Monday, August 26, 2013

How to Help a Family Member Living With Bipolar Disorder

What is bipolar disorder?

Bipolar disorder, also known as manic-depressive disorder or bipolar affective disorder, is a brain disorder that causes extreme mood swings. The mood swings are different form the normal ups and downs that we all experience.

What are some of the symptoms of bipolar disorder?

According to the National Institutes of Mental Health (NIMH), "people with bipolar disorder experience unusually intense emotional states that occur in distinct periods called "mood episodes." The elevated moods, which are characterized by overexcitement or an unusual level of happiness are most often referred to as manic episodes. People with bipolar disease also experience depressive episodes, which are characterized by extreme sadness and/ or hopelessness. One of the most difficult aspects of bipolar disease is the emotional swinging back and forth between mania and depression. "Extreme changes in energy, sleep, and behavior go along with these changes in mood" (NIMH). The changes between mania and depression are called cycling. In some cases, people experience what is called "rapid-cycling" which means the individual suffering with the disease often goes back and forth between mania and depression several times within a week, or even a day rather than having long periods of depression followed by occasional episodes of mania, or vice versa.

What is the impact of the disease on the patient?

For those individuals who have bipolar disorder with rapid cycling, the switching back and forth can be physically exhausting. Mania tends to take a lot of energy because the mood and their accompanying behaviors are so extreme and often, intense. Some researchers believe that the crash after a manic episode may be exacerbated by exhaustion cause be lack of sleep and ramped up activity. Emotionally, cycling takes it's toll as well. Confusion is not uncommon because one minute the individual is flying high and the next they are crashing which is often accompanied by long crying episodes.

What is the impact of the disease on the family?

The frequent mood swings associated with bipolar disorder can be confusion and emotionally exhausting for family members. Especially younger children may not understand why their loved one is happy one minute and sad or agitated the next. Patience, education, and compassion are required to support a family member with bipolar disorder. Below are some tips to help you on your journey.

Tips for helping family members support a loved one with bipolar disease.

  1. Avoid labeling!- Try not to identify your loved one by their disease. Avoid phrases like "Teresa is bipolar". After all, we don't say, "Teresa is depression" or "Teresa is cancer." It's much better to call it what it is. "Teresa has bipolar disorders/ disease."

  2. Understand behaviors- Become an expert on the subject. Knowledge can help demystify the unknown. Education for the whole family can improve symptom management and medication compliance, help prevent relapses, and alleviate stress for everyone. Learn to view the behaviors of your loved one in the context of the illness. Their behavior is not personal. If your loved one suddenly becomes upset, agitated or angry about something, it may be a symptom of their illness. This requires patience and compassion, not lecturing!

  3. Be aware of your own behaviors- If you are feeling angry, upset, or anxious about your loved one's behavior, those feelings will be transmitted to your loved one and may negatively affect your relationship. If you monitor your own feelings and behaviors, you'll be better equipped to help your loved one. If you're simply having an off day yourself, let your loved one know and then lay low for a while. It's important to tell your loved one how you're feeling so that they don't feel rejected, or like you're ignoring them.

  4. Learn the symptoms- One of the best things you can do for yourself is to become educated about the symptoms of bipolar disease. The National Institutes on Mental Health offers a lot of free and credible information.

  5. Know the warning signs- Suicide, which is both a stereotypic yet highly individualized act, is a common endpoint for many patients with severe psychiatric illness. The mood disorders (depression and bipolar manic-depression) are by far the most common psychiatric conditions associated with suicide. At least 25% to 50% of patients with bipolar disorder also attempt suicide at least once.

Risk Factors:

  • Having mental and substance abuse disorders

  • Family history of mental or substance abuse disorders

  • Having attempted suicide previously

  • Having a family history of physical or sexual abuse

  • Having family members or friends who have attempted suicide

  • Keeping a firearm in the home

Suicide Warning Signs

  • Talking about suicide

  • Always talking or thinking about death

  • Making comments about being hopeless, helpless, or worthless

  • Saying things like "It would be better if I wasn't here" or "I want out"

  • Worsening depression

  • A sudden switch from being very sad to being very calm or appearing to be happy

  • Having a "death wish," tempting fate by taking risks that could lead to death, like driving through red lights

  • Losing interest in things one used to care about

  • Visiting or calling people one cares about

  • Putting affairs in order... tying up lose ends... changing a will

For more detailed information, visit the Bipolar Disorder Center on WebMD.

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