“Bipolar disorder,” also known as manic-depressive illness, refers to a mood disorder characterized by episodes of mania or hypomania and depression since the onset of the condition. This directly impairs the patient’s ability to work, study, live, and interact.
During the manic phase, patients tend to have a huge temper, be easily irritable, find fault with everything, argue constantly with family members, and in severe cases exhibit impulsive behaviors like harming oneself or damaging property. Some may engage in gambling, alcohol dependence, staying up late, impulsive spending, excessive shopping, seeking multiple sexual partners, or making foolish business investments, leading to accumulating family debts.
During the depressive phase, patients become extremely suppressed, despondent, fatigued but have difficulty falling asleep, often feel helpless and hopeless, and may even contemplate suicide. If you are their partner, you may notice the loss of interest in intimacy, their indifference towards you, their sudden self-deprecation believing they are not worthy of love, pushing you away, making you feel the pain of rejection.
Individuals with bipolar disorder are in a constant fluctuation between mania and depression. For family, partners, and friends, this fluctuation and their “unreasonable” behavior can be heartbreaking and frustrating, exhausting the care and patience of those around them.
People with bipolar disorder, due to the trouble their illness brings to their families and friends, as well as the loss of self-worth, tend to have constant self-criticism and feelings of shame. This intense “stigma” deals a fatal blow to one’s confidence and self-esteem.
For family members of individuals with bipolar disorder, they also endure immense pressure. As their close ones, how should you correctly accompany and interact with them? Based on many years of counseling experience, Guangzhou’s ListeningBar psychologists have compiled the following advice for everyone.
01.
Self-Analysis and Self-Care
Dealing with individuals with bipolar disorder requires you to maintain your emotional stability. The inevitable commitment you make will also be a test in life.
If you are their partner, first honestly assess yourself, what kind of person are you? Can you maintain emotional stability? Can you be tolerant and patient enough?
If you can’t, it is advisable to break up early. Don’t give yourself difficult problems, human nature cannot withstand tests.
If you are a family member, worrying about them is normal, but what’s essential is for you to spend some time and effort to care for yourself.
Living with a family member with bipolar disorder can bring tremendous pressure, and you might be asked to fulfill some needs you never knew of. Take some time to distance yourself from family and focus on things that make you feel good, such as exercising, socializing with friends, etc. Support groups and online communities can be very beneficial, strengthening your support system and that of your family.
When your stress level rises, be aware and ensure you have enough rest and personal space.
Remember: To take care of others, you must first “take care of yourself”.
02.
Establishing a Positive Understanding of Bipolar Disorder
The emotional experience of individuals with bipolar disorder is polarized, described figuratively as: heaven and hell, light and darkness. Besides the disease itself, what can make them collapse and feel despair are the “stigma” that comes along and the peculiar looks from people around them.
Understanding the true nature of bipolar disorder and getting closer to the lives of those with bipolar disorder is an important step in “eliminating bias”.
Learn about bipolar disorder, understand its causes, symptoms exhibited by those with bipolar disorder, what kind of assistance and support family members should provide…
Some people might be in similar situations or understand your circumstances. If the patient is your only close person, when they have manic, depressive, suicidal, or psychotic symptoms, you alone have to handle situations you can’t cope with. Therefore, having others provide emotional support to you is crucial for your emotional health.
To better help them, if the family situation permits, guide them towards psychological counseling. Additionally, family members themselves need to undergo certain mental adjustments to prevent emotional or psychological issues.
03.
Diet and Exercise Regimen
(1) Try not to disrupt their routine, fix their sleep and wake-up times at night and in the morning.
(2) Encourage them to avoid smoking and alcohol and minimize consumption of caffeinated beverages.
(3) If they are on medication, remind them to take their medication according to the prescribed schedule.
(4) Encourage them to exercise: Exercise can have a positive impact on the emotional regulation of individuals with bipolar disorder.
04.
Maintain an Open Attitude
Externally, individuals with bipolar disorder may exhibit extreme variations in mood. But for the individuals themselves, they may have some irrational thoughts and feelings alongside.
It is essential to view and treat them equally and respectfully. Maintain a normal attitude in your daily interactions with them! Don’t treat them as mentally ill just because they have bipolar disorder, don’t see them as completely irrational and unreasonable…
Listening to individuals with bipolar disorder sharing their experiences with an open attitude will make them feel supported, accepted, and understood.
05.
Understanding their State
Signs of Transition and Triggers
Most individuals show some signs before experiencing manic or depressive episodes. For example, changes in sleep, appetite, and behavior.
