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How Family And Friends Can Help Those with Bipolar Disorder

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D., edited by Kathryn Patricelli, MA

The family and friends of those with bipolar disorder may become frightened at and angry about the impulsive and self-destructive behaviors associated with bipolar disorder that they see played out again and again. However, they also generally want to help the person. This is a good thing, because having access to the help and support of family and friends can make or break the chances of someone with bipolar disorder keeping themselves maximally stabilized and healthy. Family and friends provide social support and encouragement, which tends to provide a moderating influence on mood (e.g., helping mood to keep from sinking too low or too high). This influence takes on several different forms.

two women talking First, support takes the form of monitoring. Family and friends are in a perfect position to help those with bipolar disorder to monitor their moods. Often, family and friends will know that moods are shifting before patients will themselves. They can help make the person aware that he or she is again entering into a dangerous period. Family and friends can monitor medication-taking behavior. They can help patients either get back on bipolar medication when they stop taking it, or gather resources to help cope with the mood episodes that are likely to occur when patients are not medicated.

Second, family and friends can persistently encourage patients to comply with bipolar treatment and professional recommendations. This may include taking bipolar medications as prescribed, attending bipolar therapy groups, etc. Treatment compliance is important at all times. It can help prevent future mood swings from occurring. However, helping patients to comply with bipolar treatment recommendations is especially important when mood symptoms are lowering, as professional treatment offers the best opportunity to limit symptom severity. Patients frequently complain that they don't like the way that medication makes them feel and they want to stop taking it. Stopping medication also stops any preventative effect that the bipolar medications provide. This sets patients up for new mood cycles, sometimes with tragic results. Family and friends can help defuse this sort of situation by reinforcing professionals' treatment recommendations, including the importance of taking medicine as prescribed.

Third, family and friends can help support bipolar patients by helping them to "reality-test". This means to raise their awareness about times when patients' own judgments are faulty or when they are acting in odd, bizarre ways. Family and friends can help the person make more sound judgments. Often individuals suffering from bipolar disorders make excuses for their behavior, blaming other people or situations for their bipolar symptoms. Family members and friends can help point out this tendency when and if it occurs, so as to give the person an objective/outside perspective on their behavior.

Fourth, family and friends can initiate an intervention when necessary. They can make a psychiatrist appointment, or an appointment for bipolar therapy, and even accompany the person to see the doctor or therapist when this becomes necessary. This helps the person get connected to treatment and with the presence of a known person, may reduce the anxiety of seeing a professional. Family and friends can also help make arrangements for hospitalization when that becomes necessary.

Interventions are not just useful during times of crisis. During normal mood phases, family and friends can help those with bipolar disorder to plan for what they can do to minimize their future mood cycle intensities. They can then help them implement the various parts of that plan. For instance, if the mood stabilizing plan calls for regular exercise, family and friends can offer to be an exercise partner. This may increase the chances that exercise will actually take place because it is generally more pleasant to exercise when you have a partner with you. Ongoing encouragement and bipolar support are crucial to the stability of those with bipolar disorder.