment etc.
Consider your friend/loved one’s behavior, speech, energy level, mood. Do you notice a change in any of these? Develop a List of signs and symptoms that seem to fit the diagnosis. During the conversation you will want to Identify concrete examples, such as:
Sleep-Inability to get out of bed for several days or has great difficulty doing so.
Personal Care-Stopped paying attention to self-care, grooming, or hygiene.
School or Work-Is missing school or work or is having increased difficulty
Energy/Mania-Seems to have limitless and abundant energy despite getting only a few hours sleep, and may have delusions, beliefs that he or she has special powers etc.
Poor Judgment/Risky Behavior-Engages in risky behavior, such as substance abuse, impulsivity etc.
During your conversation(s) your goal will be to point out the signs and symptoms you have observed that you believe are consistent with bipolar disorder, in a compassionate and non-judgmental way.
Timing– Try to choose a a good time when you are best able to broach the discussion calmly and compassionately.
Keep in mind that it can be scary and/or overwhelming to imagine or accept a bipolar diagnosis.
Your Role-Remember that you are having this conversation because you have a close relationship and know the person well. You have earned his/her trust and he/she may be most receptive to you. It is clear that you simply care and want to help.
The Message– Among the most important messages to convey are that
you care and are concerned, and that there is help…You are not alone. To get the conversation started you may refer back to a moment when they have expressed difficulty in functioning, relationships, or mood. Or you can recall an incident where you observed atypical behavior. “I remember you were worried about…”, or “I noticed (a change in behavior or mood)…” or “I can see you are having a rough time”. “You don’t have to do this alone”. Bipolar disorder is very treatable.” Many people I have worked with believe that if they “Tough it out” or “Wait it out” their symptoms will eventually go away and they will feel better. This is rarely the case, and the longer a person goes without treatment, the more difficult it can be to get the illness under control.
Offer information/resources– Back up your concern. Have a few articles and/or online resources ready. Here is an article/list of signs and symptoms of bipolar disorder”or “Take a look at this list/questionnaire and see if you can identify with any of the signs and symptoms on the list.” You might also offer a questionnaire such as The Mood Disorder Questionnaire (MDQ)
By communicating concern in a direct but calm and caring manner, backing it up with examples and information, and offering resources and continued support you have, perhaps, moved your loved one a step closer to self-realization and and mental wellness.
To your health,
Pilar Cárdenas, M.A,M.A,LMFT
Disclaimer– This is not a substitute for medical advice.
In case of emergency, someone is in immediate danger, please take appropriate steps.
If you are in a crisis, please call 1-800-273-TALK (8255) in the US, or view our list of international hotlines. Calls are confidential and answered by a trained listener who is aware of the available resources for help in your area. They will listen to your needs and connect you to immediate assistance if necessary, or refer you to a place to go for help.
You can also text the crisis line, text “CONNECT” to 741741