|
 Centre for Addictionand Mental Health |
|
|
|
About Mental Health & Addictions
|
Help for FamiliesBipolar Disorder: An Information Guide On this page:
What Happens When Someone You Love Has Bipolar Disorder?When a family member has a chronic illness, it affects your entire family. It is not just the person with the illness who suffers. This is true of a physical illness, such as diabetes, or a mental illness, such as bipolar disorder. When your relative or partner has a mental illness, you must cope with extra stressors. People are learning more about mental illness and becoming more aware of it. Yet a certain amount of stigma remains. Fearing prejudice, your family may try to deal with mental illness alone. Furthermore, bipolar disorder will affect your relative’s mood and behaviour. At times, your family member’s mood disorder can make him or her less able to manage the illness, and he or she may become less willing to work with you in solving problems. As a family member, you will likely find both the manic and depressed phases of the illness very distressing. Your family member may have only mild mood swings. If so, you may be able to get through them without too much trouble. If, however, your relative’s mood swings are severe, you will likely find them very hard to handle. DepressionWatching a loved one struggle with depression can trigger many feelings in those who are close to the person. These feelings may range from sadness, concern, fear, helplessness and anxiety to guilt and anger. All depressive episodes are upsetting. It is likely, though, that your family member’s first episode will be the most confusing. You may not understand what is happening and why your relative is not getting better on his or her own. As a family member, you need information about depression. Without it, you may assume that your relative is lazy; you may give well-meaning advice and become frustrated and annoyed when your relative does not act on it. If your relative or partner talks about suicide, you will understandably live with a lot of worry. How to Relate to a Depressed Person Family members often do not know how to talk to a depressed person. They may be afraid to ask too many questions and upset their loved one without meaning to. At the same time, family members do not want the ill person to feel that they are not interested or are avoiding him or her. Try to support and understand your relative. Be as patient as possible. Just recognizing that depression is an illness can help your relative to feel less guilty about not functioning well. Tips for Communicating with a Depressed Person:
ManiaHow a person behaves during a manic episode stirs up intense feelings in everyone, especially family members. You may feel frustrated and annoyed, or you may even feel anger and hatred. The strength of your feelings will depend on how severe the episode is. Particularly frightening in a manic episode is if your family member, as you know him or her, seems to be replaced by a stranger. For example, a reserved, responsible woman can become loud and sexually free; a kind, gentle man can become bossy and cruel. As well, the manic person usually thinks that he or she is right and everyone else is wrong. This aspect of mania challenges families and others around the manic person. Your family member may take no responsibility for what he or she says or does. As a result, there may be times when you have to bail out your relative. Moreover, your relative can be acutely sensitive to weaknesses in others and can behave in ways that embarrass them. The severely manic individual can easily blow up. Being with someone who is severely manic has been compared to walking in a minefield - one never knows when there will be an explosion. Hardest of all, when your family member is manic, he or she may have no insight into his or her manic behaviour. If your spouse or partner is manic, you may find it very hard because you, more than anyone, may suffer from his or her anger. You may become a buffer between the person and the community as others demand that he or she be controlled. If your spouse or partner runs up large bills, you may be hounded by creditors. Some severely manic people have extramarital affairs, which they may flaunt. If this happens, you may feel humiliated and betrayed. Withdrawing from your spouse or partner and considering divorce may seem the only ways out of an intolerable situation. You should not make big decisions, such as whether or not to divorce, when the person is severely ill. The situation will probably change when he or she has recovered. How to Respond to a Manic Person Early in a manic episode, the individual may be overly happy, energetic and outgoing. Those around the person can easily be caught up in the high spirits. Stay realistic and do not get carried away by this high mood. A person who is manic feeds on attention and conflict. Try to discourage the person from becoming involved in stimulating situations, such as long talks and parties. Only a small percentage of people with bipolar disorder experience severe mania. In severe mania, the patient may become hostile and suspicious. He or she may even explode verbally and physically. Avoid arguing with someone in this state. The person will only become angrier and may even assault you. Typically, manic individuals may behave without being aware of or considering the dangers to themselves and others. They may take on risky business ventures, overspend, drive recklessly, etc. You may need to step in. The best way of preventing this kind of behaviour is to plan for it when your relative is well. During periods of stable mood, discuss and set rules that may involve safeguards. For example, consider withholding credit cards, banking privileges and car keys. Hospitalizing a person with mania can save his or her life. Tips for Communicating with a Manic Person 1. Reduce stimulation. People with mania are easily overstimulated. You may need to have fewer people visit at the same time. Or you may need to lessen noise and activity in the house. 2. Have brief conversations. 3. Deal only with immediate issues. Do not try to reason or argue. 4. Discourage discussing feelings. 5. Try not to be authoritative. Yet be firm, practical and realistic. 6. Do not jump to the person’s demands. 7. Do not get caught up with the person’s euphoria, or unrealistic expectations. 