Bipolar affective disorder (BPAD), formerly known as manic depression or manic-depressive disorder, is a chronic mental illness that significantly affects a person’s mood, causing them to experience periods of extreme highs and lows. This can get in the way of them managing their daily lives and impact their energy, activity, and concentration levels.
On the other hand, they also go through depressive episodes during which they feel intense sadness, lethargy, and hopelessness. The duration, frequency, and intensity of each episode vary from one person to another; not everyone will experience mood episodes in the same way or for the same duration. If you wish to know more information about mood episodes, we invite you to check this short video blog.
How bipolar affective disorder is experienced
In order to know how to support a loved one with BPAD, it can be useful to understand what they go through and how they can typically experience different mood episodes.
During a manic or hypomanic episode, the person may feel extremely happy and optimistic; they may be uncontrollably excited and overly confident in their abilities. It is difficult sometimes to truly appreciate feelings of happiness because they fear it is the start of a manic episode, during which they can also be abnormally agitated, irritable, and speak more than usual like they can’t get their words out fast enough. Many find themselves easily distracted, more productive and feel less need to sleep or eat, as their energy levels typically increase tenfold. This is why some may enjoy their manic or hypomanic episodes because of the boost experienced in their creativity, energy, and self-confidence. They may experience an exhilarating feeling of being on top of the world and being invulnerable, which can lead them to engage in risk-taking behaviors, such as reckless spending, fast driving, sexual promiscuity, and substance abuse. Finally, people who go through a manic or hypomanic episode typically feel less socially inhibited and may behave or say things they would normally shy away from.
During depressive episodes, people might feel extremely down and upset. It can be difficult to distinguish sadness from depression. They can suffer from a constant feeling of tiredness and emptiness, lose interest in things they previously enjoyed, and their ability to concentrate on anything. They can typically suffer from low self-esteem and an overwhelming sense of guilt and hopelessness. Their sleeping and eating patterns can also be affected, and they become socially withdrawn. In extreme cases, they can engage in suicidal thoughts and behaviors, as they perceive themselves as a burden and think this is the only way out of their suffering. Others highlighted the constant doubting they experienced, as they felt like their emotional state was unpredictable and they didn’t know how they were going to feel from one day to the next. During depressive episodes, they felt so drained that they could not get out of bed to perform the simplest mundane tasks, like taking a shower, for days on end. On the worst days, suicidal thoughts and urges could get so overwhelming that every minute became a fight for survival.
Some people with BPAD have expressed that they find depressive episodes more challenging to deal with than mania or hypomania; additionally, the contrast between their extremely high and low moods makes their depression seem more profound and debilitating.
How can you better support your loved one with BPAD?
Seeing someone you care about battle with the symptoms of bipolar disorder can feel very distressing. There are, however, many ways you can offer them support while looking after your well-being. Research has shown that when a person diagnosed with BPAD has the support of their family and friends, it can protect them from engaging in destructive behaviors and enhance their ability to manage their symptoms successfully. Remaining by the side of someone you care about who has BPAD can be key to their recovery, although it’s not always easy to know exactly what can be helpful. The following suggestions are a few ways you can manifest your support.
Educating yourself about the nuances of bipolar disorder, the causes, the affiliated symptoms, and the lines of treatment remains one of the most effective ways to help. The more you will know and understand the signs of manic and depressive episodes, the more you will be able to react appropriately to their occurrence. This will help you know what to expect and what to watch out for and provide you with a solid foundation of knowledge from which you can ask helpful questions to your loved one, significantly reducing distress for everyone involved.
Learning their warning signs and triggers goes a long way in stopping a potentially troublesome mood episode. Understanding the triggers that can lead to the emergence of an episode, such as stress, or a messy sleeping schedule, can allow you to help them avoid and manage them. As people with BPAD can sometimes find it challenging to notice it escalating symptoms or heralding signs of an episode, you can ask permission to let them know if you notice any concerning changes, calmly voice your concerns, and encourage them to seek professional help.
