Mood disorders: Help for partners and families

Everyone has ups and downs in mood. Mood disorders, which include depression and bipolar disorder, are much more than this. They are serious medical conditions, affecting how people think, behave and function.
With bipolar disorder, people have mood swings that are out of proportion or totally unrelated to events in their lives. These mood swings consist of both depressive (low) moods and manic (high, euphoric) moods.

The depressive moods resemble those of major depressive episodes. In major, or clinical, depression, a person's emotional state is abnormally low or sad, and the person cannot independently raise his or her mood.

When someone you love has a mood disorder

When someone in a family is ill, everyone is affected, not just the person with the illness. This is true whether the illness is diabetes or a mood disorder. A mental illness brings added pressures. Families often suffer for years before the symptoms are finally diagnosed. They might respond with disbelief or denial. Fearing prejudice, they can become isolated. It's natural for families to feel resentful or disappointed when mood disorders interfere with normal family life. Acknowledging the illness can help you feel less isolated and guilty and free your energy for caring for both your relative and yourself.

Bipolar disorder will affect your relative's mood and behaviour. At times, the mood disorder can make your family member less able to manage the illness, and he or she may become less willing to work with you in solving problems.

How to relate to a family member with a mood disorder

Learn as much as you can about the mood disorder and its treatment.

How to respond to a person who is manic

• Reduce stimulation and noise.
• Have brief conversations.
• Deal only with immediate issues. Do not try to reason or argue.
• Discourage discussing feelings.
• Be firm, practical and realistic, without being authoritative.
• Do not jump to the person's demands.
• Do not get caught up with the person's euphoria, or unrealistic expectations.
• 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).

How to respond to a person who is depressed

• Speak in a calm quiet voice.
• Focus on one subject at a time.
• Be patient and wait.
• Avoid quizzing the person about what made him or her feel depressed.
• Do not tell the person to "snap out of it."
• Pace yourself.

Take care of yourself

Caught up in concern and caring for the person who is ill, family members may not take proper care of themselves. They may give up their own activities and become isolated from their friends and colleagues. This may go on for some time before they realize they are emotionally and physically drained. The stress can lead to sleeping problems, exhaustion and constant irritability.

o Keep your own support network.
o Avoid becoming isolated.
o Recognize signs of stress in yourself.
o Know what situations within your family are most stressful in coping with the mood disorder.
o Keep up your interests outside the family.
o Consider having your own professional support.
o Take a little time each day just for you.

Being ready for a relapse or crisis

Families often avoid talking to their relative about relapses or crises. The best way to handle a crisis, or possibly avoid one, is to know what to do before it happens. When your relative or partner is well, write out a plan of what to do if he or she should become ill:

• Could you visit the physician together to discuss the condition and how to deal with a possible crisis?
• If your family member becomes ill, do you have advance permission to contact his or her doctor?
• Do you have consent to take your family member to hospital? If so, which hospital?
• If the person becomes unable to decide on treatment, does he or she agree that you can make that decision?

Recovery

Clients, and their friends and families, need to understand a mood disorder and develop ways to manage it. Family members can play an active role in this process.

Tips for supporting recovery

• Learn as much as you can about mood disorder -- its causes, signs and symptoms, and treatment.
• Encourage your family member to follow the treatment prescribed by the treatment team.
• Learn the warning signs of suicide. Take any threats that the person makes very seriously and get help immediately.
• Support recovery from an episode by recognizing that it is slow and gradual.
• View your family member's mood disorder as an illness, not a character flaw.
• Learn, with your family member, to distinguish a good day from hypomania and a bad day from depression. Like everybody else, people with mood disorder have good and bad days that are not part of their illness.

Adapted from Bipolar Disorder: An Information Guide © 2000, Centre for Addiction and Mental Health and Depressive Illness: A Guide for People with Depression and their Families © 1999, Centre for Addiction and Mental Health

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