What Is Bipolar Disorder?
Bipolar disorder, formerly known as manic depression, is a mental illness that causes extreme changes in mood, energy, and activity levels that affect someone’s ability to carry out daily tasks. It most often develops in older teenagers or young adults, with about 50 percent of all cases starting before age 25. According to the National Alliance on Mental Illness, nearly 3 percent of adults in the United States have bipolar disorder.
There are four types of bipolar disorder. While they all cause the same basic symptoms, they differ in their severity. Here are the four types, ranging from the most severe to the least severe:
- bipolar I disorder
- bipolar II disorder
- bipolar disorder not otherwise specified (BP-NOS)
- cyclothymic disorder (cyclothymia)
Some people with bipolar disorder may display symptoms as children, while others only show symptoms later in life. The main symptoms of this condition are intense emotional phases called “mood episodes.” These episodes can switch from extreme happiness or joy (mania) to deep sadness or hopelessness (depression) in a matter of seconds. Sometimes, people with bipolar disorder experience both happiness and sadness at the same time (mixed state).
Symptoms of a manic episode include:
- overt happiness and sociable mood for a long period of time
- high energy levels
- extreme irritability or restlessness
- talking quickly, changing ideas midconversation, or having racing thoughts
- short attention span
- sudden desire to take on new activities or projects
- sleeping too little
- impulsive, risky behavior
Symptoms of a depressive episode include:
- overt sadness or hopelessness for a long period of time
- low energy levels
- lack of interest in doing pleasurable activities
- difficulty concentrating, remembering things, and making choices
- restlessness or irritability
- extreme changes in eating or sleeping
- talk or threats of suicide
- suicide attempt
Challenges of Bipolar Disorder
When people with bipolar disorder go through mood changes, they usually experience severe changes in their energy and activity levels, sleeping patterns, and other everyday behaviors. Psychotic symptoms, such as hallucinations or delusions, may also occur during severe mood episodes. These can be frightening both for the person with bipolar disorder and for those around them.
Bipolar disorder is usually a lifelong condition. While many people with bipolar disorder may remain symptom-free for periods of time, their manic and depressive episodes usually return. Sometimes, those with bipolar disorder grow anxious during these symptom-free periods, unsure of when their mood episodes will resurface.
It’s important for people with bipolar disorder to understand how to cope with their condition. However, it’s also important that the people in their lives — such as friends, family members, employers, coworkers, and teachers — know how to help them when they’re going through a manic or depressive state.
How Can I Help Someone with Bipolar Disorder?
Living with bipolar disorder isn’t easy. Your support can make a positive difference in the life of someone living with the condition, especially during mood episodes. Here are some steps you can take to help someone with bipolar disorder:
The more you know about bipolar disorder, the more you’ll be able to help. For example, understanding the symptoms of manic and depressive episodes can help you react appropriately during severe mood changes. Start by visiting Healthline’s Bipolar Disorder Topic Center to learn more about the disorder, its symptoms, and treatments that can help.
You don’t always need to provide answers or advice to be helpful. In fact, simply being a good listener is one of the best things you can do for someone with bipolar disorder, especially when they want to talk to you about the challenges they may be facing. Offering your acceptance and understanding can go a long way in helping that person feel more comfortable with their condition. You can become a better listener by:
- actively paying attention to what the person is saying
- staying calm during conversations
- avoiding arguments
- avoiding any topics that seem to irritate or frustrate the person
Be a Champion
For people with bipolar disorder, it can sometimes feel like the whole world is against them. Assuring the person that you’re on their side can help them feel more stable. You don’t have to agree with the person’s behaviors and actions, but telling them that you’ll always have their back can be very beneficial. People with bipolar disorder often feel worthless or hopeless, so affirming their strengths and positive qualities can help them recover from their depressive episodes more easily.
Be Active in Treatment
Treatment for people with bipolar disorder usually consists of many therapy sessions and doctor visits. While you shouldn’t necessarily attend these appointments, you can help someone with bipolar disorder by accompanying them and then waiting for them until their appointment is over. These appointments can sometimes seem complicated or scary to people with bipolar disorder, so having someone there who can offer support and talk to them may help reduce any stress or anxiety they may be feeling.
Make a Plan
Bipolar disorder can be unpredictable. Someone may be down in the dumps one day, and then feel as though they’re on top of the world the next, especially for those experiencing a “mixed” episode. It’s important to have an emergency plan in place if you need to use it during severe mood episodes. This plan should include what to do if the person feels suicidal during a depressive episode or if the person gets out of control during a manic episode.
You should also have everyday plans that can help the person get through the time in between extreme episodes. These plans can include coping mechanisms, such as what the person can do when they feel a mood swing coming on, or how to complete chores or other daily activities when they have low energy levels. Make these plans when the person is in a calm and stable state of mind. It’s best to write them down so both you and that person can easily refer back to them.
Sometimes, people with bipolar disorder can become quite impulsive when they are in the manic phase of their illness. When they are well, they may ask you to hold cash or credit cards for them, which will minimize the potential financial damage they can do to themselves while in a manic phase. If you agree to do this, be prepared to be on the receiving end of some hostility when your loved one “demands” that you give them their credit cards, bank books, or cash. Think in advance if you can deal with this before agreeing to support your loved one in this way.
Support, Don’t Push
Your support can be very helpful to a person with bipolar disorder. However, you need to know when to step back and let a medical or mental health professional intervene. While people with bipolar disorder are capable of making conscious decisions, you need to understand when their moods and behaviors are out of their control. Don’t take it personally if the person experiences a setback when you’re trying to help.
It can be hard for people with mental disorders to understand what they’re experiencing. Those with bipolar disorder may experience several mood swings a day and not know why their moods are shifting. Trying to understand what the person is going through and offering your support can make a big difference in how they feel.
Don’t Neglect Yourself
While you’re caring for someone with a mental disorder, such as bipolar disorder, it can be easy to forget to care for yourself. Before you help someone, you need to make sure you have the time and emotional capability to do so. If you do, make sure you’re getting enough sleep, eating properly, and exercising regularly. Keeping yourself healthy can better allow you to keep the person you’re helping healthy.
Be Patient and Remain Optimistic
Bipolar disorder is usually a long-term condition, so the symptoms will come and go throughout a person’s life. The disorder is unpredictable, with symptom-free periods alternating with extreme mood episodes that can change quickly. For the sake of the person with bipolar disorder, remain patient and optimistic to help them stay on track to living a full, healthy life.
Know When It’s Too Much
No one knows how to handle bipolar disorder better than the specialists trained to treat it. If you’re helping a person with bipolar disorder and it feels like things are getting too difficult to handle, reach out to a medical or mental health expert right away. Call 911 if the person becomes abusive or threatens to harm themselves or others.
You asked, we answered
- How can someone build a relationship with a friend or family member who has bipolar disorder?
The most important thing to remember is that the person’s behavior is a symptom of the disease. Just as somebody with strep throat has a fever, sore throat, and may have difficulty speaking, that is not their “normal.” The same applies for the person with bipolar disorder. Sometimes, people with bipolar disorder and other mental illnesses are accustomed to people in their lives abandoning them because they are unable to “deal” with the behaviors that the person can sometimes demonstrate when they are acutely ill. Letting your loved one know that you are there to support them and help them can go a long way in establishing a trusting relationship. Allow your loved one the chance to talk about their feelings, and share your feelings with them as well. Open and honest communication is the foundation of every quality relationship.- George Krucik, MD, MBA