You don’t necessarily have to provide answers or helpful advice when it comes to offering support. In fact, one of the best ways you can be there for others is by being a good listener. This remains true in the case of BPAD; as this disorder can be characterized by confusing thoughts and extreme shifts in mood that make them doubt themselves, they may benefit from knowing that you are here for them, that you are trying your best to understand what they are going through, and that you care about them.
Listening with an open mind will allow your loved one to safely express the distressing thoughts and emotions they may be experiencing; there is no need to rush to problem-solving or argue about the validity of what they have to say. The point is to make them feel accepted and supported so they can feel safer and more grounded.
Don’t be afraid to ask questions! Everyone is different, and two people with BPAD can experience it very differently. One of the best ways to support them is to ask them directly what would be most helpful and what they need in specific situations. For instance, some may appreciate your willingness to lighten the load by helping them handle daily tasks and errands. In contrast, others may be more receptive to having you accompany them to their psychiatrist or therapist appointments or gently reminding them about their medication dosages and schedule. Some people may also benefit from encouragement to adopt healthier daily habits that can enhance their recovery, such as following a healthy sleep, diet, and exercise regimen, sticking to a regular schedule, and learning self-management techniques.
Make a contingency plan
Because BPAD can often be unpredictable, you need to set an emergency plan and agree with your loved one about what to do during severe mood episodes. This plan should include what to do if the person is feeling suicidal during a depressive episode, removing any objects that could be used for self-harm, hiding car keys or credit cards if their behavior becomes impulsive, and being prepared to contact emergency services if the situation gets out of hand.
You can also set and agree on coping mechanisms to do together, which can help them when they feel a mood change coming. Make this plan when the person is in a good and calm state of mind; it’s also useful to write it down so you can both easily refer to it when need be. Having a solid plan where you both know what to do and what to expect of one another will help you feel more confident in the face of uncertainty. Note that you should also be potentially prepared for resistance or backlash on their part when you actually implement the steps you had previously agreed upon; it is essential to consider whether you can deal with this before you decide to support them in this way.
Voice your concerns
During a manic episode, your loved one may act in ways you find inappropriate, or upsetting. Being supportive doesn’t mean you should condone any behavior you are uncomfortable with. Instead, it can be helpful to calmly discuss your feelings about these behaviors when they feel more stable. It is important that you try as much as possible not to be judgmental; explain how the specific things they have done or said made you feel and focus on how their actions affected you instead of blaming them for their mistakes. If you are feeling frustrated, take a step back, and remember that you are doing your best. You might find it easier to talk about it with a therapist or reach out to an understanding third party who can help you figure your way through this challenging situation.
Take care of yourself
Looking after someone with BPAD can be consuming; it can be easy to forget to care for yourself in the process. Remember that while their needs are important, yours are also a priority. Dedicating time and energy to looking after yourself and staying healthy physically and emotionally is crucial. It’s important to ensure you have the time, energy, and emotional ability to help them. Set boundaries regarding what you will and won’t accept, what you can participate in, and what you won’t endure; even though they may be difficult to enforce and you might feel guilty, boundaries are necessary and protect both you and your loved one. Remember that consistent self-care will allow you to be in your best shape and help them better.
Last but not least, know your limits. If you’re helping someone with BPAD and feel like things are getting too unmanageable, immediately reach out to a mental health expert. If their behavior becomes a threat to themselves or others, don’t hesitate to contact emergency services. Don’t let what they say or do prevent you from seeking help for their safety and everyone else’s. Nobody knows how to handle BPAD better than those specially trained to treat it; it’s OK to ask others for help when you need someone to lean on.
Supporting someone with BPAD can be challenging; they may experience unpredictable shifts in their mood and behavior, and it’s not always easy to know how to react and cope. You can make a massive difference in the life of your loved one by being present and taking an active part in their recovery; knowing that they have someone in their corner can encourage them to stick to their treatment plan and seek adaptive ways to manage the symptoms of their disorder. Don’t forget to look out for your health and needs, by engaging in self-care, understanding your limits, and allowing yourself to reach out for help, whether it be seeking friendly support from friends and family or having a mental health professional intervene. As you walk alongside them in their recovery journey, remember that you’re both doing your best and deserve all the support you can get.