8. Do not try to convince the person that his or her plans are unrealistic. At the same time, take steps to ensure his or her safety (e.g., removal of car keys or credit cards). Getting Treatment for Your Family MemberA partner or relative who is moderately depressed will probably agree to medical treatment without needing too much encouragement. Yet a person who is severely depressed and suicidal may refuse to be treated. This happens because the person feels so hopeless and worthless. In this case, you or someone the person trusts should insist that he or she see the doctor, even if the person protests. If your partner or relative does not have a doctor, go to the emergency department of the nearest hospital. You may see that your family member is becoming hypomanic, that is, acting more energetic than usual, sleeping less, talking a great deal. If so, you must encourage the person to see a doctor at once. That way, your relative can get medication to help calm down and stabilize his or her mood. For some people, hypomania leads to mania. If they are treated when they are hypomanic, they may avoid a full-blown manic episode. Once your partner or relative is manic, he or she may refuse to see a doctor. This is because the person will not think that he or she is ill. Families usually have a very hard time living with a manic person who refuses treatment and who cannot be legally hospitalized. Most jurisdictions in North America have mental health laws that make it hard to hospitalize people against their will. People can only be forced into hospital if they threaten to harm themselves or others, or if they cannot care for themselves. Most people will agree to go to hospital or to see their doctor. However, if a person refuses, you can then ask a doctor to make a house call and certify that the person must be hospitalized. If this is not possible, you can visit a justice of the peace. The justice of the peace will issue an order for a psychiatric assessment authorizing police to take your relative to hospital. The police are sometimes needed to get an ill person to hospital. Family members may agonize over whether or not to involve the police. They often feel very guilty about having contacted the police, even when the police were needed to protect the person’s life. Remember, when people threaten suicide, they are usually pleading for help. They should be taken seriously. Suicidal thinking is most often a temporary emotional state. During this phase, a person needs to be kept safe. Similarly, manic episodes can make a person behave dangerously with serious consequences. Manic patients are therefore best treated in hospital. Compliance with Treatment Some people are very relieved when they are finally diagnosed and get a treatment that stabilizes their moods. For others, however, the road ahead is long and bumpy. Accepting that they have a disorder that must be managed over their life-span may be traumatic. Some people must endure several manic or depressive episodes before they consistently accept help from doctors and therapists. Mild mania can be seductive to some people because it often includes feeling happy, more confident, more energetic and more creative. It may therefore provide an ongoing lure to stop them from taking their medication. As a family member, you may find it very hard to watch this process. You may try repeatedly to convince your relative to “take your medication” or “go and talk to your doctor.” Trying continually to convince and coax can lead to heated arguments and power struggles. You may be very close to the person with bipolar disorder and yet feel that your views are unwelcome. In this case, it is sometimes more effective to have another trusted person approach your relative. Care for FamiliesWhen someone has a serious illness, family members naturally feel worried and stressed. They spend time comforting or helping their loved one. As a result, they may give up their own activities. Unsure of how others may respond to their ill partner or relative, family members may also avoid having friends visit their home. Over time, they may lose touch with their own network of friends. Or they may find that caring for their depressed/manic family member has replaced their own routines and activities. Often, people take a long time to realize how emotionally and physically drained they have become. This stress can lead to sleeping badly, or feeling exhausted or irritable all the time. Recognize these signs of stress in yourself and look after your own physical and mental health. Finding your own limits and making time for yourself are key to “self-care.” Try to create a support system of friends and relatives you can rely on. Think about people you might want to confide in. Mental illness is hard for some people to understand. Be selective and confide only in people who will support you. Consider having your own professional support. You could also join a self-help organization or relative support program. Local hospitals or community mental health clinics may offer such programs. Keep up your interests outside the family and apart from your ill relative. Acknowledge and accept that at times you will feel negative about the situation. These feelings are normal - try not to feel guilty about them. Being Ready for a Relapse or CrisisFamilies often avoid talking to their relative about relapses or crises. They fear that talking about a crisis will bring one on, or they simply do not want to upset their relative. As well, everyone hopes that the last crisis was an isolated incident that will not recur. The best way to handle a crisis or possibly avoid it is to know what to do before it happens. While focusing on wellness, some planning for recurrence can help both the ill person and the family to feel more secure. When your relative or partner is well, plan what to do if he or she should become ill:
You may want to write down the terms that you and your partner or relative have agreed on. This can help to ensure that the terms are followed. Building a good relationship with the treating physician and having a pre-arranged emergency plan can also help to avoid a crisis. Tips for Helping Your Partner or Relative and Supporting Recovery
Learn, with your family member, to distinguish a good day from hypomania and a bad day from depression. Like everybody else, people with bipolar disorder have good and bad days that are not part of their illness.
|
 Related Links |
Bookmark
|
Last updated: Dec 07, 2006 11:50 AM Published: Jul 24, 2008 7:42 PM ID#P23350 |