When Your Loved One Has Bipolar
Bipolar disorder is one of the most misunderstood diagnoses in the world of mental health. It is difficult for practitioners to diagnose and more difficult to treat. Bipolar disorder is a complicated mixture of genetics, environment and experiences. Basically, if a person is genetically predispositioned to become bipolar, there is a strong possibility they will develop it regardless of how nurturing or positive the environment and experiences. As a society we see it simply as a “mood disorder” characterized by someone who switches emotions easily. Then we laugh and make jokes, “Oh man I’m so bipolar today” and go on with life. In reality, everyone has “mood swings”. We can go from happy to sad in a short amount of time. Things happen. Hormones happen. It’s life. But life for someone who has bipolar disorder is so much darker.
Bipolar I disorder is the more well-known of the two states. It is characterized by periods of “mania”. Mania is a confusing state for those witnessing the behavior because it’s difficult to know where the behavior is coming from. People who are in a state of “mania” may feel: high or elevated mood, have a lot of energy, increased activity level, talk really fast about a lot of different things, have difficulty sleeping (or not sleeping for long periods of time), being agitated, irritable or “touchy”, feel like their thoughts are going too fast, engage in reckless behavior, feel like they can do a lot of things all at one time (National Institute of Mental Health https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml). Mania is a tremendous change from the depression that the person normally exhibits. The appearance of manic episodes can occur every few weeks, to every few months, or a few times a year. I have had professors who have seen clients for years and only experienced one or two manic episodes. Often the scarcity/misunderstanding of the episodes is what can lead to misdiagnosis and improper treatment.
Bipolar II disorder is more discrete and often diagnosed as major depressive disorder. There are still episodes but instead of mania, there are depressive episodes. Even though your loved one struggles with a general feeling of depression, the depressive episodes are different. They are more intense and desperate. Your loved one feels as if things will never get better. Their movements are sluggish, they forget things a lot, feel irritable and unable to concentrate, have trouble sleeping (too little, too much) and feel as if they can’t enjoy anything (National Institute of Mental Health https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml).
Living with someone who has bipolar disorder is difficult regardless of which type they have. After a while you know when the episodes are going to start. You can feel the change coming. The look in their eye, the agitated movements of their body (twitches), the direction of their thought processes, the things they talk about. It’s scary because almost every episode ends in a threat of suicide and a desperate negotiation from loved ones. Hospitalization occurs often but only serves to stop harm; it does not treat the bipolar. Even if your loved one is able to spend a few days in a treatment facility, they will not receive the care they need. The most confusing part of bipolar disorder is the fact that sometimes it feels as if everything is fine. Your loved one is happy, maybe even optimistic. They make plans, they take care of themselves, they engage in relationships. The illusion of bipolar disorder is that everything is going to be okay. I can’t tell you how many times I’ve heard, “he/she is doing so well! I think we’re finally getting somewhere!”. Just when you think things are going to finally fall into place, another episode occurs and you’re back to square one.
There are important things you need to remember if your loved one has bipolar. 1: you have no control. I know that your daily routine revolves around your loved one with bipolar. You put a tremendous amount of effort every day into ensuring that nothing sets off your loved one. You take on all the responsibility, schedule their appointments, ensure that they get their medications and take care of their needs. But it’s not enough. You cannot control the basic biological drive that is at the center of bipolar disorder. You cannot control thoughts or actions. You cannot be with your loved one every minute of every day to ensure that they do not harm themselves. 2: there is no cure. Even when things are at their best, even if things have gone well for a long time, an episode WILL occur. People with bipolar disorder will always have episodes, no matter how far apart they are. The goal is for them to lead a productive life and to have somewhere professional to go when an episode occurs.
3: you need help just as much as they do. Your life revolves around your loved one and your need to control their life to keep them safe is your main focus. You need self-care. You need someone to talk to. Someone who understands what you’re going through. Lord knows your friends don’t. They can’t understand the mood swings .They can’t understand why your loved one can’t “just get over it”. 4: They need professional help. At the end of the day, you cannot do this alone. They need medication, cognitive behavioral therapy, intervention plans and a place to go when things are dangerous. There are many well-renowned places across the US that specializes in treating bipolar. There are many counselors and psychiatrists and doctors that specialize in bipolar. Find them. Engage them. It may take a few tries before you find the one that works well with your loved one. But at the end of the day you have to put their care into the hands of someone else. Your loved one needs control over and information about their life. They need a plan in managing their condition. Think about it: if something happens to you, who will care for them?