How to Help Someone

"I decided it's time for something new. Let's help people with bipolar illness. So I'm going back to school and I'm going into training for peer-to-peer counseling, and then going further into training on psychotherapy."
-- Greg

For families and friends, a diagnosis of bipolar disorder can be hard to accept. But it also can be a relief. Finally, a reason for the mood swings has been identified. Treatment can begin.

It's important for people with bipolar disorder to be active in their own care. But your support also can be valuable in helping them feel better.

Your help can make a difference.

Here are some things you can do to help:

Learn about bipolar disorder, its causes, and its treatment. Talk with the person's healthcare provider, if possible.
Learn to recognize the warning signs of depression (low moods) and mania (high moods). You may notice the symptoms before the patient does. If you notice symptoms, talk to the patient in a caring manner. Suggest a visit to a healthcare provider.
Encourage the patient to stay with treatment. Sometimes treatment doesn't seem to be helping, or side effects may be severe. In that case, encourage the patient to talk to the healthcare provider. If things still don't get better, you may want to suggest that the patient get a second opinion.
Work with the patient to help him or her keep healthcare provider appointments. Help make a list of the patient's healthcare providers, phone numbers, and medicines. This should include the name of the medicine, how much to take, when to take it, how to take it, and what it treats.
Help monitor medicine use. It can be dangerous to stop or restart a medicine without a healthcare provider's advice.
Use of alcohol and street drugs can make symptoms worse. Help the patient understand the dangers.
Sometimes a patient may feel that your concern is interference. This can especially happen during a mood episode. Remember that this is not a rejection of you. It is most likely part of the illness.
Do things with, rather than for, a person recovering from an episode.
Consider using times when moods are stable to discuss and develop safety plans. These could include hospitalization or withholding credit cards, car keys, or banking privileges. But keep in mind that during an episode, the patient may not follow the agreement.

Bipolar disorder is a lifelong condition. But with appropriate treatment, there is hope. Your support can make a big difference.

A treatment contract may help

For family members and friends, a "Treatment Contract" can be a good way to support a person with bipolar disorder. The contract is a written agreement of steps to take to help someone with bipolar disorder.

In the contract, the person with bipolar disorder agrees to give you permission to carry out instructions for treatment. This happens if bipolar symptoms make it difficult for the person to take care of himself or herself. Both you and the person with bipolar disorder would agree as to when, where, and how these instructions are to be carried out.

The Harvard Bipolar Research Program provides a downloadable treatment contract that you can print and fill out. You also could create a treatment contract yourself.

How much help is too much?

Am I being protective - or overprotective? Should I pay off credit card debts from a spending spree? Which of my actions will help and which will hurt?

These are hard questions. The answers may be very different from person to person and family to family.

Some people caring for loved ones with bipolar disorder can benefit from counseling or support groups. The stress on you can be very great. Find out how others are dealing with similar questions. Learn about what might work for you. Consider talking to your healthcare provider.

Your help is important. But encourage the person to take an active role in his or her treatment. Encourage self-care!

If the person becomes violent or suicidal, call 911 to get help right away.

How to help when the person wants to stop taking medicine

This chart shows some common reasons why some people with bipolar disorder stop taking their medicine. It gives ideas about what you can do to help.

Reasons commonly given for stopping medicines	Reasons to keep taking medicines	How to help your loved one
I don't like the idea of taking medicine for the rest of my life.	Bipolar disorder can produce symptoms that last, change, or even worsen over a lifetime. Only with proper treatment can bipolar disorder be managed.	Have the person with bipolar disorder talk to a support group or others who are successfully managing a chronic illness using long-term medicine. Remind the person that taking medicine is not a sign of weakness. People with all sorts of ongoing conditions, like diabetes or asthma, take medicine regularly too.
I feel better. There's nothing wrong with me anymore.	Bipolar disorder affects judgment. The person could be experiencing symptoms of a mood episode. Feeling better could just mean that the medicine is working. Going off medicine or adjusting it without consulting a healthcare provider can cause symptoms to return and get worse.	Make sure the person explains these feelings to his or her healthcare provider. It may be necessary to adjust the medicine. Having your loved one listen to the experiences of others in a support group could make him or her feel better about being on medicine.
I'm getting side effects that make me feel physically or emotionally uncomfortable. I'm gaining weight. I feel sleepy.	The symptoms being experienced may be temporary. Going off medicine or adjusting it without consulting a healthcare provider can cause symptoms to return and get worse. In some people, the benefits may outweigh the side effects. If the side effects seem to outweigh the benefits, your healthcare provider may be able to help you.	Make sure the person calls the healthcare provider right away and describes the symptoms. The healthcare provider may need to adjust the dose of the medicine or change the medicine. Tell the person to let his or her family and bipolar disorder support group know what is going on with the side effects.
I don't agree with my treatment. I don't want to take this particular medicine.	Going off medicine or adjusting it without consulting a healthcare provider can cause symptoms to return and get worse.	Tell the person to speak to the healthcare provider about other treatment options. Let the person know it's okay to get a second opinion. Tell the person it is not a good idea to go off the medicine without a healthcare provider's advice.

Next: Helping Yourself