Bipolar disorder is a mental health condition that can result in extreme shifts in mood. As this may affect how a person thinks, feels, and behaves, it may present challenges that can make it difficult to maintain friendships.
Bipolar disorder is a mood disorder that can severely disrupt a person’s life. There are different types of bipolar disorder, but common symptoms can include fluctuating moods from high to low, which some may describe as periods of mania and depression.
While the condition may provide some difficulties in maintaining relationships, many people with bipolar disorder can have healthy friendships with appropriate treatment and support.
People living with bipolar disorder can maintain strong and healthy friendships and relationships, especially if they can manage the condition well. Rather than the condition itself, it is more likely to be the symptoms of bipolar disorder that can result in relationship difficulties.
Individuals with bipolar disorder experience periods of intense emotion and behavior known as mood episodes. A person may be unable to recognize the potentially harmful or undesirable effects of these mood episodes, leading to moods and behaviors that are not typical for them.
These episodes are typically manic or depressive, but a person can also experience both extremes simultaneously or in rapid sequence. Symptoms and their severity can vary, and an episode typically lasts around a week or sometimes longer, with symptoms usually occurring every day for most of the day. In some cases, people may have large periods, sometimes years, without any symptoms.
While it can be difficult, understanding bipolar disorder and what the condition involves can help someone navigate their friendship with a bipolar person.
By being patient, understanding, and a positive influence, a supportive friend can offer a comforting environment, be aware of possible signs and triggers, and encourage someone with bipolar to follow a suitable treatment plan.
Many treatment options are available for bipolar disorder, such as medications and therapy. With the right treatment options, a person may experience long periods, during which their mood is stable, or only experience mild symptoms, which are unlikely to negatively affect a friendship.
How to be there for someone with bipolar disorder
The National Alliance on Mental Illness suggests the following tips for helping a friend with bipolar disorder:
Communication: While confronting problems may be difficult, knowing when and how to have these discussions is important. Communicating in a suitable manner and time can help prevent situations from escalating.
Recognizing symptoms: A friend may identify the early symptoms of an episode in a person with bipolar, which can help them seek treatment before it gets serious. Often, mood episodes may have warning signs. For example, generally, a lack of sleep or difficulty sleeping precedes an episode.
Reacting calmly and rationally: Even in situations when a person with bipolar disorder is exhibiting extreme behaviors, it is important to remain calm. A friend can try to listen and help them feel understood to help them work toward a positive outcome.
Additionally, the Substance Abuse and Mental Health Services Administration suggests the following advice:
- be patient and attentive, particularly during mood episodes
- listen to them without judgment
- work with the friend to create a support plan, such as a Psychiatric Advance Directive and a Suicide Safety Plan
- support the friend during treatment
A Psychiatric Advance Directive refers to a legal tool that allows a person with bipolar disorder to state their preferences for treatment in case of a crisis.
A Suicide Safety Plan describes a tool to help someone navigate suicidal feelings and urges. If a friend and other members of the support network believe a person is in danger, it is advisable to refer to these documents, and in severe cases, contact emergency services.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Try to remove any weapons, medications, or other potentially harmful objects.
- Stay with the person until professional help arrives.
Offering support to a friend can play a role in their treatment. Learning about the condition, being understanding, and showing patience can all be beneficial. Additionally, it can be helpful to encourage the person with bipolar disorder to seek professional help.
To help ensure successful treatment, a person can try:
- encouraging them to seek treatment, as it can help relieve symptoms
- helping them prepare and attend healthcare professional appointments
- contacting the healthcare providers and asking how to help, with permission
- helping them keep records of symptoms, treatment, progress, and setbacks
- encouraging them to adhere to the treatment plan a doctor prescribes
How to support someone during a manic or depressive episode
During these episodes, a person may require support, which people may be able to provide in the following ways:
Manic episodes and hypomania can involve periods of high self-esteem and grandiosity, irritability, racing thoughts, and goal-directed activities. Tips and strategies to help support someone during a manic episode can include:
- starting a conversation about how these episodes affect them to help them feel comfortable discussing their experiences
- asking how to help, as an individual experiencing an episode will often know what helps and what does not
- offering to help with self-management to help a person better manage their symptoms
- trying not to make assumptions and instead look for consistent signs and patterns
- trying to gently express any concerns without sounding critical or accusatory
- discussing challenging behaviors and trying to set boundaries
- continuing to be reassuring and supportive
- being an advocate and offering help when possible
- planning and agreeing on a crisis plan, including what to do and when to consider hospital support
A depressive episode involves periods of feeling low. This can include feelings of worthlessness, hopelessness, and acting withdrawn. Tips and strategies to help a person during a depressive episode may include:
- providing support and being open about depression and difficult emotions
- keeping in touch to let them know people are thinking of them
- avoiding being critical and trying to be patient and understanding
- offering to help but also encouraging them to do things for themselves
Episode with mixed features
A person may also experience manic and depressive symptoms in the same episode. Doctors previously called this dysphoric mania, but they now refer to this as an episode with mixed features. It may be more difficult to provide support when a person is experiencing a mixed episode. However, it is important to listen and remain patient and understanding.
While a person will want to take care of a loved one, it is vital not to understate the importance of self-care. Prioritizing self-care can allow a person to be more helpful and includes joining local support groups, exercising, getting sufficient sleep, and contacting mental health professionals.
While it can be challenging to support someone with bipolar disorder, the following tips may be helpful:
- take a break when necessary — taking time for oneself can be refreshing and can prevent a person from feeling overwhelmed
- speak with others, as sharing feelings can help a person feel support
- set boundaries and be realistic about the help an individual can offer
- if possible, try to share the caring role with others
It is important to know that while a friend can help support someone with bipolar disorder, it is not their responsibility to try and “fix” their problems. Often, offering a listening ear, empathy, and encouragement is the support a friend with bipolar may need in times of distress and may help them on the road to support themselves.
Living with bipolar disorder does not mean that a person will experience difficulty making and maintaining friendships. However, without suitable treatment and a support network, symptoms of the condition may put a strain on relationships.
Communication, empathy, and emotional awareness play a critical role in all relationships. Possessing these qualities can enable a person to be a supportive friend to someone with bipolar disorder. Providing a positive support system can help individuals manage their condition better.
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