Bipolar disorder is a chronic mental illness which causes severe shifts in mood ranging from extreme highs (mania) to extreme lows (depression). Bipolar disorder shifts in mood may occur several times a year, or only rarely.

There are several types of bipolar disorder, including the following:

  • Bipolar I disorder, characterized by at least one manic episode. This may or may not be followed by a depressive episode.
  • Bipolar II disorder, characterized by at least one major depressive episode lasting at least two weeks, and at least one episode of hypomania (a milder condition than mania) that lasts for at least four days.
  • Cyclothymic disorder, characterized by at least two years of symptoms. With this condition, the person has many episodes of hypomanic symptoms that don’t meet the full criteria for a hypomanic episode. They also have depressive symptoms that don’t meet the full diagnostic criteria for a major depressive episode. They’re never without symptoms for longer than two months at a time.

The specific symptoms of bipolar disorder vary depending on which type of bipolar disorder is diagnosed. However, some symptoms are common in most people with bipolar disorder. These symptoms include:

  • anxiety
  • trouble concentrating
  • irritability
  • mania and depression at the same time
  • disinterest and loss of pleasure in most activities
  • an inability to feel better when good things happen
  • psychosis that causes a detachment from reality, often resulting in delusions (false but strong beliefs) and hallucinations (hearing or seeing things that don’t exist)

In the United States, bipolar disorder affects about 2.8 percent of adults. If you have a friend, family member, or significant other with bipolar disorder, it’s important to be patient and understanding of their condition. Helping a person with bipolar disorder isn’t always easy though. Here’s what you should know.

During a manic episode, a person will experience feelings of high energy, creativity, and possibly joy. They’ll talk very quickly, get very little sleep, and may act hyperactively. They may also feel invincible, which can lead to risk-taking behaviors.

Symptoms of a manic episode

Some common symptoms of a manic episode include:

  • an unusually “high” or optimistic attitude
  • extreme irritability
  • unreasonable (usually grand) ideas about one’s skills or power — they may criticize partners or family members for not being as “accomplished” as they perceive themselves to be
  • abundant energy
  • racing thoughts that jump between different ideas
  • being easily distracted
  • trouble concentrating
  • impulsiveness and poor judgment
  • reckless behavior with no thought about consequences
  • delusions and hallucinations (less common)

During these episodes, a person with bipolar disorder may act recklessly. Sometimes they go as far as endangering their own life or the lives of people around them. Remember that this person can’t fully control their actions during episodes of mania. Therefore, it’s not always an option to try to reason with them to try to stop behaving a certain way.

Warning signs of a manic episode

It can be helpful to keep an eye out for the warning signs of a manic episode so that you can react accordingly. People with bipolar disorder may show different symptoms, but some common warning signs include:

  • a very sudden lift in mood
  • an unrealistic sense of optimism
  • sudden impatience and irritability
  • a surge in energy and talkativeness
  • an expression of unreasonable ideas
  • spending money in reckless or irresponsible ways

How to help during a manic episode

How to react depends on the severity of the person’s manic episode. In some cases, doctors may recommend that the person increase their medication, take a different medication, or even be brought to the hospital for treatment. Keep in mind that convincing your loved one to go to the hospital may not be easy. This is because they feel really good during these periods and are convinced that nothing is wrong with them.

In general, try to avoid entertaining any grand or unrealistic ideas from your loved one, as this may increase their likelihood to engage in risky behavior. Talk calmly to the person and encourage them to contact their medical provider to discuss the changes in their symptoms.

Taking care of yourself

Some people find that living with a person with a chronic mental health condition like bipolar disorder can be difficult. Negative behaviors exhibited by someone who is manic are often focused on those closest to them.

Honest discussions with your loved one while they’re not having a manic episode, as well as counseling, may be helpful. But if you’re having trouble handling your loved one’s behavior, be sure to reach out for help. Talk to your loved one’s doctor for information, contact family and friends for support, and consider joining a support group.

Just as it can be challenging to help a loved one through a manic episode, it can be tough to help them through a depressive episode.

Symptoms of a depressive episode

Some common symptoms of a depressive episode include:

  • sadness, hopelessness, and emptiness
  • irritability
  • inability to take pleasure in activities
  • fatigue or loss of energy
  • physical and mental lethargy
  • changes in weight or appetite, such as gaining weight and eating too much, or losing weight and eating too little
  • problems with sleep, such as sleeping too much or too little
  • problems focusing or remembering things
  • feelings of worthlessness or guilt
  • thoughts about death or suicide

How to help during a depressive episode

Just as with a manic episode, doctors may suggest a change in medication, an increase in medication, or a hospital stay for a person having a depressive episode with suicidal thoughts. Again, you’ll want to develop a coping plan for depressive episodes with your loved one when they’re not showing any symptoms. During an episode they may lack the motivation to come up with such plans.

You can also help a loved one during a depressive episode. Listen attentively, offer helpful coping advice, and try to boost them up by focusing on their positive attributes. Always talk to them in a nonjudgmental way and offer to help them with little day-to-day things they may be struggling with.

Some signs of an emergency include:

  • violent behavior or speech
  • risky behavior
  • threatening behavior or speech
  • suicidal speech or actions, or talk about death

In general, feel free to help the person as long as they don’t appear to be posing a risk to their life or the lives of others. Be patient, attentive to their speech and behavior, and supportive in their care.

But in some cases, it’s not always possible to help a person through a manic or depressive episode and you’ll need to get expert help. Call the person’s doctor right away if you’re concerned about how the episode is escalating.

If you think your loved one is considering suicide, you can get help from a crisis or suicide prevention hotline. One good option is the National Suicide Prevention Lifeline at 800-273-8255.

But if you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.Be sure to tell the dispatcher that your loved one has a mental health condition and requires special care.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

Bipolar disorder is a lifelong condition. At times, it can be a real challenge for both you and your loved one — so be sure to consider your own needs as well as theirs. It can help to keep in mind that with proper treatment, coping skills, and support, most people with bipolar disorder can manage their condition and live healthy, happy lives.

And if you need some more ideas, here’s more ways to help someone living with bipolar disorder.