Speaking to an individual who has bipolar disorder can seem like a difficult task. Truth is, though, you need to keep the line of communication open and flowing. And, yes, it will be on you to do a lot of the work. Your friend, co-worker, or family member might not be able to initiate, and it is important that you recognize whether they are going through a manic or depressive episode.
How can you speak with someone who has bipolar disorder? Here are some ways to get the conversation going in a positive and constructive manner.
Understand the Different Types of Bipolar Disorder
Not everyone has the same type of bipolar disorder. Different types mean diverse symptoms and episodes. There are actually three main categories that a person may fall under: bipolar I, bipolar II, and cyclothymia. They might also have substance- or medication-induced bipolar, a medical condition that can create bipolar symptoms, or an unspecified bipolar-related disorder.
The average age of onset is about 25 years old, but a person can be younger or older when bipolar symptoms set in. The main symptom for bipolar is experiencing “mood episodes.” This means that the person can swing between mania (extreme elation) and depression (deep hopelessness or sadness). Some people can even experience a mixed state of both mania and depression.
Bipolar disorder brings with it many challenges, both for individuals who have it and their loved ones. A change in mood state can result in a serious dip or burst in energy and activity levels. It can change their behaviors and sleep patterns. Sometimes, psychotic symptoms (such as hallucinations or delusions) co-occur with a severe mood episode. This certainly seems frightening from an outsider’s standpoint; it is for the individual, too.
People who have bipolar live with it all their lives. There can be periods of time where a person is symptom-free, but those symptoms can return. This can cause anxiety for the individual since they do not know when their next episode will occur.
Be a Good Listener
Now that you know a little bit about bipolar types and symptoms, it is time to think about how you communicate with your loved one. The first thing you need to focus on is just being a good listener. Make sure that you are actively paying attention to what this person is saying. And when you are making conversation with them, it is important to remain calm – especially if they are not. Your calmness can create a sense of stability for them.
That means avoiding arguments. You are unlikely to change the mind of someone in the midst of a manic or depressive episode just by arguing with them. In fact, sometimes, it is best to avoid triggering topics altogether. If you know which topics are sensitive for them, do not go there when your loved one is in a manic or depressive episode.
Create a Sense of Stability
As mentioned above, it is vital that you create a sense of stability with your loved one. Oftentimes, they can feel like the entire world is against them. You can show them that you are on their side by being supportive. You can simply say, “Hey, I’ve got your back,” without condoning any of their harmful or negative behaviors or attitudes.
It is easy for someone with bipolar disorder to feel worthless or hopeless. If you notice that they are in a depressive episode, you can give them some positive affirmations. Remind them of their strengths and positive attributes. Doing so might help them more smoothly transition out of their depressive episode.
Become Engaged in Their Treatment Process
You are a part of their life, and a part of their life is treatment. Whether they are just starting a treatment or have been at it for years, people with bipolar are often inundated with doctor’s appointments and counseling sessions with their therapists. You do not have to attend these appointments – in fact, you probably should not. But what you can do is go with them to their appointments and wait outside.
After their appointment, your loved one might want to open up to you about what they discussed in their appointment. Never press them to tell you anything; it must be entirely their choice. Still, this is a good time to let them unwind all the thoughts that are in their head from the appointment. This shows that you are a stable force in their life and that you are there to provide comfort as needed.
Be Supportive, Not Pushy
Here is the part where well-intentioned folks sometimes struggle. Your support can make a huge difference to someone dealing with bipolar disorder symptoms. However, when you try to intervene in their medical care or push them to seek help, they might respond by pushing you away.
People who have bipolar disorder can make their own conscious choices, but their change in mood can affect those decisions. They might experience some setbacks while trying to make good decisions with your help. Do not take this as being personal. Instead, try saying something like, “I know things are difficult right now. I’m still here to help you in any way I can.” You get to leave the ball in their court while still showing them your support.
Always Be Open and Honest
You might think you need to speak and behave in a way that spares your loved one from feeling guilt or shame over their bipolar symptoms. Yet honesty is the best policy, so it is important that you remain open and honest with this individual. Express your concerns in a calm and loving manner.
You can phrase your observations in a way that leaves room for them to choose how – or when – to respond. For example, you might want to say something like, “I noticed that you have been withdrawn recently. Would you like to talk about how you’ve been feeling?” This does not apply much pressure on them but allows you to honestly voice your concerns and observations.
Even if you disagree with something your loved one says or does, you can approach them in an honest fashion without escalating the situation. Should things begin to escalate, you can de-escalate the situation. Try repeating back the things that your loved one is saying to you to ensure that you understand them correctly. Be an active listener so that you can get back the honesty and openness that you give.
Avoid “I Understand”
Telling someone “I understand what you are going through” is incredibly misleading. You can sympathize with some of the things they are dealing with, sure, but fully empathizing with them is unlikely to occur. Instead of using “I understand,” switch up your phrasing.
Using a phrase like “I see that things are difficult for you right now” focuses on their issues and emotions. You are trying to understand what it is that this person is going through, so use words and phrases that center on your observations, not what you have gone through in your life. You can legitimize their struggles this way without totally negating your own or your observations. This shows your loved one that their voice and their emotions are being heard.
Recognize When You Need to Back Away and Gently Verbalize It
Sometimes, you will need to back away from a situation with someone who has bipolar disorder. But how do you do so without offending them and making the situation worse?
First of all, remember your own need for self-care. If your involvement with this person is causing you to throw your own needs to the wind, pause. Take a breath and back up. If this person is someone you work with, remember to keep your work and home lives as separate as possible. If this person is a friend or family member, you might need to consider letting go of the reigns and giving control over their situation to a licensed professional.
Your loved one has their limits – so do you. Focus on your own life while still lending your support. Get support for yourself if you start feeling overwhelmed. Caregivers, in particular, get overwhelmed quickly, and that is when it can be truly helpful to talk to your own counselor.
Set your boundaries and stick to them. Let your loved one know if you need some time to yourself. You can tell them, “Hey, I’m feeling worn out right now. Is it okay if we talk about things later?” Never set an absolute date, but use words like “later” to let them know you still want to support them and talk with them about their issues. You just cannot do it at the moment when you are feeling inundated and stressed out.
If you or someone you know is struggling with symptoms of bipolar depression, reach out to the National Mental Health Hotline at 866-903-3787. There is no shame in asking for help for either your loved one or yourself. You do not have to cope with their bipolar symptoms on your own. Allow a licensed professional to help both you and your loved one. The important thing to remember is that communication lets your loved one know you two are in this together.