To understand these “signals”, the best way is to talk to them. If you notice some typical behaviors before an episode, you can gently let them know.
Moreover, there may be triggers, such as stressful events.
While taking care of individuals with bipolar disorder, you may observe certain patterns of episodes, but not all mood changes will result in extreme manic or depressive episodes.
If you are unsure, it’s best to talk to them first to confirm if they are truly unwell.
06.
Guiding Them to Utilize Social Support Networks
For example, learn to receive understanding and help from close family and friends, join peer or support groups to share their emotions, feelings, and thoughts, allowing them to find genuine confidants in life, minimize feelings of loneliness or isolation.
07.
Preparation for Depressive/Manic Episodes
During their stable periods, try to ask them what kind of help and support they would need when they are in a depressive/manic episode, starting with:
Identifying and reducing triggers (what words, people, and things can easily upset them?)
What actions can you take to reduce the chances of triggers occurring?
How do you handle situations when symptoms arise? Reach an agreement in advance on possible scenarios:
· How to alert them when they engage in impulsive behavior?
· Before they make commitments or undertake projects, you can offer your perspective to prevent them from taking on unmanageable tasks;
· If they agree, you can manage their money for them;
· Help them maintain a regular lifestyle, including diet and sleep.
08.
Measures for Manic Episodes
During their high-energy moments, they may engage in impulsive behaviors, so avoid direct conflicts with them at this time.
The symptoms of mania are complex. It can be divided into three points:
(1) Hypomania.
When a patient is in extremely good spirits, pay attention and observe if they are energetic, talkative, extravagant, meddle in others’ affairs more than usual, etc. They may behave unusually, doing things that make you extremely embarrassed, strange, or frustrated.
Once you notice, remind them. Those with self-awareness will realize it and make an effort to control themselves; if they are not aware, continue to observe.
(2) Severe Hypomania.
During severe hypomania, they have a bad temper, easily irritable, and various tumultuous activities are sometimes unavoidable. Also, due to their “easily irritable” nature, they tend to engage in conflicts with others.
However, it’s essential to understand that it’s their brain misfiring, not their true thoughts, and after cognitive restoration, they often fall into deep self-blame and guilt. Avoid taking them seriously, listen more, speak less, and turning a deaf ear is a wiser solution. During this phase, try to avoid agitating the patient, keep them indoors as much as possible, even if they go out, do not let them carry money, and it’s best for a family member to accompany them to prevent unnecessary conflicts with others.
(3) Severe Loss of Control.
Directly take them to the hospital without hesitation. With proper treatment, 80% of patients can achieve clinical recovery.
09.
Measures for Depressive Episodes
During this phase, patients experience low mood, confused thoughts, restlessness, physical exhaustion, decreased appetite or loss of appetite, with severe cases potentially leading to pessimism, thoughts of suicidal ideation, even suicidal tendencies.
If the patient does not want to be disturbed and prefers to be alone for a while to process and digest their emotions, give them some time and space.
At this stage, it’s important to accompany them more, be present, without saying much or doing much, just sitting beside them, reading a book, playing with your phone, as long as you are there.
Listen to their inner voice, provide care, love, and attention;
Try not to criticize or blame them as it can worsen their feelings of guilt;
Pay attention to the symptoms and behaviors exhibited during their episodes, secure dangerous objects, and avoid overstimulating the patient.
For patients with suicidal ideation, constant supervision is vital to prevent accidents, and consider taking them to see a doctor to adjust their medication.
Conclusion:
When family members are affected by depression, they require understanding, affirmation, and companionship from their loved ones.
The psychiatrist Kay Redfield Jamison, in her memoir “An Unquiet Mind: A Memoir of Moods and Madness”, also mentioned how the warmth of her family helped her during her symptoms:
“My mother was truly extraordinary. During the long days of my deep depression, she cooked delicious meals for me, helped with laundry, and covered my medical bills. She even tolerated my irritability and annoyingly depressive moods, chauffeuring me to doctor visits, taking me to the pharmacy, and accompanying me on shopping trips.
She was like a gentle mother cat, with her eyes full of maternal light, gently holding the stray kitten by the neck to prevent it from straying too far.
Both emotionally and substantively, she provided me with a lot of safety, food, and shelter.
Her remarkable strength slowly permeated my withered heart, in conjunction with the effects of medication on my brain and the stabilizing effect of therapy on my mind, allowing me to pass through those incredible difficult years. If it weren’t for her, I wouldn’t have made it to today.”
END
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